OBJECTIVE: The aim of the study is measuring the magnitude and determining the method of finger pressure exerted by doctors on ceramic veneers during their fixation.
METHODS: A simulation model was designed in order to measure the volume of finger pressure. Veneers were produced for 2 central incisors. Doctors alternately placed veneers on the model and applied pressure on them for 20 seconds simulating the clinical stage of cementing. The operator recorded the maximum readings of the scales and entered the result on the research protocol. In addition, it was recorded which finger the doctor exerts on the veneer during its cementing to ensure a tight fit: thumb or index finger.
RESULTS: The values obtained during cementation of 54% doctors ranged up to 1 kg, 27% of doctors from 1 to 2 kg and only 19% more than 2 kg. 80% of doctors applied the main pressure on the veneer using their thumb, while the pressure force was 1.4 kg. For those doctors who pressed the veneer to the tooth with their index finger, the impact value was 0.8 kg.
CONCLUSIONS: The finger pressure on the veneer during cementation applied by dentists varies, the average pressure on the veneers was about 1.5 kg. The amount of pressure on cement during laboratory tests of cements for fixing veneers differs from clinical values many times. The development of a veneers fixation protocol, taking into account the conducted research, will ensure a reliable and accurate fit of the veneer at the stage of its cementing.
UNASSIGNED: Измерение величины и определение способа пальцевого давления, оказываемого врачами на керамические виниры во время их фиксации.
UNASSIGNED: Для измерения величины пальцевого давления была спроектирована симуляционная модель. На 2 центральных резца были изготовлены виниры. Врачи поочередно устанавливали виниры на модель и в течение 20 с на них оказывали давление, имитируя клинический этап цементирования. Оператор регистрировал максимальные показания весов и заносил полученный результат в протокол исследования. Кроме того, фиксировали, каким именно пальцем врач оказывает воздействие на винир во время его цементирования для обеспечения плотной посадки: большим или указательным.
UNASSIGNED: Установлено, что 54% врачей во время цементирования оказывают давление на винир до 1 кг, 27% врачей — от 1 до 2 кг, и только 19% врачей — более 2 кг; 80% врачей оказывали основное давление на винир, используя большой палец, при этом сила прижимного давления составила 1,4 кг. У врачей, которые прижимали винир к зубу указательным пальцем, величина воздействия была 0,8 кг.
UNASSIGNED: Пальцевое давление на винир во время его цементирования у разных врачей имеет существенные различия, в среднем давление на виниры составило около 1,5 кг. Давление на цемент во время лабораторных испытаний цементов для фиксации виниров отличается от клинических величин многократно. Разработка протокола фиксации виниров с учетом поведенных исследований обеспечит надежную и точную посадку винира на этапе его цементирования.

Placental DNA methylation (DNAm) may be a potential mechanism underlying the effects of prenatal bisphenol analogues (BPs) exposure on reproductive health. Based on the Shanghai-Minhang Birth Cohort Study (S-MBCS), this study investigated associations of placental DNAm at reproduction-related genes with prenatal BPs exposure and children\'s digit ratios at age 4 using multiple linear regression models, and mediation analysis was further used to examine the mediating role of placental DNAm in the associations between prenatal BPs exposure and digit ratios among 345 mother-child pairs. Prenatal exposure to bisphenol A (BPA) was associated with hypermethylation at Protocadherin 8 (PCDH8), RBMX Like 2 (RBMXL2), and Sperm Acrosome Associated 1 (SPACA1), while bisphenol F (BPF) exposure was associated with higher methylation levels of Fibroblast Growth Factor 13 (FGF13). Consistent patterns were found in associations between higher DNAm at the 4 genes and increased digit ratios. Further mediation analysis showed that about 15% of the effect of BPF exposure on increased digit ratios was mediated by placental FGF13 methylation. In conclusion, the altered placental DNAm status might be a mediator underlying the feminizing effect of prenatal BPs exposure.

BACKGROUND: Dupuytren\'s contractures (DC) are fibrous cords under the skin of the hand that cause one or more fingers to curl gradually and irreversibly towards the palm. These contractures are usually painless but can cause a loss of hand function. Two treatments for Dupuytren\'s contractures are widely used within the National Health Service (NHS) in the UK: removal of the contractures via surgery (limited fasciectomy) and division of the contractures via a needle inserted through the skin (needle fasciotomy). This study aims to establish the clinical and cost-effectiveness of needle fasciotomy (NF) versus limited fasciectomy (LF) for the treatment of DC in the NHS, in terms of patient-reported hand function and resource utilisation.
METHODS: Hand-2 is a national multi-centre, two-arm, parallel-group randomised, non-inferiority trial. Patients will be eligible to join the trial if they are aged 18 years or older, have at least one previously untreated finger with a well-defined Dupuytren\'s contracture of 30° or greater that causes functional problems and is suitable for treatment with either LF or NF. Patients with a contracture of the distal interphalangeal joint only are ineligible. Eligible consenting patients will be randomised 1:1 to receive either NF or LF and will be followed up for 24 months post-treatment. A QuinteT Recruitment Intervention will be used to optimise recruitment. The primary outcome measure is the participant-reported assessment of hand function, assessed by the Hand Health Profile of the Patient Evaluation Measure (PEM) questionnaire at 12 months post-treatment. Secondary outcomes include other patient-reported measures, loss of finger movement, and cost-effectiveness, reported over the 24-month post-treatment. Embedded qualitative research will explore patient experiences and acceptability of treatment at 2 years post-surgery.
CONCLUSIONS: This study will determine whether treatment with needle fasciotomy is non-inferior to limited fasciectomy in terms of patient-reported hand function at 12 months post-treatment.
BACKGROUND: International Standard Registered Clinical/soCial sTudy ISRCTN12525655. Registered on 18th September 2020.

BACKGROUND: Sclerotherapy has shown superior efficacy among the nonsurgical options for managing digital mucous cysts (DMC). Notably, previous research has indicated that bleomycin offers a more favorable side-effect profile and similar efficacy to conventional sclerosing agents.
OBJECTIVE: This study aimed to assess the efficacy and safety of bleomycin intralesional injection (ILI) for treating DMC through a comparative analysis of corticosteroid ILI and surgical excision.
METHODS: We retrospectively reviewed electronic medical records and clinical photographs. Telephone interviews were conducted to further investigate long-term treatment efficacy, safety, and overall treatment satisfaction.
RESULTS: Ten patients underwent surgical excision, and 13 and 15 patients received bleomycin and corticosteroid ILI, respectively. Both surgical excision and bleomycin ILI demonstrated superior treatment efficacy compared to corticosteroid ILI. No statistically significant difference in the treatment effectiveness between surgical excision and bleomycin ILI was observed. No significant adverse effects were observed. In the survey, the level of satisfaction was the highest for bleomycin ILI, followed by surgical excision and corticosteroid ILI.
CONCLUSIONS: This study revealed that bleomycin ILI exhibits a treatment efficacy higher than that of corticosteroid ILI and slightly lower than that of surgical excision, without any side effects. Therefore, bleomycin ILI is a safe and effective therapeutic option for the treatment of DMC.

To address several common problems of finger vein recognition, a lightweight finger vein recognition algorithm by means of a small sample has been proposed in this study. First of all, a Gabor filter is applied to deal with the images for the purpose of that these processed images can simulate a kind of situation of finger vein at low temperature, such that the generalization ability of the algorithm model can be improved as well. By cutting down the amount of convolutional layers and fully connected layers in VGG-19, a lightweight network can be given. Meanwhile, the activation function of some convolutional layers is replaced to protect the network weight that can be updated successfully. After then, a multi-attention mechanism is introduced to the modified network architecture to result in improving the ability of extracting important features. Finally, a strategy based on transfer learning has been used to reduce the training time in the model training phase. Honestly, it is obvious that the proposed finger vein recognition algorithm has a good performance in recognition accuracy, robustness and speed. The experimental results show that the recognition accuracy can arrive at about 98.45%, which has had better performance in comparison with some existing algorithms.

Objective.Diagnosis of incipient acute hypovolemia is challenging as vital signs are typically normal and patients remain asymptomatic at early stages. The early identification of this entity would affect patients\' outcome if physicians were able to treat it precociously. Thus, the development of a noninvasive, continuous bedside monitoring tool to detect occult hypovolemia before patients become hemodynamically unstable is clinically relevant. We hypothesize that pulse oximeter\'s alternant (AC) and continuous (DC) components of the infrared light are sensitive to acute and small changes in patient\'s volemia. We aimed to test this hypothesis in a cohort of healthy blood donors as a model of slight hypovolemia.Approach.We planned to prospectively study blood donor volunteers removing 450 ml of blood in supine position. Noninvasive arterial blood pressure, heart rate, and finger pulse oximetry were recorded. Data was analyzed before donation, after donation and during blood auto-transfusion generated by the passive leg-rising (PLR) maneuver.Main results.Sixty-six volunteers (44% women) accomplished the protocol successfully. No clinical symptoms of hypovolemia, arterial hypotension (systolic pressure < 90 mmHg), brady-tachycardia (heart rate <60 and >100 beats-per-minute) or hypoxemia (SpO2< 90%) were observed during donation. The AC signal before donation (median 0.21 and interquartile range 0.17 a.u.) increased after donation [0.26(0.19) a.u;p< 0.001]. The DC signal before donation [94.05(3.63) a.u] increased after blood extraction [94.65(3.49) a.u;p< 0.001]. When the legs\' blood was auto-transfused during the PLR, the AC [0.21(0.13) a.u.;p= 0.54] and the DC [94.25(3.94) a.u.;p= 0.19] returned to pre-donation levels.Significance.The AC and DC components of finger pulse oximetry changed during blood donation in asymptomatic volunteers. The continuous monitoring of these signals could be helpful in detecting occult acute hypovolemia. New pulse oximeters should be developed combining the AC/DC signals with a functional hemodynamic monitoring of fluid responsiveness to define which patient needs fluid administration.

BACKGROUND: Over 80% of patients with stroke experience finger grasping dysfunction, affecting independence in activities of daily living and quality of life. In routine training, task-oriented training is usually used for functional hand training, which may improve finger grasping performance after stroke, while augmented therapy may lead to a better treatment outcome. As a new technology-supported training, the hand rehabilitation robot provides opportunities to improve the therapeutic effect by increasing the training intensity. However, most hand rehabilitation robots commonly applied in clinics are based on a passive training mode and lack the sensory feedback function of fingers, which is not conducive to patients completing more accurate grasping movements. A force feedback hand rehabilitation robot can compensate for these defects. However, its clinical efficacy in patients with stroke remains unknown. This study aimed to investigate the effectiveness and added value of a force feedback hand rehabilitation robot combined with task-oriented training in stroke patients with hemiplegia.
METHODS: In this single-blinded randomised controlled trial, 44 stroke patients with hemiplegia were randomly divided into experimental (n = 22) and control (n = 22) groups. Both groups received 40 min/day of conventional upper limb rehabilitation training. The experimental group received 20 min/day of task-oriented training assisted by a force feedback rehabilitation robot, and the control group received 20 min/day of task-oriented training assisted by therapists. Training was provided for 4 weeks, 5 times/week. The Fugl-Meyer motor function assessment of the hand part (FMA-Hand), Action Research Arm Test (ARAT), grip strength, Modified Ashworth scale (MAS), range of motion (ROM), Brunnstrom recovery stages of the hand (BRS-H), and Barthel index (BI) were used to evaluate the effect of two groups before and after treatment.
RESULTS: Intra-group comparison: In both groups, the FMA-Hand, ARAT, grip strength, AROM, BRS-H, and BI scores after 4 weeks of treatment were significantly higher than those before treatment (p < 0.05), whereas there was no significant difference in finger flexor MAS scores before and after treatment (p > 0.05). Inter-group comparison: After 4 weeks of treatment, the experimental group\'s FMA-Hand total score, ARAT, grip strength, and AROM were significantly better than those of the control group (p < 0.05). However, there were no statistically significant differences in the scores of each sub-item of the FMA-Hand after Bonferroni correction (p > 0.007). In addition, there were no statistically significant differences in MAS, BRS-H, and BI scores (p > 0.05).
CONCLUSIONS: Hand performance improved in patients with stroke after 4 weeks of task-oriented training. The use of a force feedback hand rehabilitation robot to support task-oriented training showed additional value over conventional task-oriented training in stroke patients with hand dysfunction.
BACKGROUND: NCT05841108.

The emergence of the pointing gesture is a major developmental milestone in human infancy. Pointing fosters preverbal communication and is key for language and theory of mind development. Little is known about its ontogenetic origins and whether its pathway is similar across different cultures. The goal of this study was to examine the theoretical proposal that social pointing is preceded by a non-social use of the index finger and later becomes a social-communicative gesture. Moreover, the study investigated to which extent the emergence of social pointing differs cross-culturally. We assessed non-social index-finger use and social pointing in 647 infants aged 3- to 24 months from 4 different countries (China, Germany, Japan, and Türkiye). Non-social index-finger use and social pointing increased with infants\' age, such that social pointing became more dominant than non-social index-finger use with age. Whereas social pointing was reported across countries, its reported frequency differed between cultures with significantly greater social pointing frequency in infants from Türkiye, China, and Germany compared to Japanese infants. Our study supports theoretical proposals of the dominance of non-social index-finger use during early infancy with social pointing becoming more prominent as infants get older. These findings contribute to our understanding of infants\' use of their index finger for social and non-social purposes during the first two years of life.

Recent evidence suggests that using finger-based strategies is beneficial for the acquisition of basic numerical skills. There are basically two finger-based strategies to be distinguished: (a) finger counting (i.e., extending single fingers successively) and (b) finger number gesturing (i.e., extending fingers simultaneously to represent magnitudes). In this study, we investigated both spontaneous and prompted finger counting and finger number gesturing as well as their contribution to basic numerical skills in 3- to 5-year-olds (N = 156). Results revealed that only 6% of children spontaneously used their fingers for counting when asked to name a specific number of animals, whereas 59% applied finger number gesturing to show their age. This indicates that the spontaneous use of finger-based strategies depends heavily on the specific context. Moreover, children performed significantly better in prompted finger counting than in finger number gesturing, suggesting that both strategies build on each other. Finally, both prompted finger counting and finger number gesturing significantly and individually predicted counting, cardinal number knowledge, and basic arithmetic. These results indicate that finger counting and finger number gesturing follow and positively relate to numerical development.

BACKGROUND: This study aimed to investigate the associations of digital ulcers (DUs) in patients with systemic sclerosis (SSc).
METHODS: This retrospective study investigated the demographic characteristics, specific autoantibodies, organ involvement, and laboratory tests in patients with SSc from our hospital.
RESULTS: This study enrolled 144 patients with SSc. The DU+ group consisted of 15 (10.4%) patients. Patients with SSc having DUs have longer disease duration, higher fibrinogen, higher fibrin degradation product, and lower cholesterol. None of the patients used cholesterol-lowering drugs before onset of DUs. The study also demonstrated a higher prevalence of anti-dsDNA and anti-histone antibodies in patients with SSc with DUs. Anti-dsDNA antibody is a specific antibody for SLE with a specificity of 96-99%. A total of 86.1% (124/144) of patients suffered from diffuse cutaneous SSc, and 28.5% (41/144) of patients suffered from overlap syndrome.
CONCLUSIONS: Our study indicated that patients with SSc with fibrinogen of >2.895 g/L (p = 0.043) and cholesterol of <3.340 mmol/L (p = 0.036), which is equal to 129.258 mg/dL, are at high risk of developing DUs.