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Mixed crop livestock farming (MCLF) is a growing practice in organic farming where livestock and crops are grown near each other to promote environmental sustainability through recycling. However, MCLF livestock are reservoirs of many zoonotic pathogens, such as Staphylococcus spp., and can serve as sources of crosscontamination for plant food products. A surveillance study was conducted to determine the prevalence and antibiotic-resistance patterns of various Staphylococcus spp. species isolated from the environment of multiple MCLFs and produced from preharvest and post-harvest levels within the DC-Maryland metropolitan area. A total of 3038 environmental and pre-harvest produce and 836 post-harvest produce samples were collected from eight farms and two retail supermarkets. In addition, 36 skin swabs from farmworkers and university students were also collected. PCR was used to confirm the presence of Staphylococcus spp. in all samples. Major species were identified using a species-specific multiplex PCR. An antibiogram assay was performed to determine antibiotic resistance profiles. The overall prevalence of Staphylococcus spp. was 12.18% pre-harvest and 7.54% post-harvest. The most identified species was Staphylococcus epidermidis (19.86%), while most isolates remained unknown (73.90%). Approximately 83.33% of skin swabs were positive for Staphylococcus spp., with Staphylococcus xylosus being the predominant species (16.7%). The highest percentage of isolates were resistant to aminoglycosides and macrolides, with 24.11% of tested samples being multidrug-resistant. S. epidermidis had the most resistance compared to the other species. This study suggests that antibiotic-resistant Staphylococcus spp. is present in mixed farm environments, and proper steps need to be taken to control the transmission between livestock, crops, and humans. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this pilot in vivo study was to investigate corneocyte size and transepidermal water loss (TEWL) in facial cheek and volar forearm skin as a function of consecutive tape stripping. Changes in corneocyte size and transepidermal water loss (TEWL) were measured as a function of stratum corneum (SC) depth at both anatomical sites. To our knowledge, this is the first published quantitative comparison based on these parameters. This work complements our previously published studies on face skin barrier recovery at 24 h and 4 weeks post‐tape stripping [Gorcea et al., Skin Res. Technol., 19, 2013, e375‐e382; Gorcea et al., Int. J. Cosmet. Sci. 35, 2013, 250]. Methods: Transepidermal water loss in vivo measurements of forearm and facial skin sites were taken before tape stripping commenced (baseline) and after each tape was collected. Optical microscopy and image analysis techniques were employed to characterize corneocyte size as a function of skin depth (tape strip number) for both anatomical sites. Results: Transepidermal water loss increased significantly from baseline with sequential tape stripping at both anatomical skin sites. Volar forearm skin required approximately three times as many tapes to 'damage' the SC barrier (arbitrarily defined as twice baseline TEWL) compared to facial cheek skin demonstrating significant differences in barrier properties between cheeks and forearms (P < 0.05). Corneocyte size decreased significantly with depth for both sites (P < 0.001). Corneocytes from face skin were significantly smaller than corneocytes from volar forearm skin. Conclusion: Statistically significant differences between facial and body skin stratum corneum cell morphology and transepidermal water loss were demonstrated and quantitatively measured as a function of tape stripping. [ABSTRACT FROM AUTHOR]

Albeit differences in climbing-specific strength of the forearms have been demonstrated between lead and boulder climbers, little is known about the potential differences in force and power output of the upper body pulling-apparatus between disciplines. The aim of this study was to compare the climbing-specific upper-body strength and finger flexor endurance between lead and boulder climbers, as well as to examine the relative utilization of force when testing on a ledge hold compared to a jug hold. Sixteen boulder climbers (red-point climbing grade 17.9 ± 3.3) and fifteen lead climbers (red-point climbing grade 20.5 ± 3.5) performing on an advanced level volunteered for the study. Peak force, average force and rate of force development (RFD) were measured during an isometric pull-up, average velocity in dynamic pull-up, and finger flexor endurance in an intermittent test to fatigue. The isometric pull-up was performed on a ledge hold (high finger strength requirements) and on a jug hold (very low finger strength requirements). Boulder climbers demonstrated a higher maximal and explosive strength in all strength and power measurements (26.2–52.9%, ES = 0.90–1.12, p = 0.006–0.023), whereas the finger flexor endurance test showed no significant difference between the groups (p = 0.088). Both groups were able to utilize 57–69% of peak force, average force and RFD in the ledge condition compared to the jug condition, but the relative utilization was not different between the groups (p = 0.290–0.996). In conclusion, boulder climbers were stronger and more explosive compared to lead climbers, whereas no differences in finger flexor endurance were observed. Performing climbing-specific tests on a smaller hold appears to limit the force and power output equally between the two groups. [ABSTRACT FROM AUTHOR]

This study aimed to reveal the distribution pattern of antebrachial cutaneous nerves and provide a morphological basis for sensory reconstruction during flap transplantation. Forearm specimens containing skin and subcutaneous fat were obtained from 24 upper extremities of 12 adult cadavers. Cutaneous nerves were visualized using modified Sihler's staining. Then the data was used to show the distribution pattern and innervation area of the forearm cutaneous nerve. The anterior branch of lateral antebrachial cutaneous nerve innervates 26% of the medial anterior forearm; the posterior branch innervates 38.21% of the lateral anterior forearm and 24.46% of the lateral posterior forearm. The anterior branch of medial antebrachial cutaneous nerve innervates the medial aspect of the forearm covering 27.67% of the anterior region; the posterior branch the lateral part of the forearm covering 7.67% and 34.75% of the anterior and posterior regions, respectively. The posterior antebrachial cutaneous nerve covers 41.04% of the posterior forearm. Coaptations were found between the branches of these cutaneous nerves. The relatively dense secondary nerve branches were found in the middle 1/3 of the lateral anterior forearm and the middle 1/3 of the medial posterior forearm. The relatively dense tertiary nerve branches were the middle 1/3 and lower 1/3 of the medial anterior forearm. The intradermal nerve branches were the relatively dense in the middle 1/3 of the medial anterior and lateral posterior forearm. The middle 1/3 of the medial and lateral forearm had the relatively dense total nerve branches. These results can be used sensory matching while designing forearm flaps for reconstruction surgeries to obtain improved recovery of sensory. [ABSTRACT FROM AUTHOR]

Research investigating the dynamics of coupled physical systems has demonstrated that small feedback delays can allow a dynamic response system to anticipate chaotic behavior. This counterintuitive phenomenon, termed anticipatory synchronization, has been observed in coupled electrical circuits, laser semi-conductors, and artificial neurons. Recent research indicates that the same process might also support the ability of humans to anticipate the occurrence of chaotic behavior in other individuals. Motivated by this latter work, the current study examined whether the process of feedback delay induced anticipatory synchronization could be employed to develop an interactive artificial agent capable of anticipating chaotic human movement. Results revealed that incorporating such delays within the movement-control dynamics of an artificial agent not only enhances an artificial agent’s ability to anticipate chaotic human behavior, but to synchronize with such behavior in a manner similar to natural human-human anticipatory synchronization. The implication of these findings for the development of human-machine interaction systems is discussed. [ABSTRACT FROM AUTHOR]

Substantial controversy exists as to which part of brain activity is genuinely attributable to pain-related percepts and which activity is due to general aspects of sensory stimulation, such as its salience, or the accompanying arousal. The challenge posed by this question rests largely in the fact that pain per se exhibits highly intense but unspecific characteristics. These therefore should be matched by potential control conditions. Here, we used a unique combination of functional magnetic resonance imaging (fMRI) and behavioral and autonomic measures to address this longstanding debate in pain research. Subjects rated perceived intensity in a sequence alternating between heat and sound stimuli. Neuronal activity was monitored using fMRI. Either modality was presented in 6 different intensities, 3 of which lay above the pain threshold (for heat) or the unpleasantness threshold (for sound). We performed our analysis on 26 volunteers in which psychophysiological responses (as per skin conductance responses [SCRs]) did not differ between the 2 stimulus modalities. Having thus ascertained a comparable amount of stimulation-related but unspecific activation, we analyzed stimulus-response functions (SRFs) after painful stimulation and contrasted them with those of the matched acoustic control condition. Furthermore, analysis of fMRI data was performed on the brain surface to circumvent blurring issues stemming from the close proximity of several regions of interest located in heavily folded cortical areas. We focused our analyses on insular and peri-insular regions that are strongly involved in processing of painful stimuli. We employed an axiomatic approach to determine areas showing higher activation in painful compared to nonpainful heat and, at the same time, showing a steeper SRF for painful heat compared to unpleasant sound. Intriguingly, an area in the posterior parietal operculum emerged, whose response showed a pain preference after satisfying all axiomatic constraints. This result has important implications for the interpretation of functional imaging findings in pain research, because it clearly demonstrates that there are areas where activity following painful stimulation is not due to general attributes or results of sensory stimulation, such as salience or arousal. Conversely, several areas did not conform to the formulated axioms to rule out general factors as explanations. [ABSTRACT FROM AUTHOR]

In patients with sickle cell disease (SCD), poor outcome measures compromise the potential success of clinical trials. Contrast-enhanced ultrasound (CEUS) is a technique that can non-invasively quantify deep tissue microvascular blood flow. We tested the hypothesis that CEUS of forearm skeletal muscle could be used to: 1) assess microvascular abnormalities that occur during vaso-occlusive crisis; and 2) test new therapies for SCD that are targeted to improving the status of the microcirculation. We performed a prospective study, CEUS perfusion imaging of resting forearm muscle was performed in adults with SCD: 1) during and after a pain episode, and 2) before, during, and after a 24-hour infusion of the investigative agent, regadenoson, an adenosine A2A agonist. CEUS destruction-replenishment time-intensity data were analyzed to measure microvascular blood flow, as well as its components, microvascular blood volume and flux rate. Serial CEUS measurements were obtained in 32 adults with SCD. For the studies during crisis, there was a 30% reduction in microvascular blood flow compared to steady-state (p = 0.031), a reduction that was largely due to microvascular flux rate. For the regadenoson group, a non-significant 25% increase in flux rate and 9% increase in microvascular blood flow compared to baseline were detected during infusion. In a study of adults with SCD, CEUS detected changes in microvascular blood flow associated with vaso-occlusive crises. No changes were found during an infusion of the adenosine A2A agonist, regadenoson. This study provides preliminary evidence that CEUS could detect blood flow changes consistent with SCD physiology. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate and compare the levels of electromyographic activation in the pectoralis major, anterior deltoid, triceps brachii, forearm, rectus abdominis, external oblique, and rectus femoris muscles during a horizontal bench press in two situations: 1) with the feet on the ground; and 2) with active hip flexion and 90° of knee flexion. Twenty young men were familiarized with the procedure and the calculation of one-rep max (1RM). In a second session, electromyographic activity values were recorded in both bench press situations (with the feet on the ground vs active hip flexion and knees at 90°) at 60% 1RM. Performing the bench press with the hips and knees flexed produced significantly greater muscle activation of all elevated muscles (p < 0.01; d > 0.5). The pectoralis major showed the greatest activation, followed by the anterior deltoid and the triceps brachii. In addition, the greater activation of the abdominal muscles occurs due to the need to stabilize the core while performing the bench press with hip and knee flexion as well as the lumbar spine due to traction of the hip flexors. [ABSTRACT FROM AUTHOR]

Background: Extensive studies have been carried out over the years to determine the maximum acceptable weight that a worker is capable of lifting in a given situation among Occidental populations across Europe and US. Nonetheless, studies that place emphasis on using lifting frequency as the quantifying task parameter, especially in developing countries such as Malaysia, appear to be in scarcity. Hence, this study determined the maximum acceptable frequency of lift (MAFL) for combined manual material handling (MMH) tasks amongst Malaysian males. Method: Two lifting loads were considered in this study: 1 kg and 5 kg. Each subject adjusted his frequency of lifting using a psychophysical approach. The subjects were instructed to perform combined MMH task as fast as they could over a period of 45 minutes without exhausting themselves or becoming overheated. The physiological response energy expenditure was recorded during the experimental sessions. The ratings of perceived exertion (RPE) for four body parts (forearms, upper arm, lower back and entire body) were recorded after the subjects had completed the instructed task. Results: The mean frequencies of the MMH task had been 6.8 and 5.5 cycles/minute for lifting load of 1 and 5 kg, respectively, while the mean energy expenditure values were 4.16 and 5.62 kcal/min for 1 and 5 kg load, respectively. These displayed a significant difference in the Maximum Acceptable Frequency of Lift (MAFL) between the two loads, energy expenditure and RPE (p < 0.05) whereby the subjects appeared to work harder physiologically for heavier load. Conclusion: It can be concluded that it is significant to assess physiological response and RPE in determining the maximum acceptable lifting frequency at varied levels of load weight. The findings retrieved in this study can aid in designing tasks that do not exceed the capacity of workers in order to minimise the risk of WRMSDs. [ABSTRACT FROM AUTHOR]

Background: Optical measurement techniques and recent advances in wearable technology have made heart rate (HR) sensing simpler and more affordable. Objectives: The Polar OH1 is an arm worn optical heart rate monitor. The objectives of this study are two-fold; 1) to validate the OH1 optical HR sensor with the gold standard of HR measurement, electrocardiography (ECG), over a range of moderate to high intensity physical activities, 2) to validate wearing the OH1 at the temple as an alternative location to its recommended wearing location around the forearm and upper arm. Methods: Twenty-four individuals participated in a physical exercise protocol, by walking on a treadmill and riding a stationary spin bike at different speeds while the criterion measure, ECG and Polar OH1 HR were recorded simultaneously at three different body locations; forearm, upper arm and the temple. Time synchronised HR data points were compared using Bland-Altman analyses and intraclass correlation. Results: The intraclass correlation between the ECG and Polar OH1, for the aggregated data, was 0.99 and the estimated mean bias ranged 0.27–0.33 bpm for the sensor locations. The three sensors exhibited a 95% limit of agreement (LoA: forearm 5.22, -4.68 bpm; upper arm 5.15, -4.49; temple 5.22, -4.66). The mean of the ECG HR for the aggregated data was 112.15 ± 24.52 bpm. The intraclass correlation of HR values below and above this mean were 0.98 and 0.99 respectively. The reported mean bias ranged 0.38–0.47 bpm (95% LoA: forearm 6.14, -5.38 bpm; upper arm 6.07, -5.13 bpm; temple 6.09, -5.31 bpm), and 0.15–0.16 bpm (95% LoA: forearm 3.99, -3.69 bpm; upper arm 3.90, -3.58 bpm; temple 4.06, -3.76 bpm) respectively. During different exercise intensities, the intraclass correlation ranged 0.95–0.99 for the three sensor locations. During the entire protocol, the estimated mean bias was in the range -0.15–0.55 bpm, 0.01–0.53 bpm and -0.37–0.48 bpm, for the forearm, upper arm and temple locations respectively. The corresponding upper limits of 95% LoA were 3.22–7.03 bpm, 3.25–6.82 bpm and 3.18–7.04 bpm while the lower limits of 95% LoA were -6.36–(-2.35) bpm, -6.46–(-2.30) bpm and -7.42–(-2.41) bpm. Conclusion: Polar OH1 demonstrates high level of agreement with the criterion measure ECG HR, thus can be used as a valid measure of HR in lab and field settings during moderate and high intensity physical activities. [ABSTRACT FROM AUTHOR]

Background: The Tuberculin Skin Test (TST) is a relatively simple test for detecting latent tuberculosis infection (LTBI) but requires regular quality assurance to ensure proper technique for administration and reading. The objective of this study was to estimate the accuracy and reproducibility of an mhealth approach (the mTST) to measure the size of swelling immediately following TST administration (TST injection bleb) and after 48–72 hours (TST induration). Methods: Five non-clinical and one clinical reviewer measured the size of TST injection blebs, and TST indurations using smartphone acquired photos of sites of TST administration and readings in patients, or saline injections in volunteers. The reference standard was the onsite measurement (measured by an experienced TB nurse) of the actual TST injection bleb, or induration. Agreement of reviewers’ measurements with the reference standard, as well as agreement within and between reviewers, was estimated using Cohen's kappa coefficient. Results: Using the mTST method to assess bleb size in 64 photos of different TST injections, agreement between reviewers, and the reference standard was very good to excellent (κ ranged from 0.75 to 0.87), and within-reviewer reproducibility of readings was excellent (κ ranged from 0.86 to 0.96). Using the mTST method to assess TST induration in 72 photos, reviewers were able to detect no induration (<5mm) and induration of 15mm or greater with accuracy of 95% and 92% respectively, but accuracy was only 20% and 77% for reactions of 5-9mm and 10-14mm respectively. Conclusion: The mTST approach appears to be a reliable tool to assess TST administration. The mTST approach was accurate to read indurations of 0-4mm or 15+mm, but less accurate for reactions of 5-14mm. We believe the mTST approach could be useful for training and quality assurance in locations where on-site supervision is not possible. [ABSTRACT FROM AUTHOR]

This study was aimed to evaluate the changes of impedance parameters of patients who were admitted to a long-term care hospital by measuring bioelectrical impedance. The subjects were 18 patients who had infusion therapy through peripheral intravenous (IV) catheters and had at least an infiltration. The impedance parameters were measured with a multi-channel impedance measuring instrument (Vector Impedance Meter) twice; at starting IV infusion after catheter insertion and infiltration detected. As results, the resistance (R) after infiltration significantly decreased compared to the initial resistance. At 50 kHz, the resistances were 498.2±79.3 [Ω] before infiltration and 369.4±85.6 [Ω] after infiltration. The magnitude of the reactance (XC) decreased after infiltration. At 50 kHz, the measured reactance was -31.1±8.3 [Ω] before infiltration and -24.5±5.9 [Ω] after infiltration. The data points plotted in the R-XC graph shifted from the first quadrant before infiltration to third quadrant after infiltration. Our findings suggest that bioelectrical impedance is an effective method for detection of infiltration in a noninvasive and quantitative manner. [ABSTRACT FROM AUTHOR]

Objectives: The current understanding of hypermobility and its diagnostic criteria is still insufficient to create a complete and systematic clinical presentation of the disorder. The objective of this study was to assess the prevalence of joint hypermobility syndrome (JHS) amongst a cohort of jazz dancers, by analyzing its presence in accordance with a number of diagnostic criteria, and to verify potential risk factors for joint hypermobility in jazz dancers. Methods: 77 jazz dancers from the Polish Dance Theater were examined (58 female and 19 male). The prevalence of JHS was assessed using the following diagnostic tools: a structured interview, Beighton score, Grahame & Hakim questionnaire, and Sachse’s criteria, in the modified version proposed by Kapandji. Results: The prevalence of JHS in this cohort of jazz dancers differed significantly, depending on which criteria were adopted (p = 0.001) with Beighton score, Grahame & Hakim questionnaire, and Sachse’s criteria identifying 64.9%, 74% and 59.7% of the sample as JHS respectively. Hypermobility was significantly more prevalent in women than men (p < 0.05). Conclusions: This study demonstrated a significant prevalence of joint hypermobility in jazz dancers and corroborates the findings of other researchers, indicating the need for unified diagnostic criteria for JHS in dancers. [ABSTRACT FROM AUTHOR]

In the clinical field of diagnosis and monitoring of bone diseases, high-resolution peripheral quantitative computed tomography (HR-pQCT) is an important imaging modality. It provides a resolution where quantitative bone morphometry can be extracted in vivo on patients. It is known that HR-pQCT provides slight differences in morphometric indices compared to the current standard approach micro-computed tomography (micro-CT). The most obvious reason for this is the restriction of the radiation dose and with this a lower image resolution. With advances in micro-CT evaluation techniques such as patient-specific remodeling simulations or dynamic bone morphometry, a higher image resolution would potentially also allow the application of such novel evaluation techniques to clinical HR-pQCT measurements. Virtual supersampling as post-processing step was considered to increase the image resolution of HR-pQCT scans. The hypothesis was that this technique preserves the structural bone morphometry. Supersampling from 82 μm to virtual 41 μm by trilinear interpolation of the grayscale values of 42 human cadaveric forearms resulted in strong correlations of structural parameters (R2: 0.96–1.00). BV/TV was slightly overestimated (4.3%, R2: 1.00) compared to the HR-pQCT resolution. Tb.N was overestimated (7.47%; R2: 0.99) and Tb.Th was slightly underestimated (-4.20%; R2: 0.98). The technique was reproducible with PE%CV between 1.96% (SMI) and 7.88% (Conn.D). In a clinical setting with 205 human forearms with or without fracture measured at 82 μm resolution HR-pQCT, the technique was sensitive to changes between groups in all parameters (p < 0.05) except trabecular thickness. In conclusion, we demonstrated that supersampling preserves the bone morphometry from HR-pQCT scans and is reproducible and sensitive to changes between groups. Supersampling can be used to investigate on the resolution dependency of HR-pQCT images and gain more insight into this imaging modality. [ABSTRACT FROM AUTHOR]

Previous studies revealed that healthy individuals consistently misjudge the size and shape of their hidden hand during a localisation task. Specifically, they overestimate the width of their hand and underestimate the length of their fingers. This would also imply that the same individuals misjudge the actual location of at least some parts of their hand during the task. Therefore, the primary aim of the current study was to determine whether healthy individuals could accurately locate the actual position of their hand when hidden from view, and whether accuracy depends on the type of localisation task used, the orientation of the hidden hand, and whether the left or right hand is tested. Sixteen healthy right-handed participants performed a hand localisation task that involved both pointing to and verbally indicating the perceived position of landmarks on their hidden hand. Hand position was consistently misjudged as closer to the wrist (proximal bias) and, to a lesser extent, away from the thumb (ulnar bias). The magnitude of these biases depended on the localisation task (pointing vs. verbal), the orientation of the hand (straight vs. rotated), and the hand tested (left vs. right). Furthermore, the proximal location bias increased in size as the duration of the experiment increased, while the magnitude of ulnar bias remained stable through the experiment. Finally, the resultant maps of perceived hand location appear to replicate the previously reported overestimation of hand width and underestimation of finger length. Once again, the magnitude of these distortions is dependent on the task, orientation, and hand tested. These findings underscore the need to control and standardise each component of the hand localisation task in future studies. [ABSTRACT FROM AUTHOR]

Objective: The use of activity and sleep trackers that operate through dedicated smartphone applications has become popular in the general population. However, the validity of the data they provide has been disappointing and only Total Sleep Time (TST) is reliably recorded in healthy individuals for any of the devices tested. The purpose of this study was to evaluate the ability of two sleep trackers (Withings pulse 02 (W) and Jawbone Up (U)) to measure sleep parameters in patients suffering from obstructive sleep apnea (OSA). Methods: All patients evaluated for OSA in our sleep laboratory underwent overnight polysomnography (PSG). PSG was conducted simultaneously with three other devices: two consumer-level sleep monitors (U and W) and one actigraph (Bodymedia SenseWear Pro Armband (SWA)). Results: Of 36 patients evaluated, 22 (17 men) were diagnosed with OSA (mean apnea-hypopnea index of 37+ 23/h). Single comparisons of sleep trackers (U and W) and actigraph (SWA) were performed. Compared to PSG, SWA correctly assessed TST and Wake After Sleep Onset (WASO), and U and W correctly assessed Time In Bed (TIB) and light sleep. Intraclass correlations (ICC) revealed poor validity for all parameters and devices, except for WASO assessed by SWA. Conclusions: This is the first study assessing the validity of sleep trackers in OSA patients. In this series, we have confirmed the limited performance of wearable sleep monitors that has been previously observed in healthy subjects. In OSA patients, wearable app-based health technologies provide a good estimation of TIB and light sleep but with very poor ICC. [ABSTRACT FROM AUTHOR]

Epidermal ceramides are indispensable lipids that maintain the functions of the stratum corneum. Esterified omega-hydroxyacyl-sphingosine (EOS) ceramide with a linoleate moiety is one of the most important ceramide species for forming cornified lipid envelopes. This linoleate moiety is eventually metabolized to trihydroxy-linoleic acid (triol, 9,10,13-trihydroxy-11E-octadecenoic acid). Thus, we assumed that a decrease of triols might reflect skin barrier dysfunction. Against this background, the purposes of this study were to measure the triols by a simple tape-stripping method and to determine the correlation between the amount of triols and transepidermal water loss (TEWL) as an indicator of barrier dysfunction in atopic dermatitis patients. Twenty Japanese subjects with normal skin and 20 atopic dermatitis patients were enrolled in this study. TEWL was measured and triols of the stratum corneum were analyzed by tape-stripping. The results showed for the first time that triols in the stratum corneum could be simply measured using the tape-stripping method. The triol levels in atopic dermatitis patients were much higher than those in healthy subjects. Moreover, the triol levels correlated with TEWL of non-lesional forearm skin in patients with atopic dermatitis. The results suggest that the assaying of triol levels via non-invasive tape-stripping could be beneficial for monitoring barrier function in atopic dermatitis. [ABSTRACT FROM AUTHOR]

Objective: Previous studies suggest that the presence of diabetic peripheral polyneuropathy (DPN) is associated with atherosclerotic diseases; however, little is known about the relationship between diabetic nerve conduction velocity (NCV) versus arterial stiffness and atherosclerosis parameters. Methods: The subjects in this study were 292 men with type 2 diabetes mellitus (T2DM). All subjects underwent NCV examination at median and tibial nerves as motor nerve (MCV) as well as median and sural nerves as sensory nerve (SCV). Brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness (IMT) were evaluated as arterial stiffness and atherosclerosis parameters. Results: Pearson’s correlation coefficient showed that NCV at all sites negatively correlated with baPWV, maximal and mean IMT (IMT-Max and IMT-Mean), and plaque score (all p values p<0.01 at least). Multiple regression analyses adjusted for confounding factors such as age, duration of diabetes, body mass index, HbA1c, fasting C-peptide, systolic blood pressure, HDL-cholesterol, LDL-cholesterol and albuminuria showed that the association of NCV with IMT-Max, ITM-Mean, and plaque score remained significant (all p values p<0.05 at least) except that between SCV at median and IMT-Max. Moreover, SCV at median (forearm) and sural were significantly associated with baPWV (p = 0.023 and p = 0.027, respectively). Conclusion: The present study showed that DPN estimated by quantitative NCV is linearly associated with the deterioration of arterial stiffness and atherosclerosis parameters in T2DM independently of various diabetic and atherosclerotic factors. [ABSTRACT FROM AUTHOR]

Background: According to between-arms assessments, more than 50% of individuals with stroke have an impaired position sense. Our previous work, which employed a clinical assessment and slightly differing tasks, indicates that individuals who have a deficit on a between-forearms position-localization task do not necessarily have a deficit on a single-forearm position-localization task. Objective: Our goal here was to, using robotics tools, determine whether individuals with stroke who have a deficit when matching forearm positions within an arm also have a deficit when mirroring forearm positions between arms, independent of the arm that leads the task. Methods: Eighteen participants with chronic hemiparetic stroke and nine controls completed a single-arm position-matching experiment and between-arms position-mirroring experiment. For each experiment, the reference forearm (left/right) passively rotated about the elbow joint to a reference target location (flexion/extension), and then the participant actively rotated their same/opposite forearm to match/mirror the reference forearm’s position. Participants with stroke were classified as having a position-matching/-mirroring deficit based on a quantitative threshold that was derived from the controls’ data. Results: On our single-arm task, one participant with stroke was classified as having a position-matching deficit with a mean magnitude of error greater than 10.7° when referencing their paretic arm. Position-matching ability did not significantly differ for the controls and the remaining seventeen participants with stroke. On our between-arms task, seven participants with stroke were classified as having a position-mirroring deficit with a mean magnitude of error greater than 10.1°. Position-mirroring accuracy was worse for these participants with stroke, when referencing their paretic arm, than the controls. Concluding remark: Findings underscore the need for assessing within-arm position-matching deficits, in addition to between-arms position-mirroring deficits when referencing each arm, to comprehensively evaluate an individual’s ability to locate their forearm(s). [ABSTRACT FROM AUTHOR]

Background: The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend intra-access flow (Qa) measurement as the preferred vascular access surveillance method over static intra-access pressure ratio (SIAPR). Recently, it has become possible to perform Qa measurement during hemodialysis using thermodilution method called blood temperature monitoring (BTM) with the Twister device. The aim of this study was to investigate the correlation between Qa by BTM and SIAPR and to compare the performance of two tests in prediction of vascular access stenosis. Methods: The study was performed from January 2016 to November 2017 and included 97 patients with arteriovenous fistulas (AVF). Qa by BTM and SIAPR were simultaneously measured every 1~3 months with a total of 449 measurements during study period. Results: In our study population, mean age was 59.9±10.0 years and 61.9% were diabetes. The mean Qa obtained by BTM was 1186±588 mL/min. There was no correlation between Qa by BTM and venous SIAPR (r = 0.061, P = 0.196). Angiography identified 36 stenotic AVFs (37.1%) among the study subjects. They included 13 cases with only inflow stenosis, 6 with only outflow stenosis, and 17 with stenosis on both sides. Receiver-operating characteristic (ROC) curve analysis showed that Qa by BTM had higher discriminative ability to diagnose vascular access stenosis compared to SIAPR (P <0.001). The Qa less than 583 mL/min showed the highest diagnostic accuracy in vascular stenosis prediction. Conclusion: Intradialytic measurement of Qa by BTM showed better diagnostic power over venous SIAPR in prediction of vascular access stenosis. [ABSTRACT FROM AUTHOR]

Bats transition from flightless, milk-sustained infants to volant, foraging juveniles in the span of a few weeks to a few months. This rapid development is accompanied by fast growth and weight gain, but behavioral development remains poorly understood. We addressed development of maternal support and pup independence for Peters’ tent-making bat (Uroderma bilobatum) in light of population level reproductive patterns. Uroderma bilobatum exhibited seasonal bimodal polyoestry at our study site. Births occurred over one month within a reproductive bout, resulting in variable levels of behavioral development for pups in the same maternity group. Pups reached adult forearm length more quickly than adult mass, facilitating the ontogeny of flight. Maternal support consisted of nursing and thermoregulation, transporting pups between night and day roosts, and milk provisioning between foraging bouts. We did not observe provisioning with solid food. Pups interacted only with their own mother. Between 25 to 40 days into a reproductive bout they matured by suckling progressively less and fledging over multiple nights in a two-stage process assisted by mothers. We describe several parturition events as well as a novel form of stereotyped tactile stimulation involving forearm pulses by mothers against suckling pups that may serve to promote weaning. Rapid behavioral changes in both pups and mothers accompany pup morphological development through maturation. [ABSTRACT FROM AUTHOR]

Roughly one quarter of active upper limb prosthetic technology is rejected by the user, and user surveys have identified key areas requiring improvement: function, comfort, cost, durability, and appearance. Here we present the first systematic, clinical assessment of a novel prosthetic hand, the SoftHand Pro (SHP), in participants with transradial amputation and age-matched, limb-intact participants. The SHP is a robust and functional prosthetic hand that minimizes cost and weight using an underactuated design with a single motor. Participants with limb loss were evaluated on functional clinical measures before and after a 6–8 hour training period with the SHP as well as with their own prosthesis; limb-intact participants were tested only before and after SHP training. Participants with limb loss also evaluated their own prosthesis and the SHP (following training) using subjective questionnaires. Both objective and subjective results were positive and illuminated the strengths and weaknesses of the SHP. In particular, results pre-training show the SHP is easy to use, and significant improvement in the Activities Measure for Upper Limb Amputees in both groups following a 6–8 hour training highlights the ease of learning the unique features of the SHP (median improvement: 4.71 and 3.26 and p = 0.009 and 0.036 for limb loss and limb-intact groups, respectively). Further, we found no difference in performance compared to participant’s own commercial devices in several clinical measures and found performance surpassing these devices on two functional tasks, buttoning a shirt and using a cell phone, suggesting a functional prosthetic design. Finally, improvements are needed in the SHP design and/or training in light of poor results in small object manipulation. Taken together, these results show the promise of the SHP, a flexible and adaptive prosthetic hand, and pave a path forward to ensuring higher functionality in future. [ABSTRACT FROM AUTHOR]

Neuroscience investigations are most often focused on the prediction of future perception or decisions based on prior brain states or stimulus presentations. However, the brain can also process information retroactively, such that later stimuli impact conscious percepts of the stimuli that have already occurred (called “postdiction”). Postdictive effects have thus far been mostly unimodal (such as apparent motion), and the models for postdiction have accordingly been limited to early sensory regions of one modality. We have discovered two related multimodal illusions in which audition instigates postdictive changes in visual perception. In the first illusion (called the “Illusory Audiovisual Rabbit”), the location of an illusory flash is influenced by an auditory beep-flash pair that follows the perceived illusory flash. In the second illusion (called the “Invisible Audiovisual Rabbit”), a beep-flash pair following a real flash suppresses the perception of the earlier flash. Thus, we showed experimentally that these two effects are influenced significantly by postdiction. The audiovisual rabbit illusions indicate that postdiction can bridge the senses, uncovering a relatively-neglected yet critical type of neural processing underlying perceptual awareness. Furthermore, these two new illusions broaden the Double Flash Illusion, in which a single real flash is doubled by two sounds. Whereas the double flash indicated that audition can create an illusory flash, these rabbit illusions expand audition’s influence on vision to the suppression of a real flash and the relocation of an illusory flash. These new additions to auditory-visual interactions indicate a spatio-temporally fine-tuned coupling of the senses to generate perception. [ABSTRACT FROM AUTHOR]

Background: C-Tb, an ESAT-6/CFP-10-based skin test, has similar sensitivity for active TB compared to tuberculin skin test (TST) and QuantiFERON-TB-Gold-In-Tube (QFT). However, data are limited in children and HIV-infected persons. Methods: Asymptomatic South African contacts <5 years (n = 87; HIV-uninfected), or symptomatic individuals of all ages presenting to clinics with suspected TB (n = 1003; 30% HIV-infected) were recruited from eight South African centres. C-Tb and TST were allocated to either forearm double blinded. Samples for QFT were collected in parallel, and test-positivity rates were compared. Results: In participants with microbiologically confirmed TB (n = 75; 45% HIV-infected) sensitivity of C-Tb, TST and QFT were similar (72% versus 75% versus 73%; p>0.5). All 3 tests had similar positivity rates in HIV-infected participants with active TB, however, positivity rates were reduced when CD4 counts were <100 cells/μL. In participants where active TB was excluded (n = 920), C-Tb (41%), TST (43%), and QFT (44%) also had similar test-positivity rates. Among asymptomatic contacts aged below five, 32% (28/87) tested positive with C-Tb and 32% (28/87) with TST (concordance 89%). Overall, C-Tb and TST showed a similar safety profile. Conclusion: C-Tb was safe and showed similar test-positivity rates, compared to TST and QFT, in children and HIV-infected persons with active or latent M. tuberculosis infection. These data inform the utility of C-Tb in clinical practice. Trial registration: ClinicalTrials.gov . EudraCT 2011-005078-40. [ABSTRACT FROM AUTHOR]

Inertial sensor technology has assumed an increasingly important role in the field of human motion analysis. However, the reliability of the kinematic estimates could still be critical for specific applications in the field of functional evaluation and motor rehabilitation. Within this context, the definition of subject-specific multi-body kinematic models is crucial since it affects the accuracy and repeatability of movement reconstruction. A key step for kinematic model calibration is the determination of bony segment lengths. This study proposes a functional approach for the in vivo estimation of the humerus length using a single magneto-inertial measurement unit (MIMU) positioned on the right distal posterior forearm. The humerus length was estimated as the distance between the shoulder elevation axis and the elbow flexion–extension axis. The calibration exercise involved five shoulder elevations in the sagittal plane with the elbow completely extended and five elbow flexion–extensions with the upper arm rigidly aligned to the trunk. Validation of the method was conducted on five healthy subjects using the humerus length computed from magnetic resonance imaging as the gold standard. The method showed mean absolute errors of 12 ± 9 mm, which were in the estimate of the humerus length. When using magneto-inertial technology, the proposed functional method represents a promising alternative to the regressive methods or manual measurements for performing kinematic model calibrations. Although the proposed methodology was validated for the estimation of the humerus length, the same approach can be potentially extended to other body segments. [ABSTRACT FROM AUTHOR]

High frequency electrical stimulation (HFS) of the skin induces increased pinprick sensitivity in the surrounding unconditioned skin. The aim of the present study was to investigate the contribution of A-fiber nociceptors to this increased pinprick sensitivity. For this we assessed if the perception and brain responses elicited by low-intensity intra-epidermal electrical stimulation (IES), a method preferentially activating Aδ-fiber nociceptors, are increased in the area of HFS-induced increased pinprick sensitivity. HFS was delivered to one of the two forearms of seventeen healthy volunteers. Mechanical pinprick stimulation and IES were delivered at both arms before HFS (T0), 20 minutes after HFS (T1) and 45 minutes after HFS (T2). In all participants, HFS induced an increase in pinprick perception at the HFS-treated arm, adjacent to the site of HFS. This increase was significant at both T1 and T2. HFS did not affect the percept elicited by IES, but did enhance the magnitude of the N2 wave of IES-evoked brain potentials, both at T1 and at T2. Our results show that HFS induces a long-lasting enhancement of the N2 wave elicited by IES in the area of secondary hyperalgesia, indicating that HFS enhances the responsiveness of the central nervous system to nociceptive A-fiber input. However, we found no evidence that HFS affects the perception elicited by IES, which may suggest that the population of nociceptors that mediate the perception elicited by IES do not contribute to HFS-induced increased pinprick sensitivity. [ABSTRACT FROM AUTHOR]

The reflection of passive arm displacement in a mirror is a powerful means of inducing a kinaesthetic illusion in the static arm hidden behind the mirror. Our recent research findings suggest that this illusion is not solely visual in origin but results from the combination of visual and proprioceptive signals from the two arms. To determine the respective contributions of visual and proprioceptive signals to this illusion, we reproduced the mirror paradigm in virtual reality. As in the physical version of the mirror paradigm, one of the participant’s arms (the left arm, in our study) could be flexed or extended passively. This movement was combined with displacements of the avatar’s left and right forearms, as viewed in a first-person perspective through a virtual reality headset. In order to distinguish between visual and proprioceptive contributions, two unimodal conditions were applied separately: displacement of the avatar’s forearms in the absence of physical displacement of the left arm (the visual condition), and displacement of the left forearm while the avatar’s forearms were masked (the proprioceptive condition). Of the 34 female participants included in the study, 28 experienced a kinaesthetic mirror illusion in their static (right) arm. The strength of the illusion (expressed in terms of speed and duration) evoked by the bimodal condition was much higher than that observed in either of the two unimodal conditions. Our present results confirm that the involvement of visual signals in the mirror illusion—often considered as a prototypic visual illusion—has been overstated. The mirror illusion also involves non-visual signals (bilateral proprioceptive-somaesthetic signals, in fact) that interact with the visual signals and strengthen the kinaesthetic effect. [ABSTRACT FROM AUTHOR]

Previous research points to two major hypotheses regarding the mechanisms by which touch can be experienced as erotogenic. The first concerns the body part to which touch is applied (erogenous zones) and the second the modality of touch (sensual touch optimal in activating C Tactile afferents). In this study, we explored for the first time the relation between those two mechanisms in actual and imagined social touch. In a first experiment, we randomly assigned “Giver” and “Receiver” roles within 19 romantic couples (20 females, 18 males, age 32.34 ± 8.71SD years) and asked the “Giver” to apply CT-optimal (3 cm/s) vs. CT-suboptimal (18 cm/s) touch on an erogenous (neck) vs. non-erogenous zone (forehead) of their partner. We then obtained ratings of pleasantness and sexual arousal from both “Receivers” and “Givers”. In a second experiment, 32 healthy females (age 25.16 ± 5.91SD years) were asked to imagine CT-optimal vs. CT-suboptimal stimulation (stroking vs. patting) and velocity (3 cm/s vs. 18 cm/s) on different erogenous vs. non-erogenous zones and rate pleasantness. While both erogenous body part and CT-optimal, sensual touch were found to increase pleasant and erotic sensations, the results showed a lack of an interaction. Furthermore, pleasantness was induced by mere imagination of touch without any tactile stimulation, and touch that was sexually arousing for the receiver was rated as more sexually arousing for the giver as well, pointing to top-down, learned expectations of sensory pleasure and erogeneity. Taken together, these studies provide the first direct evidence that while both the body location to which touch is applied and the mode of touch contribute to pleasant and erotic sensations, these two factors appear to mediate subjective pleasantness and erogeneity by, at least partly, independent mechanisms. [ABSTRACT FROM AUTHOR]

Mindfulness based stress reduction (MBSR) training has been proposed to improve attentional skills by modulating thalamo-cortical loops that affect the sensitivity of relevant cortical areas like the somatosensory cortex. This modulation may be reflected in the electroencephalographic (EEG) alpha rhythm, and could affect the processing of subsequently applied intracutaneous electrical stimuli. Participants took part in an MBSR training and participated in two EEG sessions. EEG was measured in variants of an endogenous orienting paradigm in which attention had to be directed to the left or right forearm. After the orienting interval, the electrical stimulus was applied, equally likely on the attended or the unattended forearm. One group of participants took part in the EEG session before and after the training, while the other group took part after the training, and another time, eight weeks later. The influence of the MBSR training and spatial attention were examined with behavioral measures, lateralized alpha power within the orienting interval, and with event-related potentials (ERPs) evoked by the electrical stimuli. Self-reported mindfulness was clearly affected by the training, but no influence was found on other behavioral measures. Alpha power was clearly lateralized due to spatial attention and several ERP components (N130, N180, P340) were modulated by spatial attention but no support was found for an influence of the MBSR training. Finally, analyses revealed that individual differences in training time modulated some of the observed effects, but no support was found for an influence on attentional orienting. [ABSTRACT FROM AUTHOR]

Suction experiments have been extensively applied for skin characterization. In these tests the deformation behavior of superficial tissue layers determines the elevation of the skin surface observed when a predefined negative (suction) pressure history is applied. The ability of such measurements to differentiate between skin conditions is limited by the variability of the elevation response observed in repeated experiments. The scatter was shown to be associated with the force exerted by the observer when holding the instrument against the skin. We have developed a novel suction device and a measurement procedure aiming at a tighter control of mechanical boundary conditions during the experiments. The new device weighs only 3.5 g and thus allows to minimize the force applied on the skin during the test. In this way, it is possible to reliably characterize the mechanical response of skin, also in case of low values of suction pressure and deformation. The influence of the contact force is analyzed through experiments on skin and synthetic materials, and rationalized based on corresponding finite element calculations. A comparative study, involving measurements on four body locations in two subjects by three observers, showed the good performance of the new procedure, specific advantages, and limitations with respect to the Cutometer®, i.e. the suction device most widely applied for skin characterization. As a byproduct of the present investigation, a correction procedure is proposed for the Cutometer measurements, which allows to partially compensate for the influence of the contact force. The characteristics of the new suction method are discussed in view of future applications for diagnostic purposes. [ABSTRACT FROM AUTHOR]

Data describing the effect of in vivo B cell depletion on general bone loss in patients with rheumatoid arthritis (RA) are limited. Given the pathogenetic role of B cells in RA, it is tempting to speculate that B cell depletion might have a beneficial effect on bone loss. We prospectively investigated the changes in bone mineral density (BMD), bone turnover, inflammation and disease activity before and after rituximab in 45 RA patients over a 12 month period, 36 patients of whom completed the study and were included in the analysis. There was no significant change in our primary endpoint; lumbar spine BMD after 12 months. However, we found a significant decrease in neck of femur (mean -0.017 g/cm2, 95% CI -0.030, -0.004 p = 0.011) and total femur BMD (mean -0.016 g/cm2, 95% CI -0.025, -0.007 p = 0.001). Additionally, there was a significant increase in procollagen type 1 amino-terminal propeptide (P1NP) and bone specific alkaline phosphatase (BAP); biomarkers of bone formation (median change from baseline to 12 months; P1NP 11.3 μg/L, 95% CI -1.1, 24.8 p = 0.025; BAP 2.5 μg/L, 95% CI 1.2, 3.6 p = 0.002), but no significant change in bone resorption or osteocyte markers. The fall in BMD occurred despite improvement in disease control. Post-menopausal women had the lowest mean lumbar spine, femoral and forearm BMD at baseline and after 12 months, additionally they had a higher level of bone turnover throughout the study. In conclusion, BMD was maintained at the lumbar spine and forearm, but fell at the femur sites. A high prevalence of vitamin D deficiency was observed and these patients had lower BMD and evidence of higher bone turnover. [ABSTRACT FROM AUTHOR]

Background: Medical Infrared Imaging (MII) is an investigative method that can be potentially used in emergency care to non-invasively detect thermal signatures associated with change in blood flow. We have developed a protocol for the use of MII in the Emergency Department (ED) and shown that it is feasible. To derive initial data for sample size calculations, we performed an exploratory study in patients with fever and sepsis. Methods: The Leicester MII protocol was used to image the temperature patterns along the arm among three patient groups (control, fever and sepsis) of a total 56 patients. Anatomical markers were used to divide this gradient into upper arm, forearm, hand and finger regions. Variations in measurements within and between these regions were described. Results: The thermal gradient down the arm was successfully extracted in all patients. The distribution of values in each region of the arm was described in control, fever and sepsis patients. There was a significant gradient between upper arm and finger in controls (2.75, p < 0.0001), but no gradient in fever (p = 0.944) or sepsis (p = 0.710). This was reflected in the finger/arm difference, which was of -2.74°C (±3.50) in controls, -0.39C (±2.48) in fever, and -1.80°C (±3.09) in sepsis. Conclusions: This study found different thermal gradients along the arm in control and febrile groups, and defined the degree of individual variation. It is likely that the difference between upper arm temperature and finger temperature (representing the temperature gradient down the arm) may be more useful than absolute measurements in future studies. [ABSTRACT FROM AUTHOR]

Background: Accelerated bone loss occurs rapidly following renal transplantation due to intensive immunosuppression and persistent hyperparathyroidism. In renal transplant recipients (RTRs) due to the hyperparathyroidism the non-dominant forearm is often utilized as a peripheral measurement site for dual-energy x-ray absorptiometry (DXA) measurements. The forearm is also the site of previous created distal arteriovenous fistulas (AVF). Although AVF remain patent long after successful transplantation, there are no data available concerning their impact on radial bone DXA measurements. Methods: In this cross-sectional study we performed DXA in 40 RTRs with preexisting distal AVF (RTRs-AVF) to assess areal bone mineral density (aBMD) differences between both forearms (three areas) and compared our findings to patients with chronic kidney disease (CKD, n = 40), pre-emptive RTRs (RTRs-pre, n = 15) and healthy volunteers (n = 20). In addition, we assessed relevant demographic, biochemical and clinical aspects. Results: We found a marked radial asymmetry between the forearms in RTRs with preexisting AVF. The radial aBMD at the distal AVF forearm was lower compared to the contralateral forearm, resulting in significant differences for all three areas analyzed: the Rad-1/3: median (interquartile range) in g/cm2, Rad-1/3: 0.760 (0.641–0.804) vs. 0.742 (0.642, 0.794), p = 0.016; ultradistal radius, Rad-UD: 0.433 (0.392–0.507) vs. 0.420 (0.356, 0.475), p = 0.004; and total radius, Rad-total: 0.603 (0.518, 0.655) vs. 0.599 (0.504, 0.642), p = 0.001). No such asymmetries were observed in any other groups. Lower aBMD in AVF forearm subregions resulted in misclassification of osteoporosis. Conclusions: In renal transplant recipients, a previously created distal fistula may exert a negative impact on the radial bone leading to significant site-to-site aBMD differences, which can result in diagnostic misclassifications. [ABSTRACT FROM AUTHOR]

Spinal muscular atrophy (SMA) is a monogenic disorder caused by loss of function mutations in the survival motor neuron 1 gene, which results in a broad range of disease severity, from neonatal to adult onset. There is currently a concerted effort to define the natural history of the disease and develop outcome measures that accurately capture its complexity. As several therapeutic strategies are currently under investigation and both the FDA and EMA have recently approved the first medical treatment for SMA, there is a critical need to identify the right association of responsive outcome measures and biomarkers for individual patient follow-up. As an approved treatment becomes available, untreated patients will soon become rare, further intensifying the need for a rapid, prospective and longitudinal study of the natural history of SMA Type 2 and 3. Here we present the baseline assessments of 81 patients aged 2 to 30 years of which 19 are non-sitter SMA Type 2, 34 are sitter SMA Type 2, 9 non-ambulant SMA Type 3 and 19 ambulant SMA Type 3. Collecting these data at nine sites in France, Germany and Belgium established the feasibility of gathering consistent data from numerous and demanding assessments in a multicenter SMA study. Most assessments discriminated between the four groups well. This included the Motor Function Measure (MFM), pulmonary function testing, strength, electroneuromyography, muscle imaging and workspace volume. Additionally, all of the assessments showed good correlation with the MFM score. As the untreated patient population decreases, having reliable and valid multi-site data will be imperative for recruitment in clinical trials. The pending two-year study results will evaluate the sensitivity of the studied outcomes and biomarkers to disease progression. Trial Registration: ClinicalTrials.gov (). [ABSTRACT FROM AUTHOR]

When pointing to parts of our own body (e.g., the opposite index finger), the position of the target is derived from proprioceptive signals. Consistent with the principles of multisensory integration, it has been found that participants better matched the position of their index finger when they also had visual cues about its location. Unlike vision, touch may not provide an additional information about finger position in space, since fingertip tactile information theoretically remains the same irrespective of the postural configuration of the upper limb. However, since tactile and proprioceptive information are ultimately coded within the same population of posterior parietal neurons within high-level spatial representations, we nevertheless hypothesized that additional tactile information could benefit the processing of proprioceptive signals. To investigate the influence of tactile information on proprioceptive localization, we asked 19 participants to reach with the right hand towards the opposite unseen index finger (proprioceptive target). Vibrotactile stimuli were applied to the target index finger prior to movement execution. We found that participants made smaller errors and more consistent reaches following tactile stimulation. These results demonstrate that transient touch provided at the proprioceptive target improves subsequent reaching precision and accuracy. Such improvement was not observed when tactile stimulation was delivered to a distinct body part (the shoulder). This suggests a specific spatial integration of touch and proprioception at the level of high-level cortical body representations, resulting in touch improving position sense. [ABSTRACT FROM AUTHOR]

Background: Mitochondrial and neurogenetic diseases can present diagnostic challenges. We investigated if near infrared spectroscopy with the vascular occlusion test is able to differentiate between children with mitochondrial disease and children with neurogenetic disease or healthy controls. Methods: Prospective observational study conducted in a tertiary children’s hospital. Results: Forty-three children with mitochondrial disease (including both genetically confirmed primary mitochondrial disease and cases with biochemical evidence of mitochondrial dysfunction), 19 children with non-mitochondrial neurogenetic disease and 13 healthy controls were recruited. The delta tissue oxygen index (ΔTOI) values showed greater variability amongst children with mitochondrial disease and neurogenetic disease than healthy controls despite the median ΔTOI being similar (median 14.1 and 18.8, t-test, p = 0.16). A low ΔTOI identifies cases with a higher probability of mitochondrial disease or neurogenetic disease compared to healthy controls (positive likelihood ratio: 3.67; 95%CI:1.01–13). A high ΔTOI with the near infrared spectroscopy with vascular occlusion test identifies cases with a lower probability of having a disease (negative likelihood ratio: 0.51; 95%CI:0.36–0.74). Conclusion: Near infrared spectroscopy with vascular occlusion test might be able to discriminate children with mitochondrial disease and neurogenetic disease from healthy controls. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the spectrum of upper limb functional activities and imaging finding in a cohort of patients affected by Duchenne muscular dystrophy. Thirty-one patients of age between 5 and 29 years were included in the study (17 ambulant and 14 non-ambulant). They were all assessed using the Performance of Upper Limb (PUL) test and muscle MRI of shoulder, arm and forearm in order to establish if the functional scores obtained at shoulder, mid and distal level related to specific patterns of involvement in each upper limb segment on muscle MRI. At shoulder level, latissimus dorsi, serratus anterior, infraspinatus and subscapularis were always involved, even in patients with full functional scores at shoulder level. Diffuse and severe involvement of all muscles was found in the patients with a PUL shoulder functional score of ≤ 5. At arm level biceps brachii, brachialis and triceps were generally concordantly involved or spared. Some degree of involvement could already be detected in patients with reduced scores on the PUL mid domain. They were generally severely involved in patients with functional scores less than 6 at mid-level. At distal level supinator and pronator muscles were often involved, followed by brachioradialis and, less frequently, by the muscles of the flexor compartment. The extensor muscles were generally completely spared. A diffuse and severe involvement was found only in patients who had very low scores (8 or below) on the PUL distal domain. The integrated use of functional scales and imaging allowed to establish patterns of involvement at each level, and the functional scores that were more frequently associated with diffuse and severe involvement. [ABSTRACT FROM AUTHOR]

Background & Aims: The effects of acute stress on allergic symptoms are little understood. The intention of this clinical study was to study the effects of acute stress and related mediators in allergic rhinitis (AR), taking the wheal and flare reaction in skin prick testing (SPT) as a readout. Methods: 19 healthy and 21 AR patients were first subjected to SPTs with grass pollen-, birch pollen- and house dust mite allergen extracts, histamine and negative control. Subsequently, participants were exposed to a standardized Trier Social Stress Test (TSST), followed by SPT on the contralateral forearm. Stress responders were identified based on the salivary cortisol levels and State-subscale of State-Trait-Anxiety Inventory (STAI-S). Blood samples were collected before and after TSST and adrenaline, noradrenaline, serotonin, oxytocin, platelet activating factor and prostaglandin D2 were analyzed by enzyme immunoassay (EIA). Results: SPT results of 14/21 allergics and 11/19 healthy who responded with stress after TSST were evaluated. No significant differences regarding SPT to allergens or histamine before and after the stress test could be calculated at the group level. But, the wheal and flare sizes after TSST increased or decreased substantially in several individuals, and unmasked sensitization in one “healthy” person, which could not be correlated with any mediator tested. The most significant finding, however, was that, independent of TSST, the baseline levels of oxytocin and noradrenaline were significantly higher in allergics. Conclusion: High baseline levels of noradrenaline points toward higher stress levels in allergic patients, which might be counterregulated by elevated oxytocin. Moreover, our data indicate that acute stress may have a significant influence on SPT fidelity in susceptible individuals. [ABSTRACT FROM AUTHOR]

The aim of this study was to comprehensively describe the physiological responses to an acute bout of mild cold in young lean men (n = 11, age: 23 ± 2 years, body mass index: 23.1 ± 1.2 kg/m2) to better understand the underlying mechanisms of non-shivering thermogenesis and how it is regulated. Resting energy expenditure, substrate metabolism, skin temperature, thermal comfort perception, superficial muscle activity, hemodynamics of the forearm and abdominal regions, and heart rate variability were measured under warm conditions (22.7 ± 0.2°C) and during an individualized cooling protocol (air-conditioning and water cooling vest) in a cold room (19.4 ± 0.1°C). The temperature of the cooling vest started at 16.6°C and decreased ~ 1.4°C every 10 minutes until participants shivered (93.5 ± 26.3 min). All measurements were analysed across 4 periods: warm period, at 31% and at 64% of individual´s cold exposure time until shivering occurred, and at the shivering threshold. Energy expenditure increased from warm period to 31% of cold exposure by 16.7% (P = 0.078) and to the shivering threshold by 31.7% (P = 0.023). Fat oxidation increased by 72.6% from warm period to 31% of cold exposure (P = 0.004), whereas no changes occurred in carbohydrates oxidation. As shivering came closer, the skin temperature and thermal comfort perception decreased (all P<0.05), except in the supraclavicular skin temperature, which did not change (P>0.05). Furthermore, the superficial muscle activation increased at the shivering threshold. It is noteworthy that the largest physiological changes occurred during the first 30 minutes of cold exposure, when the participants felt less discomfort. [ABSTRACT FROM AUTHOR]

Background: New methodologies to estimate gestational age (GA) at birth are demanded to face the limited access to obstetric ultrasonography and imprecision of postnatal scores. The study analyzed the correlation between neonatal skin thickness and pregnancy duration. Secondarily, it investigated the influence of fetal growth profiles on tissue layer dimensions. Methods and findings: In a feasibility study, 222 infants selected at a term-to-preterm ratio of 1:1 were assessed. Reliable information on GA was based on the early ultrasonography-based reference. The thicknesses of the epidermal and dermal skin layers were examined using high-frequency ultrasonography. We scanned the skin over the forearm and foot plantar surface of the newborns. A multivariate regression model was adjusted to determine the correlation of GA with skin layer dimensions. The best model to correlate skin thickness with GA was fitted using the epidermal layer on the forearm site, adjusted to cofactors, as follows: Gestational age (weeks) = −28.0 + 12.8 Ln (Thickness) − 4.4 Incubator staying; R2 = 0.604 (P<0.001). In this model, the constant value for the standard of fetal growth was statistically null. The dermal layer thickness on the forearm and plantar surfaces had a negative moderate linear correlation with GA (R = −0.370, P<0.001 and R = −0.421, P<0.001, respectively). The univariate statistical analyses revealed the influence of underweight and overweight profiles on neonatal skin thickness at birth. Of the 222 infants, 53 (23.9%) had inappropriate fetal growths expected for their GA. Epidermal thickness was not fetal growth standard dependent as follows: 172.2 (19.8) μm for adequate for GA, 171.4 (20.6) μm for SGA, and 177.7 (15.2) μm for LGA (P = 0.525, mean [SD] on the forearm). Conclusions: The analysis highlights a new opportunity to relate GA at birth to neonatal skin layer thickness. As this parameter was not influenced by the standard of fetal growth, skin maturity can contribute to clinical applications. [ABSTRACT FROM AUTHOR]

The modulatory role of the primary motor cortex (M1), reflected by an inhibitory effect of M1-stimulation on clinical pain, motivated us to deepen our understanding of M1’s role in pain modulation. We used Transcranial Magnetic Stimulation (TMS)-induced virtual lesion (VL) to interrupt with M1 activity during noxious heat pain. We hypothesized that TMS-VL will effect experimental pain ratings. Three VL protocols were applied consisting of single-pulse TMS to transiently interfere with right M1 activity: (1) VLM1- TMS applied to 11 subjects, 20 msec before the individual’s first pain-related M1 peak activation, as determined by source analysis (sLORETA), (2) VL-50 (N = 16; TMS applied 50 ms prior to noxious stimulus onset), and (3) VL+150 (N = 16; TMS applied 150 ms after noxious stimulus onset). Each protocol included 3 conditions ('pain-alone', ' TMS-VL', and ‘SHAM-VL’), each consisted of 30 noxious heat stimuli. Pain ratings were compared, in each protocol, for TMS-VL vs. SHAM-VL and vs. pain-alone conditions. Repeated measures analysis of variance, corrected for multiple comparisons revealed no significant differences in the pain ratings between the different conditions within each protocol. Therefore, our results from this exploratory study suggest that a single pulse TMS-induced VL that is targeted to M1 failed to interrupt experimental pain processing in the specific three stimulation timing examined here. [ABSTRACT FROM AUTHOR]

The large body of work demonstrating hyperthermic impairment of neuromuscular function has utilized maximal isometric contractions, but extrapolating these findings to whole-body exercise and submaximal, dynamic contractions may be problematic. We isolated and compared core and skin temperature influences on an isometric force task versus a position task requiring dynamic maintenance of joint angle. Surface electromyography (sEMG) was measured on the flexor carpi radialis at 60% of baseline maximal voluntary contraction while either pushing against a rigid restraint (force task) or while maintaining a constant wrist angle and supporting an equivalent inertial load (position task). Twenty participants performed each task at 0.5°C rectal temperature (Tre) intervals while being passively heated from 37.1±0.3°C to ≥1.5°C Tre and then cooled to 37.8±0.3°C, permitting separate analyses of core versus skin temperature influences. During a 3-s contraction, trend analysis revealed a quadratic trend that peaked during hyperthermia for root-mean-square (RMS) amplitude during the force task. In contrast, RMS amplitude during the position task remained stable with passive heating, then rapidly increased with the initial decrease in skin temperature at the onset of passive cooling (p = 0.010). Combined hot core and hot skin elicited shifts toward higher frequencies in the sEMG signal during the force task (p = 0.003), whereas inconsistent changes in the frequency spectra occurred for the position task. Based on the patterns of RMS amplitude in response to thermal stress, we conclude that core temperature was the primary thermal afferent influencing neuromuscular response during a submaximal force task, with minimal input from skin temperature. However, skin temperature was the primary thermal afferent during a position task with minimal core temperature influence. Therefore, temperature has a task-dependent impact on neuromuscular responses. [ABSTRACT FROM AUTHOR]

Sunscreen users are often inadequately protected and become sunburned. This study aimed to investigate how much two consecutive sunscreen applications increased the quantity of sunscreen applied and decreased the skin area left without sunscreen (missed area) compared to a single application. Thirty-one healthy volunteers wearing swimwear were included and applied sunscreen two consecutive times in a laboratory environment. Participants had pictures taken in black light before and after each application. As sunscreens absorb black light, the darkness of the skin increased with increasing amounts of sunscreen applied. We conducted a standard curve establishing a link between change in picture darkness and quantity of sunscreen. The quantity of sunscreen at selected skin sites as well as the percentage of missed area was determined after each application. Participants had missed a median of 20% of their available body surface after a single application. After double application they had missed 9%. The decrease in missed areas was significant for the whole body surface and for each of the body regions separately. The median participant had applied between 13% and 100% more sunscreen at the selected skin sites after double application than after single application. We recommend double application, especially before intense sun exposure. [ABSTRACT FROM AUTHOR]

Background: Emollients are a mainstay of treatment in atopic dermatitis (AD), a disease distinguished by skin bacterial dysbiosis. However, changes in skin microbiota when emollients are used as a potential AD preventative measure in infants remain incompletely characterized. Results: We compared skin barrier parameters, AD development, and bacterial 16S ribosomal RNA gene sequences of cheek, dorsal and volar forearm samples from 6-month-old infants with a family history of atopy randomized to receive emollients (n = 11) or no emollients (controls, n = 12). The emollient group had a lower skin pH than the control group. The number of bacterial taxa in the emollient group was higher than in the control group at all sites. The Streptococcus salivarius proportion was higher in the emollient versus control groups at all sites. S. salivarius proportion appeared higher in infants without AD compared to infants with AD. A decrease in S. salivarius abundance was further identified in a separate larger population of older children demonstrating an inverse correlation between AD severity at sampling sites and S. salivarius proportions. Conclusions: The decreased skin pH and the increased proportion of S. salivarius after long-term emollient use in infants at risk for developing AD may contribute to the preventative effects of emollients in high-risk infants. [ABSTRACT FROM AUTHOR]

It is still challenging to achieve a complex grasp or fine finger control by using surface functional electrical stimulation (FES), which usually requires a precise electrode configuration under laboratory or clinical settings. The goals of this study are as follows: 1) to study the possibility of selectively activating individual fingers; 2) to investigate whether the current activation threshold and selective range of individual fingers are affected by two factors: changes in the electrode position and forearm rotation (pronation, neutral and supination); and 3) to explore a theoretical model for guidance of the electrode placement used for selective activation of individual fingers. A coordinate system with more than 400 grid points was established over the forearm skin surface. A searching procedure was used to traverse all grid points to identify the stimulation points for finger extension/flexion by applying monophasic stimulation pulses. Some of the stimulation points for finger extension and flexion were selected and tested in their respective two different forearm postures according to the number and the type of the activated fingers and the strength of finger action response to the electrical stimulation at the stimulation point. The activation thresholds and current ranges of the selectively activated finger at each stimulation point were determined by visual analysis. The stimulation points were divided into three groups (“Low”, “Medium” and “High”) according to the thresholds of the 1st activated fingers. The angles produced by the selectively activated finger within selective current ranges were measured and analyzed. Selective stimulation of extension/flexion is possible for most fingers. Small changes in electrode position and forearm rotation have no significant effect on the threshold amplitude and the current range for the selective activation of most fingers (p > 0.05). The current range is the largest (more than 2 mA) for selective activation of the thumb, followed by those for the index, ring, middle and little fingers. The stimulation points in the “Low” group for all five fingers lead to noticeable finger angles at low current intensity, especially for the index, middle, and ring fingers. The slopes of the finger angle variation in the “Low” group for digits 2~4 are inversely proportional to the current intensity, whereas the slopes of the finger angle variation in other groups and in all groups for the thumb and little finger are proportional to the current intensity. It is possible to selectively activate the extension/flexion of most fingers by stimulating the forearm muscles. The physiological characteristics of each finger should be considered when placing the negative electrode for selective stimulation of individual fingers. The electrode placement used for the selective activation of individual fingers should not be confined to the location with the lowest activation threshold. [ABSTRACT FROM AUTHOR]

Introduction: Transradial coronary angiography (TRC) can be performed with a one-catheter approach for the right and left coronary ostium (R/LCO). We investigated the performance of a special diagnostic catheter widely used for the one-catheter-approach, the Tiger (Tiger II, TerumoTM). Methods: In a dual center registry we analyzed 1412 TRC-procedures exclusively performed by experienced TRC-operators. We compared the performance of the Tiger with Judkins catheters by retrospectively judging ostial catheter stability during contrast injection, and by measuring contrast use, fluoroscopy time (FT) and complication rate. Results: Poor or failed ostial engagement was found in 40.5% in the Tiger group, compared to 46.6% with the use of Judkins catheters (p<0.183). Ostial instability of the Tiger was found more often during engagement of the LCO than the RCO (34.4% vs. 10.8%, p<0.001), whereas it was similar in the LCO and RCO for Judkins catheters (27.4% vs. 26.7%, p = 0.840). TRC-procedures performed with Tiger catheters were associated with less contrast volume (63.48 ± 29.83mL vs. 82.51 ± 56.58mL, p<0.004) and shorter FT than with Judkins catheters. (198.27 ± 194.8sec vs. 326.85 ± 329.70sec). Forearm hematomas occurred less often with the Tiger (1.2% vs. 6.6%, p< 0.02). Conclusion: The Tiger employed as a single catheter in TRC is an effective tool to achieve lower contrast volume and fluoroscopy time at a low complication rate. Unstable engagement affects predominantly the left coronary artery, but its overall frequency is similar for both, the Tiger and Judkins catheters. [ABSTRACT FROM AUTHOR]

Steatocystoma multiplex is a rare disorder of the pilosebaceous unit. We reported Thirty-seven years old female presented with small round lumps in her forearms noticed five years back. The cysts size and number did not increase over the past five years with no redness, pain or itching and no family history of a similar condition. The features of steatocystoma multiplex and its dermatological finding are discussed.

Bone mineral accrual during puberty is important, especially in girls, because it is related to reduced risks of osteoporosis in adulthood. Previous research has shown that jumping or plyometric exercises may be effective in increasing bone mineral density in adolescents. Rope skipping is a form of activity that involves jumping, thus regular skipping may also increase bone mineral density in pubertal girls. To this end, we conducted a quasi-experimental to examine the effects of rope skipping on girls’ bone mineral density and cardiovascular fitness. 176 Hong Kong girls (age = 12.23 ± 1.80 years at baseline) were recruited to take part in the study. Bone density at their forearms and calcanei were measured twice over two academic years (mean time between visits was 10.3 months). Using multilevel modeling analyses and adjusting for participants’ height and physical activity, we found that girls who participated in weekly rope skipping activities, compared to those who did not, had higher levels of bone density at the calcanei (B = 0.023, p < .01). However, no differences were found for bone density at forearms or participants’ cardiovascular fitness. The rates of change of these variables across time were also not significantly different. Results suggest that regular rope skipping may increase girls’ bone density at the lower extremities, irrespective of the amount of self-report physical activity. However, further research is required to examine the potential dose-response relation between skipping behaviors and the measured outcomes. [ABSTRACT FROM AUTHOR]