BACKGROUND: As acute myocardial infarction (AMI) prevalence is increasing because of lifestyle changes, the incidence of atypical symptoms in acute coronary syndrome (ACS) is rising and making misdiagnosing of this fatal event more probable. To better approach the patients with atypical symptoms, we tend to present a rare case of AMI with wrist pain.
METHODS: A 41-year-old man presented to the emergency room (ER) with severe both-hand wrist pain and mild epigastric pain. His electrocardiogram (ECG) showed anterior ST-elevation myocardial infarction (MI) with an ejection fraction of 35-40%. His angiography showed severe left anterior descending artery (LAD), and first obtuse marginal artery (OM1) artery stenosis. He underwent Primary percutaneous coronary intervention (PCI). The patient recovered without serious complications and was discharged the day after PCI.
CONCLUSIONS: In this rare case of AMI with wrist pain, it is important to know that atypical symptoms can be present at various levels of symptoms, which prevents future misdiagnosis.

BACKGROUND: Closing the control loop between users and their prostheses by providing artificial sensory feedback is a fundamental step toward the full restoration of lost sensory-motor functions.
METHODS: We propose a novel approach to provide artificial proprioceptive feedback about two degrees of freedom using a single array of 8 vibration motors (compact solution). The performance afforded by the novel method during an online closed-loop control task was compared to that achieved using the conventional approach, in which the same information was conveyed using two arrays of 8 and 4 vibromotors (one array per degree of freedom), respectively. The new method employed Gaussian interpolation to modulate the intensity profile across a single array of vibration motors (compact feedback) to convey wrist rotation and hand aperture by adjusting the mean and standard deviation of the Gaussian, respectively. Ten able-bodied participants and four transradial amputees performed a target achievement control test by utilizing pattern recognition with compact and conventional vibrotactile feedback to control the Hannes prosthetic hand (test conditions). A second group of ten able-bodied participants performed the same experiment in control conditions with visual and auditory feedback as well as no-feedback.
RESULTS: Conventional and compact approaches resulted in similar positioning accuracy, time and path efficiency, and total trial time. The comparison with control condition revealed that vibrational feedback was intuitive and useful, but also underlined the power of incidental feedback sources. Notably, amputee participants achieved similar performance to that of able-bodied participants.
CONCLUSIONS: The study therefore shows that the novel feedback strategy conveys useful information about prosthesis movements while reducing the number of motors without compromising performance. This is an important step toward the full integration of such an interface into a prosthesis socket for clinical use.

BACKGROUND: Fractures of the distal radius in childhood are frequent but rarely lead to relevant growth disturbances.
OBJECTIVE: The experiences of a pediatric trauma center over 15 years are exemplarily presented and discussed.
METHODS: Osteotomies of the distal radius were selected and the clinical and radiological findings were recorded and analyzed.
RESULTS: Posttraumatic growth disturbances were corrected in 10 cases with a median age of 13 ½ years. In six cases an iatrogenic cause was also possible. In two cases callus distraction with secondary palmar plate osteosynthesis was used for consolidation. In eight cases primary ad hoc corrections were carried out using palmar plate osteosynthesis (six with iliac crest and two with allogeneic grafts). In five cases the distal ulnar growth plate was also addressed. During follow-up breakage of one plate was registered. After an average of 31 months postoperatively, 9 children had full range of motion (ROM) and in 1 case there was an extension deficit of 10o.
CONCLUSIONS: It is important to evaluate the cause of the mostly partially inhibiting growth disturbances to draw preventive conclusions. From a clinical perspective the visible deformity is given priority and the pain and functional limitations are less relevant. The indications for corrective surgery must include the age of the patient, remaining growth potential, size and localization of the growth plate bridge, the deformity and the individual wishes of patients and parents. In most cases a full correction is possible with palmar plate osteosynthesis and an iliac crest graft. External fixation and callus distraction is an alternative in cases where the correction is more extensive. The distal ulnar growth plate should be controlled concerning further growth potential before hardware removal.
UNASSIGNED: HINTERGRUND: Distale Radiusfrakturen im Kindesalter sind häufig, führen aber selten zu relevanten Wachstumsstörungen.
UNASSIGNED: Die Erfahrungen eines kindertraumatologischen Zentrums über 15 Jahre sollen exemplarisch dargestellt und diskutiert werden.
METHODS: Nach Selektion der Osteotomien am distalen Radius wurden klinische und radiologische Daten erfasst und analysiert.
UNASSIGNED: Zehn posttraumatische Wachstumsstörungen wurden bei Patienten im mittleren Alter von 13 ½ Jahren korrigiert. In 6 Fällen war eine iatrogene Mitursache möglich. Zwei Kallusdistraktionen (mit sekundärer palmarer Plattenosteosynthese) stehen 8 primären Ad-hoc-Korrekturen mithilfe einer palmaren Platte (5-mal mit Beckenkammspan, 2‑mal mit allogenem Interponat) gegenüber. In 5 Fällen wurde zusätzlich die distale Ulnafuge adressiert. Im Verlauf wurde ein Plattenbruch registriert. Nach im Mittel 31 Monaten war in 9 Fällen die „range of motion“ (ROM) seitengleich; einmal bestand ein Extensionsdefizit von 10o.
CONCLUSIONS: Bei den meist partiellen hemmenden Wachstumsstörungen sind kausal iatrogene Ursachen zu evaluieren, um präventive Schlüsse ziehen zu können. Klinisch steht die sichtbare Deformität bei Kindern klar im Vordergrund; Schmerz und Funktionsstörungen sind weniger relevant. Die Indikation zur Korrektur muss Patientenalter, verbliebene Wachstumspotenz, Breite und Lokalisation der Fugenbrücke, die Deformität und die Patienten‑/Elternwünsche einbeziehen. Meist kann ad hoc mithilfe einer palmaren Platte und eines Beckenkamminterponats korrigiert werden; ein Fixateur zur Kallusdistraktion ist die Alternative bei größerem Korrekturumfang. Bei der Metallentfernung sollte die distale Ulnafuge nochmals auf weiteres Wachstumspotenzial überprüft werden.

Human-Machine Interfaces (HMIs) have gained popularity as they allow for an effortless and natural interaction between the user and the machine by processing information gathered from a single or multiple sensing modalities and transcribing user intentions to the desired actions. Their operability depends on frequent periodic re-calibration using newly acquired data due to their adaptation needs in dynamic environments, where test-time data continuously change in unforeseen ways, a cause that significantly contributes to their abandonment and remains unexplored by the Ultrasound-based (US-based) HMI community. In this work, we conduct a thorough investigation of Unsupervised Domain Adaptation (UDA) algorithms for the re-calibration of US-based HMIs during within-day sessions, which utilize unlabeled data for re-calibration. Our experimentation led us to the proposal of a CNN-based architecture for simultaneous wrist rotation angle and finger gesture prediction that achieves comparable performance with the state-of-the-art while featuring 87.92% less trainable parameters. According to our findings, DANN (a Domain-Adversarial training algorithm), with proper initialization, offers an average 24.99% classification accuracy performance enhancement when compared to no re-calibration setting. However, our results suggest that in cases where the experimental setup and the UDA configuration may differ, observed enhancements would be rather small or even unnoticeable.

Tai Chi is a Chinese martial art that provides an adaptive and accessible exercise for older adults with varying functional capacity. While Tai Chi is widely recommended for its physical benefits, wider adoption in at-home practice presents challenges for practitioners, as limited feedback may hamper learning. This study examined the feasibility of using a wearable sensor, combined with machine learning (ML) approaches, to automatically and objectively classify Tai Chi expertise. We hypothesized that the combination of wrist acceleration profiles with ML approaches would be able to accurately classify practitioners\' Tai Chi expertise levels. Twelve older active Tai Chi practitioners were recruited for this study. The self-reported lifetime practice hours were used to identify subjects in low, medium, or highly experienced groups. Using 15 acceleration-derived features from a wearable sensor during a self-guided Tai Chi movement and 8 ML architectures, we found multiclass classification performance to range from 0.73 to 0.97 in accuracy and F1-score. Based on feature importance analysis, the top three features were found to each result in a 16-19% performance drop in accuracy. These findings suggest that wrist-wearable-based ML models may accurately classify practice-related changes in movement patterns, which may be helpful in quantifying progress in at-home exercises.

To gain insights into the impact of upper limb (UL) dysfunctions after breast cancer treatment, this study aimed to develop a temporal convolutional neural network (TCN) to detect functional daily UL use in breast cancer survivors using data from a wrist-worn accelerometer. A pre-existing dataset of 10 breast cancer survivors was used that contained raw 3-axis acceleration data and simultaneously recorded video data, captured during four daily life activities. The input of our TCN consists of a 3-axis acceleration sequence with a receptive field of 243 samples. The 4 ResNet TCN blocks perform dilated temporal convolutions with a kernel of size 3 and a dilation rate that increases by a factor of 3 after each iteration. Outcomes of interest were functional UL use (minutes) and percentage UL use. We found strong agreement between the video and predicted data for functional UL use (ICC = 0.975) and moderately strong agreement for %UL use (ICC = 0.794). The TCN model overestimated the functional UL use by 0.71 min and 3.06%. Model performance showed good accuracy, f1, and AUPRC scores (0.875, 0.909, 0.954, respectively). In conclusion, using wrist-worn accelerometer data, the TCN model effectively identified functional UL use in daily life among breast cancer survivors.

UNASSIGNED: The wrist is a complex joint that plays a role in several everyday tasks. Various radiological indices have been created to assess the alignment and structure of the wrist using standard X-ray images. Nevertheless, these indicators may differ based on variables such as age, gender, ethnicity, handedness, and wrist position. This research aimed to assess the radiological indices of the wrist in a group of healthy people from Jordan and investigate the impact of age and gender on these indices.
UNASSIGNED: We obtained data from a sample of 385 patients who presented at our hospital with minor non-specific wrist pain and satisfied the specified criteria for inclusion. We conducted measurements of radial inclination, radial height, volar tilt, ulnar variance, and carpal height ratio using both anteroposterior and lateral views of the wrist. We used linear regression and independent sample t-test to examine the correlation between age, gender, and radiological indicators. The reliability of the measurements was assessed using the intraclass correlation coefficient (ICC).
UNASSIGNED: Our study revealed a negative correlation between age and carpal height ratio (r = -0.13, p = 0.03). However, no significant gender differences were seen in any of the radiological indices (p > 0.05). Our findings indicate that ulnar variance had the greatest level of reliability across observers, with an intra-observer intraclass correlation coefficient (ICC) of 0.95 and an inter-observer ICC of 0.8. Conversely, volar tilt exhibited the lowest inter-observer reliability, with an ICC of 0.1.Our results provide a valuable point of reference for the wrist morphology and alignment in the Jordanian population. Our suggestion is that the carpal height ratio might indicate alterations in the wrist joint due to aging, whereas ulnar variation may serve as a dependable indicator of wrist alignment. We suggest doing more research to investigate the biological and anatomical factors behind these results and to compare them with other demographic groups.

Scapholunate ligament lesion is the most common ligament lesion in the wrist. We assessed the reliability of sonography in detecting it during Watson test. Twenty patients with scapholunate ligament lesion confirmed on MRI and intraoperatively were assessed preoperatively between July 2020 and April 2023. Sonography was performed on the scaphoid dorsal subluxation in wrist neutral and during Watson test and compared with the healthy contralateral side. Dorsal subluxation was measured by two independent investigators and intra- and inter-observer reliability were assessed. We found a significant difference between dorsal subluxation of the scaphoid in the healthy (0.89 mm, SD 0.67 mm) compared to the pathological side (1.67 mm, SD 0.95 mm). Reliability was very good and the standard error of measurement was less than 0.4 mm for all measurements. Sonography during Watson test demonstrated high reliability in diagnosing scapholunate lesions. LEVEL OF EVIDENCE: III.

Chronic disease management and follow-up are vital for realizing sustained patient well-being and optimal health outcomes. Recent advancements in wearable technologies, particularly wrist-worn devices, offer promising solutions for longitudinal patient monitoring, replacing subjective, intermittent self-reporting with objective, continuous monitoring. However, collecting and analyzing data from wearables presents several challenges, such as data entry errors, non-wear periods, missing data, and wearable artifacts. In this work, we explore these data analysis challenges using two real-world datasets (mBrain21 and ETRI lifelog2020). We introduce practical countermeasures, including participant compliance visualizations, interaction-triggered questionnaires to assess personal bias, and an optimized pipeline for detecting non-wear periods. Additionally, we propose a visualization-oriented approach to validate processing pipelines using scalable tools such as tsflex and Plotly-Resampler. Lastly, we present a bootstrapping methodology to evaluate the variability of wearable-derived features in the presence of partially missing data segments. Prioritizing transparency and reproducibility, we provide open access to our detailed code examples, facilitating adaptation in future wearable research. In conclusion, our contributions provide actionable approaches for improving wearable data collection and analysis.

OBJECTIVE: This study aimed to assess clinical, functional and radiological outcomes after three-corner arthrodesis in patients suffering from symptomatic scapholunate or scaphoid non-union advanced collapsed wrists. We hypothesised that three-corner arthrodesis provided satisfactory clinical and radiological results in the long term.
METHODS: This was a retrospective study of 13 patients (14 wrists) who underwent a three-corner arthrodesis between March 2004 and January 2019 with a mean follow-up of 6,7 years. Clinical assessment consisted of wrist motion, grip strength, pain and functional scores (Quick-DASH, PRWE, MWS). All complications and surgical revisions were investigated. Radiographic assessment searched for union, evaluated carpal height and ulnar translation, lunate tilt and occurrence of radio-lunate arthritis.
RESULTS: At the last follow-up Quick-DASH and PRWE scores were 24,87(± 17.2) and 47.4 (± 26.9) respectively and were significantly improved. Wrist motion was 35°, 32°, 10° et 24° of flexion, extension, radial and ulnar deviation respectively. Union was obtained for 13 (92,9%) wrists. The mean radiolunate angle was 11° (-17°-34°). Three patients needed reintervention, which 2 consisted of total wrist arthrodesis due to persisting pain. Mild signs of radio-lunate arthritis were found in three patients.
CONCLUSIONS: Three-corner arthrodesis seemed to provide satisfactory long-term functional outcomes. The union rate was high and even patients with signs of radio-lunate arthritis still had improved outcomes at the last follow-up. It could be a part of surgical options in wrists with radio- and midcarpal arthritis, among other procedures.