This study investigates the inheritability of lip print and fingerprint patterns among family members, thereby to enhance forensic identification methods and contribute to genetic research on human traits. The study was initiated after obtaining institutional human ethical clearance. The sample comprised of 213 participants from 57 families, the research analysed the correlation between lip and fingerprint patterns, focusing on gender differences and inheritance of lip and finger patterns among the family members. The Chi-square test was used to find the association between the lip prints and fingerprints among the study participants. P value < 0.05 was considered as statistically significant. The findings revealed that type II branched lip prints (39.9%) and whorl fingerprints (58.68%) were predominant among participants, with significant gender differences ( P < 0.000). Though the overall association between lip prints and fingerprints was not statistically significant ( P = 0.344), a strong correlation was reported between the gender ( P < 0.000). The inheritance patterns indicated a higher familial correlation for lip prints among son and son (100%) compared to fingerprints, suggesting a genetic influence on these traits. The study underscores the potential of integrating lip prints into forensic practices alongside traditional fingerprinting methods, advocating for further exploration of biometric characteristics in personal identification and familial inheritance.
Deciding between multiple options in a split second is a crucial aspect in various domains, including traffic, aviation, policing, and sports. Both drift-diffusion modeling (DDM), a computational model that approaches decision-making as noisy evidence accumulation, and finger tracking have been suggested to capture the evolution of a decision over time. In this study, we comparatively applied DDM and finger tracking to examine the processes underlying split-second decision-making within an anticipatory handball penalty task. Participants were shown temporally occluded videos of handball penalties and predicted shot direction by either pointing or continuously swiping toward one of two target areas. We extended previous research by using an optical motion capture system to track trajectories of both pointing and swiping and also calculated drift-diffusion models grouped by response modality. Results indicate that the DDM robustly mirrors the decision-making process. The model reflects the movement differences between pointing and swiping accurately in the non-decision time and shows consistent correlations between response modalities. In contrast, the finger tracking parameters (i.e., area under the curve, velocity, x-flips, and entropy) did not show consistent correlations between pointing and swiping trials and were strongly dependent on response modality. Furthermore, the effect of the response modality manipulation could not be clearly identified by finger tracking parameters. We conclude that DDM when compared to finger tracking seems to provide more modality-invariant insights into the processes underlying decision-making across different response tasks (i.e., modalities).
Fingertip and nail bed injuries present a clinical challenge, requiring restoration of sensory, functional, and cosmetic integrity without donor-site morbidity. Multilayer dermal regeneration templates (DRTs), including Integra and Terudermis, offer a promising alternative to traditional flap techniques. This retrospective comparative study included 30 patients with Allen type I-III fingertip injuries treated at a tertiary medical center in Taiwan between January 2020 and December 2022. Reconstructions utilized Integra (n = 12) or Terudermis (n = 18). At 6 months, outcomes were assessed for wound-healing efficacy, cosmetic appearance, sensory recovery, functional restoration, and patient satisfaction. Data were analyzed using the Mann-Whitney U test and Fisher exact test (P < 0.05). Both Integra and Terudermis achieved comparable outcomes (P > 0.05). Differences in finger length (0.37 cm) and nail bed area (0.34 cm2) were minimal. Vancouver Scar Scale scores ranged from 4 to 5. The mean 2-point discrimination on the affected side was 5.83 mm, with a 13.4% incidence of hook nail. Average distal interphalangeal joint range of motion was 79.0 degrees, and patient satisfaction averaged 4.8 out of 5. Complete epithelialization occurred within 38.9 days. Multilayer DRTs are effective for fingertip and nail bed reconstruction, offering comparable healing efficiency, reliable sensory and functional recovery, and favorable cosmetic and patient-reported outcomes. Integra and Terudermis demonstrated comparable outcomes, supporting their use as viable, donor-site-free options in fingertip reconstruction.
Finger millet (Eleusine coracana (L.) Gaertn.) is a resilient yet underutilized cereal with exceptional potential to withstand adverse environmental conditions. Despite its adaptability, the genetic and physiological bases of its stress tolerance remain insufficiently characterized and poorly integrated into modern crop improvement pipelines. This review critically evaluates current knowledge of finger millet responses to major abiotic stresses such as drought, salinity, temperature extremes, and heavy metal toxicity with the aim of identifying key regulatory nodes and translational opportunities. At the physiological level, finger millet displays notable plasticity through modulation of root system architecture, transpiration efficiency, and leaf structural traits. Biochemically, it accumulates osmoprotectants such as proline, enhances antioxidant enzyme activities, and activates detoxification pathways to mitigate cellular damage. These responses are orchestrated by diverse molecular regulators, including transcription factors, signaling proteins, and stress-responsive genes. However, a clear framework connecting physiological traits to molecular regulation remains lacking. Recent advances in genomics, transcriptomics, proteomics, and metabolomics provide powerful tools for dissecting complex stress adaptation networks. Furthermore, CRISPR/Cas9-mediated genome editing offers new avenues for precise trait enhancement. Yet, the incorporation of these technologies into breeding programs is still limited, particularly regarding genotype-phenotype associations and evaluation under multi-stress field conditions. This review highlights the integration of physiological, biochemical, and molecular strategies as a roadmap for precision breeding in finger millet. By linking molecular insights to practical agronomic outcomes, we advocate repositioning finger millet as a model system for developing climate-resilient cereals.
This study aimed to clinically evaluate a digital biomarker, the Finger Fold Index (FFI), derived from the ratio of joint diameter to finger fold surface area in hand photographs, for the assessment of joint swelling in inflammatory arthritis. Smartphone hand photographs from patients with rheumatoid (RA) and psoriatic arthritis (PsA) were analyzed using a machine learning pipeline for automated detection and processing of joint diameter and finger folds at the proximal interphalangeal (PIP) joints. The FFI was clinically evaluated by correlation with joint swelling scores (0-3) and DAS28-CRP. A healthy cohort was used to establish FFI cut-offs, which were then compared to the arthritis cohorts. A total of 1275 PIP joint images of 124 arthritis patients and 53 healthy individuals were included. FFI values correlated with swelling scores in the arthritis population with r = 0.443 (95% CI 0.384-0.498), while mean FFI values were weakly correlated with DAS28-CRP dichotomized at 3.2 (r = 0.310; 95% CI 0.123-0.475). ROC analysis showed moderate discriminative performance of the prediction models for PIP joint swelling (2-4), with AUCs ranging from 0.664 to 0.786 (95% CI 0.615-0.868). Notably, diagnostic performance was characterized by low specificity. FFI values exceeding the healthy cut-offs were associated with swelling (Cramer's V = 0.400-0.631; p < 0.001) with the strongest association observed in cases of more pronounced swelling (grade 3). Longitudinal studies are needed to assess sensitivity to change and to establish whether this biomarker can be used for remote patient monitoring. Further refinement of the algorithm is warranted, as current diagnostic accuracy remains insufficient for clinical implementation. However, integration with additional clinical information, such as patient-reported outcomes, may improve performance and support future applicability in clinical practice.
Microsurgical procedures demand precise hand-eye coordination, yet the surgeon's hands often remain outside the visual field until instruments enter the microscope view, impairing spatial awareness. We developed the finger-touch approach (FTA) to provide an additional proprioceptive reference point, hypothesizing it would improve safety and confidence without compromising efficiency. A simulation task was designed to replicate microsurgical suture-cutting assistance, one of the most common procedures performed by a microsurgery assistant. Postgraduate-year 1 to 2 junior residents (JR), and plastic surgery residents/fellows (PSF) performed the task using two approaches: a conventional method and the FTA, which involved touching the instrument to the assistant's index finger before entering the microscopic field. The number of unintended contacts, time to reach the microscopic field, and trajectory variability were measured. Microsurgical precision and psychological responses were compared between the methods. Eighteen JRs and five PSFs participated. FTA significantly reduced unintended contacts among JRs compared with the conventional approach (0.1 vs. 0.0, p = 0.003), without affecting the time to reach the field or trajectory variability. In contrast, no significant differences were observed among PSFs. Posttask questionnaire revealed higher positive psychological responses among JRs compared with PSFs in comfort with the FTA (94.4% vs. 40.0%, p = 0.021) and interest in incorporating the technique into actual surgery (100% vs. 60.0%, p = 0.040). FTA improves safety and psychological comfort among novice microsurgical assistants. The technique requires minimal instruction without additional equipment, making it readily implementable in training programs and clinical practices for beginners.
In this study, raw finger millet (FM) and solid-state fermented finger millet (FFM) were incorporated into composite noodles (FMN and FFMN respectively) by replacing wheat flour at 0%, 5%, 10%, and 15% substitution levels. The cooking quality, textural properties, tensile properties, sensory attributes and in vitro digestibility of noodles were evaluated. Results indicated that FM and FFM addition shortened the optimal cooking time of noodles, significantly enhanced free phenolic content (from 15.70 mg/g to 23.04 mg/g for FMN, and to 24.83 mg/g for FFMN), and reduced the extent of starch digestion (the estimated maximum starch hydrolysis extent decreased from 86.60% to 73.15% for FMN and 68.52% for FFMN). However, the hardness of FMN increased while that of FFMN decreased. Noticeably, FFMN exhibited superior performance to those with FMN, and FFMN with 10% substitution exhibited best sensory characteristics. This study offered a new strategy for the application of FFM in noodles.
Trigger finger (stenosing tenosynovitis) reflects abnormal tendon-pulley mechanics, primarily at the A1 pulley; however, objective assessment during functional motion remains limited in routine clinical practice. We evaluated electrical contact resistance (ECR) from a wearable tactile sensor during standardized digit motion and examined its association with symptoms. Nine participants with Green grade II-III trigger finger were prospectively enrolled. An origami-inspired pentagon-knot graphene-paper tactile sensor measured ECR over the A1 and A2 pulleys during repeated flexion-extension cycles. A 4-week intervention program (electrical stimulation plus infrared irradiation; three sessions per week) enabled repeated measurements. ECR and patient-reported outcomes were collected at weekly Tuesday assessments, with ECR recorded immediately before and after the session (ECRpre and ECRpost). Outcomes included pain (visual analog scale [VAS]) and triggering severity (ST), frequency (FT), and functional impact (FIT). Within-session change was defined as ΔECRsession = ECRpre - ECRpost. Analyses used linear mixed-effects models, repeated-measures correlation (rmcorr; rrm coefficient) and week-adjusted fixed-effects regression. Sensor placement and recording were feasible, with no adverse events. Across 27 paired weekly sessions (Weeks 1-4), ECR decreased from pre- to post-session at both pulleys (model-estimated mean ΔECRsession: A1 0.0795; A2 0.0990; both P < 0.001). A1 ECRpre declined over Weeks 1-4 (rrm = - 0.672; P = 0.0016). At matched weekly timepoints (N = 6; n = 24), A1 ECRpre correlated with VAS (rrm = 0.781; P < 0.001), FT (rrm = 0.578; P = 0.0095), and ST (rrm = 0.543; P = 0.0164), but not FIT (rrm = 0.165; P = 0.50). Larger A1 ΔECRsession values were associated with greater subsequent week-to-week pain improvement (rrm = 0.625; P = 0.0042). In a fixed-effects model adjusting for week, A1 ECRpre independently predicted VAS (β = 29.19; P = 0.018). Wearable ECR sensing was safe and feasible in this pilot study and demonstrated consistent within-session responsiveness. Clinically, motion-acquired ECR may serve as an objective adjunct for tracking session-level changes and week-to-week status with symptom scales. Retrospectively registered at ChiCTR (ChiCTR2600120811 approved).
Sexual maturation and fertility of the malaria causing parasite, Plasmodium spp., is critical to transmission between hosts. This developmental process involves an intricate gene expression regulatory network that drives gametocyte commitment, development, and the production of male and female gametes. Here, we characterized the role of the CCCH-type zinc-finger protein Plasmodium falciparum Male Development 3 ( Pf MD3) in the formation of gametes. Genetic disruption of Pf MD3 revealed a male fertility defect that decreased infectivity to mosquitoes. Molecular characterization of Pf MD3 revealed its binding to mRNA transcripts associated with male gamete development through a specific RNA sequence. Gametocyte proteins encoded by these Pf MD3-bound transcripts decreased significantly in Pf MD3 knockout parasites, suggesting that Pf MD3 impacts translation. In addition to RNA-binding, Pf MD3 also interacts with proteins involved in mRNA processing and nuclear export that influence translational regulation. This study establishes Pf MD3 as an RNA-binding protein that impacts lineage-specific translation and male gamete fertility.
Different formulas are being used to determine the internal diameter (ID) of the cuffed endotracheal (ET) tube in pediatric patients. Recently, a new formula was proposed to predict the ET tube size based on middle finger length (MFL). The aim of this study was to determine the accuracy of this new formula in predicting the cuffed ET tube and to compare it with other commonly used formulas. This comparative observational study was carried out among 120 samples of children up to 12 years of age undergoing surgery under general anesthesia after taking their consent. All the details regarding the patient's age, height, weight, and MFL were collected a day before surgery and the ET tube details and the predicted ET tube size by the five formulae were collected on the day of surgery. They were entered into Microsoft Excel sheet and analyzed using STATA software version 17. Out of 120 study participants, the fraction of patients in whom the exact ID of cuffed ET tube was correctly predicted with the MFL, age-based formulas (ABFs), height-based formula (HBF), weight-based formula (WBF), and Multivariate prediction tool (MPT) formula were 20%, 18.3%, 0%, 3.3%, and 0.8%, respectively. The predicted ID size within 0.5 mm difference excluding the exact fit for MFL formula, ABF, HBF, WBF, and MPT formula was 20.8%, 57.5%, 12.5%, 30.8%, and 22.5%, respectively. The predicted ID size potentially too big >0.5 mm difference for MFL formula, ABF, HBF, WBF, and MPT formulas were 59.2%, 24.2%, 87.5%, 65.8%, and 76.7%, respectively. Pearson correlation coefficient for all the formulas was r > 0.80 and shows a strong positive correlation which was statistically significant (P < 0.001). ABFs were more accurate compared to other formulae in predicting the ET tube size in case of pediatric patients, but in children less than 5 years of age, MFL formula was a better predictor than other formulas. Résumé Contexte et objectif:Différentes formules sont utilisées pour déterminer le diamètre interne (DI) de la sonde endotrachéale (ET) à ballonnet chez les patients pédiatriques.Récemment, une nouvelle formule a été proposée pour prédire la taille de la sonde ET en fonction de la longueur du majeur (LM). L’objectif de cette étude était de déterminer la précision de cette nouvelle formule pour prédire la taille de la sonde ET à ballonnet et de la comparer à d’autres formules couramment utilisées.Matériel et méthodes:Cette étude observationnelle comparative a été menée auprès de 120 enfants âgés de 12 ans et moins, subissant une intervention chirurgicale sous anesthésie générale après avoir obtenu leur consentement. Toutes les données concernant l’âge, la taille, le poids et la LM des patients ont été recueillies la veille de l’intervention. Les données relatives à la sonde ET et la taille de la sonde prédite par les cinq formules ont été recueillies le jour de l’intervention. Les données ont été saisies dans une feuille Microsoft Excel et analysées à l’aide du logiciel STATA version 17.Résultats:Sur 120 participants à l’étude, la proportion de patients chez lesquels le diamètre interne exact de la sonde endotrachéale à ballonnet a été correctement prédit par la formule MFL, les formules basées sur l’âge (ABF), la formule basée sur la taille (HBF), la formule basée sur le poids (WBF) et la formule test de prédiction multivarié (MPT)était respectivement de 20 %, 18,3 %, 0 %, 3,3 % et 0,8 %.La proportion de diamètres internes prédits à moins de 0,5 mm de la valeur exacte, hors ajustement parfait, était respectivement de 20,8 %, 57,5 %,12,5 %, 30,8 % et 22,5 % pour les formules MFL, ABF, HBF, WBF et MPT. La taille du diamètre interne prédite potentiellement trop grande (différence > 0,5 mm) pour les formules MFL, ABF, HBF, WBF et MPT était respectivement de 59,2 %, 24,2 %, 87,5 %, 65,8 % et 76,7 %. Le coefficient de corrélation de Pearson pour toutes les formules était r > 0,80 et montre une forte corrélation positive statistiquement significative (P < 0,001).Conclusion:Les formules ABF étaient plus précises que les autres formules pour prédire la taille de la sonde endotrachéale chez les patients pédiatriques, mais chez les enfants de moins de 5 ans, la formule MFL était un meilleur prédicteur que les autres formules.
Bony and soft tissue hand injuries are common and their ensuing management can result in adhesions between tendons and the surrounding bone, soft tissues or inserted hardware. Knowledge of the patterns of motion restriction imparted by different adhesions has implications for rehabilitation protocols following injury or surgery. The aim of this study was to quantify the degree and pattern of digital motion loss due to adhesions at various levels of the flexor apparatus in a cadaveric model. Ten cadaveric limbs underwent range of motion assessment of the digits in a standardized fashion. Simulated adhesions were performed by applying suture anchors at the level of the middle phalanx, before subsequently being excised and further adhesions performed at the level of the proximal phalanx. The range of motion of the metacarpophalangeal (MCPJ), proximal (PIPJ) and distal interphalangeal joints (DIPJ) were recorded for each measurement. Following the placement of a simulated adhesion between the flexor digitorum superficialis and FDP tendons at the level of the proximal phalanx, median total flexion reduced by 32.6°, predominantly occurring at the level of the DIPJ. Extension decreased by 9.2°. When a simulated adhesion was placed between the FDP tendon and middle phalanx, median total flexion reduced by 14.4°, predominantly occurring at the DIPJ. Extension decreased by 8.6°. Adhesions in the flexor apparatus led to restrictions in both flexion and extension range, with DIPJ flexion being disproportionately affected. Interestingly, adhesions at different locations yielded similar patterns of motion loss, likely secondary to the FDPs substantial role in digital flexion. These findings may inform hypothesis for clinical practice and may assist in the future management of flexor tendon injuries, though must be taken in the context of a cadaveric, FDP dominant model.
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The Finger iridectomy technique (FIT) utilizes the capabilities of small-gauge, machine-controlled, aspiration-cutter technology within visco-elastic stabilized and optimized anterior segment. A small diameter inked blade was used to create a beveled, self-sealing corneal incision. Visco-elastic was introduced to fill and manipulate the iris away from the target tissue. Then, the tubular, blunt-tipped, 27-gauge device with its single side port is placed onto the tumor where tumor parts are aspirated into and sliced by its internal guillotine blade. The liberated cells and microchunks collect within the aspiration-cutter shaft and effluent tubing assisted by machine-assisted, and surgeon-modulated aspiration. After the removal of the aspiration cutter from the eye, a 3 mL syringe was attached to the blue connector of the effluent tubing. Then, the tip of the aspiration cutter was placed in a small cup of balanced salt solution used to wash through and thus move the specimen into the syringe. Two aspiration passes were required. The visco-elastic was removed to prevent the post-operative increase in eye pressure. This technique was found to provide both cells for cytology and tissue for histology and immuno-histochemical analysis. In addition, the use of visco-elastic and the ability to both aspirate and cut allows for evacuation of secondary hemorrhage. Compared to manually controlled aspiration and sharp-tipped needles used for fine-needle aspiration biopsy (FNAB), FIT's aspiration-cutter-assisted biopsy herein described has provided enhanced tissue yield, minimal complications, and no vision loss. This video provides details on the surgical technique, to facilitate its adoption, and integration into clinical practice.
This paper introduces a soft hand exoskeleton based on an underactuated biomimetic pulley differential mechanism for fingers flexion including the thumb. The mechanism is powered by a single motor, enabling adaptive movement of the thumb, index and middle fingers to accommodate irregularly shaped objects. Unlike the existing pulley differential mechanisms, the proposed pulley differential design couples the thumb with the index and middle fingers and enforces a mechanical force constraint, where the thumb force is always equal to the combined forces of the index and middle fingers. This provides equilibrium grasp across infinite hand poses without individual finger control. To achieve a range of grasps, the device is equipped with three solenoids that allow deactivation of individual fingers. The grasping kinetics for the proposed mechanism are tested experimentally on eight able bodied subjects. The results demonstrate that the mechanism achieves a stable grasp on both regular and irregular shaped objects, with a minimal and acceptable alteration in the finger positions compared to their normal human poses. Power grasps exert grasping forces of 10.3 N and 11.5 N on regular and irregular shapes, respectively, with maximum finger pose changes of approximately 9.8% and 8.9% from the full range of joint motion. Pinch grasp deactivates the middle finger, enabling the thumb and index finger to provide a sufficient grasp of approximately 7N on both sides. This mechanism concept show potential for performing diverse daily activities requiring various hand poses.
The degree to which motor and psychosocial functions may recover following hand and upper-extremity transplantation (HUET) remains unclear. This study quantifies HUET outcome changes in the first 10 years post-transplantation to provide insight into this question. A systematic review of PubMed, Embase, Cochrane, and Medline yielded 2104 records; 118 articles were included in the final review. HUETs above the proximal third of the forearm were designated as proximal and the remaining distal. Semmes-Weinstein Monofilament (SWMF) test, grip strength, Kapandji, finger and thumb total active range of motions (TAROMs), Carroll, Short Form 36 (SF-36), Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), and Hand Transplantation Score System (HTSS) were recorded according to patient and postoperative year (POY). Ninety-seven patients were identified between 1998 and 2025. Distal HUETs' SWMF improved from POY1 (4 [4-4]) to POY2 (5 [4-6]). Power grip remained constant for distal and proximal HUETs, but proximal HUETs recovered less than distal HUETs (4.51 ± 1.49 kg vs 7.33 ± 0.71 kg). Lateral pinch strengths did not differ between groups. Proximal HUETs' lateral grips demonstrated sustained improvement after POY3. Bilateral HUETs demonstrated higher SF-36 scores than unilateral HUETs across POY1-10. HTSS measured significant improvements in distal HUETs increasing from 65 (57-79.5) (POY1) to 76 (71-85) by POY3, while proximal HUET only improved from POY1 (61 [45-70.5]) at POY8-10 (82.5 [72-91.5]). Finger TAROMs remained largely unchanged after POY1 while distal and proximal Kapandji thumb opposition scores improved at POY3-6 and POY8-10, respectively. Transplant level influenced recovery of power grip and HTSS. HUET power grip strength and finger TAROM stabilized after POY1 while lateral grip, Kapandji scores, HTSS, and SWMF showed improvements in the decade following transplantation, mostly for distal HUETs. Bilateral HUETs had better psychosocial (SF-36) outcomes than unilateral HUETs, but no difference in DASH scores. Therapeutic IV.
Nontraumatic posterior interosseous nerve (PIN) palsy is an uncommon entrapment neuropathy, and there is limited evidence regarding ultrasound-guided nerve mobilization as part of rehabilitation. Here, we report a case of PIN palsy associated with a ganglion cyst in the radial tunnel, focusing on the clinical course and ultrasound-based evaluation of nerve morphology and motion. The patient presented with dorsal forearm pain, marked weakness of the fingers, and thumb extension. Ultrasonography revealed a hypoechoic ganglion compressing and flattening the PIN near the arcade of Frohse. The initial management consisted of weekly ultrasound-guided aspiration of the ganglion combined with conventional physical therapy, including low-frequency electrical stimulation, stretching, and active-assist exercises for finger extension. Although pain decreased promptly after decompression, motor recovery remained limited, and follow-up ultrasonography showed persistent nerve flattening and reduced longitudinal gliding. Therefore, an ultrasound-guided nerve mobilization program was added to restore nerve gliding around the compression site while continuously monitoring the nerve and its surrounding structures. Over subsequent sessions, finger extension strength and hand function improved in parallel with a reduction in the nerve cross-sectional area, normalization of the flattening ratio, and qualitative recovery of nerve sliding on ultrasonography. This case suggests that ultrasound-guided nerve mobilization may be a useful adjunct to decompression and exercise therapy in PIN palsy related to ganglion compression and highlights the value of serial ultrasound assessment, including quantitative evaluation such as particle image velocimetry (PIV), for guiding and validating rehabilitation in peripheral nerve disorders.
Chronic arm and hand hemiparesis is a major cause of disability after stroke. Unfortunately, standard-of-care rehabilitation falls well short of the high doses required to experience improvements. In this feasibility study, we explored the use of cervical epidural spinal cord stimulation (SCS) to assist motor function and provide meaningful functional improvements without the need of a high-dose rehabilitation program. Here we report the final outcomes of this study testing safety, feasibility and preliminary efficacy of cervical SCS as a neuroprosthetic approach for chronic post-stroke upper limb hemiparesis. We implanted seven participants with profound motor deficits (Fugl-Meyer Assessment (FMA) scores 15-35) using two leads implanted unilaterally in the cervical spinal cord for 4 weeks. No serious adverse events occurred. Under SCS ON, motor function immediately improved regardless of impairment severity (average +32% strength and +5.6 FMA points). Notably, three of seven participants with residual corticospinal connectivity to finger muscles improved hand/finger movement with SCS. Despite performing only 8.6 hours of motor activity (5.5 hours with SCS ON), participants improved by an average of +6.6 FMA points at the end of the study compared to baseline, and spasticity decreased in all participants. Although all benefited, our preliminary analysis indicates that spared sensory function may be a determinant of responsiveness to SCS. These findings provide preliminary evidence of the safety, feasibility and efficacy of cervical SCS for chronic post-stroke hemiparesis, suggesting its potential as a fully implantable neuroprosthetic solution for assisting upper limb function in daily living. ClinicalTrials.gov identifier: NCT04512690 .
Human telomerase processively adds telomeric repeats (dGGTTAG) to chromosome 3'-ends to maintain telomere length. While mostly absent in somatic cells, telomerase is aberrantly upregulated in most tumor cells to sustain cellular immortality, making it a promising oncology target. However, to date there are no reported structures of human telomerase with inhibitor, impeding structure-based drug design and optimization. We report nine cryo-electron microscopy structures of human telomerase with and without BIBR1532, a highly selective small-molecule telomerase inhibitor. Unexpectedly, BIBR1532 binds a previously unknown pocket between TERT finger and palm. BIBR1532 inhibits each step but disproportionately affects the rate-limiting first step of telomere repeat nucleotide addition. The structures reveal a rigid finger that explains telomerase's slow rate and low fidelity. Our study provides insights into telomerase catalytic mechanism and its inhibition by BIBR1532, explains why prior BIBR derivatives did not improve potency and suggests a rational approach for design of small-molecule telomerase inhibitors.
The rapid growth of climbing has led to an increase in climbing-related injuries, particularly finger pulley injuries, which account for up to 20% of all climbing injuries. These injuries result from sport-specific gripping techniques that place supra-maximal loads on the flexor tendon-pulley system, most notably during crimp gripping. This review summarizes the anatomy and biomechanics of the finger pulley system, common mechanisms of injury, and associated risk factors. Clinical evaluation, including key physical examination findings and the role of imaging-especially dynamic ultrasound-is discussed. Injury grading guides management, with most pulley injuries treated conservatively through immobilization, taping or splinting, and structured rehabilitation, while severe injuries may require surgical intervention. Evidence-based recommendations for rehabilitation, prevention strategies, and graded return-to-sport protocols are presented to assist clinicians, therapists, and coaches in optimizing recovery and minimizing reinjury risk in climbers.
EMR, an Endoplasmic Reticulum Associated Degradation (ERAD)-Mediating RING finger E3 ligase initially identified as an ER-resident protein, was unexpectedly detected in the cytoplasm under ER stress conditions. This unanticipated subcellular distribution prompted us to explore the uncharacterized functions of cytoplasmic EMR. Using an integrated approach that combines bioinformatics, biochemical, and physiological analyses, we show that EMR also acts as a specific heat-responsive regulator. Heat exposure causes Zn2+ to dissociate from the RING finger domain of EMR, triggering a conformational change from monomeric to oligomeric form driven by increased hydrophobicity. This structural reorganization, mediated by Zn2+ coordination, transforms EMR's function from an E3 ligase to a molecular chaperone. Importantly, this functional switch contributes significantly to plant thermotolerance, as EMR's chaperone activity effectively prevents heat-induced protein unfolding and aggregation of vital cellular proteins. Consequently, transgenic Arabidopsis lines overexpressing EMR in an EMR-null-mutant (emr) background, 35S:EMR, showed significantly improved thermotolerance compared to wild-type and emr plants. The critical role of EMR's chaperone activity in conferring heat stress resistance was further substantiated by the observation that 35S:EMR(C/S) plants, in which EMR(C/S) primarily retains chaperone function, exhibited heat stress tolerance comparable to that of 35S:EMR plants. Proteomic profiling after heat shock identified candidate client substrates of EMR's chaperone activity, which are mainly involved in critical cellular processes such as protein translation and energy metabolism, highlighting EMR's broad cytoprotective role. Overall, these results demonstrate that the bifunctional properties of EMR are essential for environmental stress recognition and adaptive signaling, thereby driving thermotolerance in plants.