Clenched Fist Research Articles

Trisomy 18: Prenatal Diagnosis and Outcome in a Tertiary Care Fetal Medicine Center in South India

AbstractEdwards' syndrome (trisomy 18) is the second most common aneuploidy known in humans, with an overall incidence of 1 in 6,000 live births. It occurs due to the presence of complete or part of an extra copy of chromosome 18 in all or a few body cells of the affected fetus, and it causes major anomalies in the organ systems. Despite this, an accurate diagnosis is often not made antenatally due to its very varied phenotype and the subtle nature of some of the common and consistent findings associated with this condition. This leads to lapses or delays in cytogenetic confirmation as well as delays in decision regarding termination of pregnancies with this mostly lethal fetal aneuploidy. We describe the prenatal profile of 45 confirmed cases of trisomy 18 at a tertiary fetal medicine unit. The presence of a combination of ultrasound (US) findings described in these cases will help alert sonologists and clinicians to suspect this condition and offer a confirmative cytogenetic test without delay for prenatal diagnosis. This study describes the prenatal diagnostic profile of cytogenetically confirmed trisomy 18 cases in a tertiary fetal medicine center in India. A retrospective analysis of records of 45 prenatally diagnosed trisomy 18 cases at a single tertiary fetal medicine center over a period of 11 years was done. Data were collected to describe maternal demography, indication for evaluation, major and minor US findings (trimester-wise), type of invasive test, and gestational age at diagnosis. Outcomes in terms of pregnancy termination, miscarriage, stillbirth, or livebirth were documented. Presenting at a mean maternal age and gestation age of 31.7 years and 22 + 5 weeks, respectively, 41/45 (91%) fetuses showed major and 40/45 (89%) showed minor US findings with an overall US sensitivity of 100%. The most common major US finding was a cardiac anomaly in 26 (57.8%) patients, while clenched fist with pointing index finger, observed in 17 (37.8%) cases, was the most common minor US finding. Fetal growth restriction (FGR) was noted in 20 (44.4%) patients. After cytogenetic confirmation, 37.8% underwent termination, 17.8% had a fetal demise, and only 11.1% had live birth with the longest survival noted at 5.5 months postnatally. Gender was documented in 13 fetuses with a male-to-female ratio of 0.6. A meticulously performed US examination can detect a combination of anomalies that could alert the sonologist to the possibility of trisomy 18. While the US profile could vary among fetuses, an understanding of the spectrum of the anomalies commonly seen in these fetuses would enable caregivers to reach an early accurate diagnosis, and offer appropriate genetic counseling and pregnancy decisions in these cases.

Validation of the Clenched Fist View in Detecting Scapholunate Ligamentous Injury.

The purpose of this study was to determine the predictive value of the clenched fist stress views in identifying scapholunate ligament injuries. An institutional review board-approved retrospective chart review was conducted of adult patients who underwent diagnostic arthroscopy with a ligamentous wrist injury from 2015 to 2020. Standard posteroanterior, lateral, and clenched fist stress radiographs were reviewed and scapholunate ligament gaps recorded. A total of 124 patients were included, of which 88 had normal standard radiographs and clenched fist radiographs. The positive predictive value of the clenched fist view was 69%, whereas the negative predictive value was 58%. The sensitivity of the clenched fist view was 40%, while the specificity was 82%. Of those patients with a negative clenched fist view, 42% were found to have an arthroscopic Geissler classification of 3 or higher scapholunate ligament injury. Despite the emphasis on stress radiographic views, a normal stress clenched fist view does not preclude arthroscopic findings of a Geissler class 3 or greater injury in symptomatic patients. The sensitivity of a clenched fist view is only 40%. These findings question the utility of stress radiographs when assessing for scapholunate ligament injuries.

Carpal instability after partial trapeziectomy, total trapeziectomy and the resection of the distal scaphoid pole: a cadaveric study.

Non-dissociative carpal instability (CIND) may lead to severe functional impairment. Destabilisation of the scapho-trapezial-trapezoidal (STT) ligament complex seems to result in a CIND. In one group with eight cadaver arms, distal scaphoid pole was resected with the adjacent ligaments. In the other eight cadavers, hemitrapeziectomy was performed followed by total trapeziectomy. CT scans were performed in different wrist positions, and the changed positions of the scaphoid, lunate and capitate were measured in comparison to non-operated wrists. Mainly in clenched fist position, dissociation between proximal and distal row can be determined after total trapeziectomy and resection of distal scaphoid pole. Capitate rotates dorsally up to 24°, the scaphoid up to 17° and the lunate up to 7° compared to the non-operated wrists. Resection of the distal scaphoid pole results in dorsal rotation of capitate and scaphoid of about 14° and the lunate 8°. Relative scapholunate and capitolunate angle increased significantly after total trapeziectomy, especially in clenched fist position. After scaphoid pole resection, significant SL and CL angles changescould be seen in almost every wrist position. Destabilisation of the STT ligament complex by total trapeziectomy or distal scaphoid pole resection results in dissociation of the proximal and distal carpal row without instability within the proximal or distal row, corresponding to a CIND. III.

BUBANJ MEMORIAL PARK: A MEMORIAL TO THE VICTIMS OF NAZI TERROR AND MASS EXECUTIONS IN WORLD WAR II

The "Bubanj" Memorial complex, locate on Bubanj Hill at the outskirts of Niš, was built with the aim of marking the site of mass executions of the innocent victims of Nazism in the Second World War. It is a symbol of suffering but also of resistance, struggle and desire for freedom, embodied in the symbolic depiction of three huge clenched fists. The "Three fists” symbolize resistance and defiance against fascism. They are a recurrent reminder of the importance of freedom as the supreme human value. The paper first briefly presents the eugenics policy, which was the ideological basis of Nazism and ferocious Nazi crimes. Then, the authors outline the historical circumstances leading to the establishment of the Concentration Camp Crveni krst in Niš and Bubanj Hill as the execution site. The central part of the paper focuses on the construction of the Bubanj memorial complex, its importance in the post-war Yugoslav society, and its current position on the cultural map of Serbia. While calling attention to the agony sustained by victims of Nazi terror in these parts of Serbia, the authors highlight the strength and resilience of the people who endeavored to preserve and defend freedom and right to dignified life as ultimate human values.

Stimulus-Response Compatibility During Fighting Task Simulation: Influences of the Opponent's Spatial Codes on the Accuracy and Response Time.

Manual Reaction Time measures have been widely used to study interactions between perceptual, cognitive, and motor functions. The Stimulus-Response Compatibility is a phenomenon characterized through faster Manual Reaction Times when stimuli and response locations coincide (correspondent condition) than when they are on different sides (noncorrespondent condition). The present study adapted a protocol to study if the Stimulus-Response Compatibility effect can be detected during a virtual combat simulation. Twenty-seven participants were instructed to defend themselves by clicking a key in order to block the presented punch. Videos of two fighters were used, granting two types of basic strokes: the back fist, a punch performed with the dorsal part of the fighter's hand, starting at the opposite side to which it is directed; and the hook punch, performed with a clenched fist starting and finishing ipsilaterally. The Manual Reaction Times were different between the correspondent and noncorrespondent conditions, F(1, 26) = 9.925; p < .004; η2 = .276, with an Stimulus-Response Compatibility effect of 72ms. Errors were also different, F(1, 26) = 23.199; p < .001; η2 = .472, between the correspondent (13%) and the noncorrespondent conditions (23%). The study concluded that spatial codes presented at the beginning of the punch movement perception substantially influenced the response execution.

Postoperative Management Early Active Mobilization of Extensor Tendon Repair at Zone (V-VII)

Background: The extensor tendons are particularly vulnerable to trauma because their superficial location in a clenched fist, the thin mobile subcutaneous tissue offers little protection, and lacerations of the extensor tendons are common over joints that are easily exposed to contamination. Objective: To assess the evaluation of the postoperative early active mobilization protocol of extensor tendon repair at zone (V-VII). Methods: In this prospective study was carried out at Orthopedic Dept., 250 Bed General Hospital, Kishoreganj, Bangladesh from January to June 2023. Total 40 cases of fresh injury of extensor tendon at zone V to VII were treated. A protocol of early active mobilization was undertaken, using an easy to follow rehabilitation plan. Routine history taking with details of the injury, the object causing the injury, the dominant hand and the position during the injury, Physical examination, included the zone, and the possible tendons involved together with any associated injury. Results: Forty patients of fresh extensor tendon injuries were included in this study, their ages ranged from 20 to 55 years. There were 33 males (82.5%) and 7 females (17.5%). The dominant hand was involved in 29 of patients (72.5%). The nature of injuries was sharp cut in 34 patients (85%), with crush injuries in 6 patients (15%). The most common site of injuries was zone VI, VII and zone V respectively, and the most common tendon injured was EDC, EI, and EDM. Only 7 patients (17.5%) had single tendon injury, While 33 patients (82.5%) had multiple tendon injuries. At the end of the 6th weeks post operatively, the overall outcome result are summarized. Conclusion: The early mobilization of repaired extensor tendon reduces the formation of adhesion as compared to rigid immobilization. We recommend the use of this protocol following extensor tendon repair in the hand at zone V, VI, and VII in cooperative patient. It will give fairly acceptable results.

OnabotulinumtoxinA Treatment of Upper Limb Spasticity: Analysis of US Practice Patterns From the ASPIRE Study

<h3>Research Objectives</h3> To examine onabotulinumtoxinA (onabotA) utilization patterns within 8 additional muscle groups consistent with updated US label in patients with upper limb (UL) spasticity from the Adult Spasticity International Registry (ASPIRE) study over a 2-year period1-6. <h3>Design</h3> Multicenter, prospective, observational study (NCT01930786). <h3>Setting</h3> US clinical sites. <h3>Participants</h3> Adult patients who received onabotA to UL muscles for spasticity. <h3>Interventions</h3> Total onabotA dose ≤400 U per treatment session consistent with US label. <h3>Main Outcome Measures</h3> OnabotA treatment utilization. <h3>Results</h3> Of 443 US patients, 336 had UL spasticity, 45 of whom received ≤400 U onabotA injections in selected muscles consistent with the newly approved label. Mean age (SD) was 51.3 (16.0) years, 26 (58%) were male, and 23 (51%) were onabotA-naive. Postures treated included clenched fist (71.1%), flexed wrist (55.6%), flexed elbow (73.3%), thumb in palm (20.0%), intrinsic plus hand (20.0%), and pronated forearm (31.1%). Treated postures presenting in patients who received onabotA injections only in muscles consistent with label before July 2021 included clenched fist (93.8%), flexed wrist (100%), flexed elbow (12.1%), and thumb in palm (33.3%). Treated postures in patients who received onabotA injections in muscles consistent with the expanded label in July 2021 included clenched fist (100%), flexed wrist (100%), flexed elbow (100%), thumb in palm (100%), intrinsic plus hand (100%), and pronated forearm (100%). The majority of patients (80.0%) had >1 abnormal posture. Of 38 adverse events (AEs), 1 treatment-related AE (muscular weakness) and no treatment-related serious AEs were reported. <h3>Conclusions</h3> This ASPIRE post hoc analysis provides real-world evidence of the opportunity to educate on the expanded label for onabotA, highlighting elbow, forearm, and finger postures and the ability to treat, on-label, multiple UL postures more holistically. <h3>Author(s) Disclosures</h3> GEF: Consultant for, research grants from Allergan (an AbbVie company), Ipsen, Merz. WF: Research grants: NIH. MCM: Research support: AbbVie, Merz; Advisory board: Ipsen, Pacira. KN: Nothing to report. M Schwartz: Biostatistical consultant: Allergan (an AbbVie company). M Sadeghi, AZ: Employee: AbbVie. AE: Consultant: Allergan (an AbbVie company), Ipsen, Merz; Research grants: Allergan (an AbbVie company), Ipsen.

벽사 정재만류 승무 호흡에 나타난 소매틱 움직임 ‘BA’ 원리연구

This study aims to find out the basic principles for education and treatment applying the ‘BA’ Principles of somatic movements to the high, normal, and low breathings shown in BJJS. As a result, firstly, ‘to breathe well’ is upper breathing(exhalation) found in the “gideng(기덩)” upper/flat/lower breathing shown in the 3st small beat of the 1st beat of Hangeul Janggo’s vocal sound, which is shown in all the courses of BJJS. This awakens Myeongmunhyeol and relaxes and lifts up diaphragm to control the thorax to be narrower. And, using drumstick, the awakening of the high breathing with a clenched fist arouses Sobuhyeol(少府穴) and Nogung(勞宮) to enhance the Hwagang (火降) of the heart and its outer membrane when upper/flat/lower breathing(inhalation) is going down. Secondly, ‘to align the body(Align)’ is the awakening of the flat breathing found in upper/flat/lower breathing that is found to be the heavenly mind of the seat of the heart(mind), the central danjeon among the three danjeon’s of Jeong-Shin-Gi. Therefore, BJJS can seek for emotional stability with a sound body through good Breathing of high/normal/low breathings, Aligning of body with heavenly mind, to move the body in an arranged manner. The implication of this study is to provide a steppingstone for avatar breathing of the dancing of BJJS, based on body breathing.

Sankara Is Not Dead, dir. Lucie Viver

<i>Sankara Is Not Dead,</i> dir. Lucie Viver

The Long Christmas Dinner, Abbey Theatre, Dublin, Ireland

<i>The Long Christmas Dinner</i>, Abbey Theatre, Dublin, Ireland

Levine’s Sign Points to Spontaneous Coronary Artery Dissection in a Healthy Young Male

Levine’s sign is a universal sign of ischemic chest pain, defined as an individual holding a clenched fist over the chest that has a low sensitivity but is relatively specific for ischemia. Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic and a very unusual cause of acute myocardial infarction.In literature, it has been more common in young women, postpartum, or with fibromuscular dysplasia. Strenuous exercise is a rare cause of SCAD. We describe a case of a healthy 46-year-old Hispanic male who presented to ER after his morning gym session. The initial EKG was unremarkable. However, due to Levine's sign, a repeat EKG was done and showed hyperacute T waves with J-point elevation in the anterior leads. An immediate coronary angiogram revealed a spontaneous coronary artery dissection in the mid-left anterior descending artery (LAD) segment. Given the resolution of the chest pain and thrombolysis in myocardial infarction (TIMI) 3 flow, no intervention was done. The patient was managed medically with an uneventful recovery. In the current times, with the advent of high sensitivity troponin along with other rapid multimodality imaging techniques, the importance of physical signs and symptoms like Levine's sign has diminished. Yet, they still remain a vital part of patient evaluation. Additionally, SCAD is uncommon in males. However, this patient was consuming energy booster powder that may have predisposed him to the SCAD. In our opinion, Levine's sign still has high clinical value in the right context. We also postulate that energy booster supplements may have serious deleterious cardiovascular effects, and large studies are necessary to understand their full effects on the cardiovascular system.

25, 50 &amp; 75 years ago

25, 50 &amp; 75 years ago

Validity and reliability of the novel three-item occupational violence patient risk assessment tool.

AimTo develop and psychometrically test an occupational violence (OV) risk assessment tool in the emergency department (ED).DesignThree studies were conducted in phases: content validity, predictive validity and inter‐rater reliability from June 2019 to March 2021.MethodsFor content validity, ED end users (mainly nurses) were recruited to rate items that would appropriately assess for OV risk. Subsequently, a risk assessment tool was developed and tested for its predictive validity and inter‐rater reliability. For predictive validity, triage notes of ED presentations in a month with the highest OV were assessed for presence of OV risk. Each presentation was then matched with events recorded in the OV incident register. Sensitivity and specificity values were calculated. For inter‐rater reliability, two assessors—trained and untrained—independently assessed the triage notes for presence of OV risk. Cohen's kappa was calculated.ResultsTwo rounds of content validity with a total of N = 81 end users led to the development of a three‐domain tool that assesses for OV risk using aggression history, behavioural concerns (i.e., angry, clenched fist, demanding, threatening language or resisting care) and clinical presentation concerns (i.e., alcohol/drug intoxication and erratic cognition). Recommended risk ratings are low (score = 0 risk domain present), moderate (score = 1 risk domain present) and high (score = 2–3 risk domains present), with an area under the curve of 0.77 (95% confidence interval 0.7–0.81, p < .01). Moderate risk rating had a 61% sensitivity and 91% specificity, whereas high risk rating had 37% sensitivity and 97% specificity. Inter‐rater reliability ranged from 0.67 to 0.75 (p < .01), suggesting moderate agreement.ConclusionsThe novel three‐domain OV risk assessment tool was shown to be appropriate and relevant for application in EDs. The tool, developed through a rigorous content validity process, demonstrates acceptable predictive validity and inter‐rater reliability.ImpactThe developed tool is currently piloted in a single hospital ED, with a view to extend to inpatient settings and other hospitals.

Clinical and molecular cytogenetic description of a female patient with de novo 18q inversion duplication/deletion

The genetic causes of global developmental delay (GDD) and intellectual disability (ID) are heterogeneous. Chromosomal imbalance has been recognized as the most frequent cause of ID for years. We describe the report of a female patient aged 1 year and 5 months at presentation who had GDD, prenatal growth retardation, failure to thrive, microcephaly, dysmorphic facial features including: broad forehead, high anterior hair line with sparse scalp hair, wide palpebral fissures, long eye lashes, blue sclera, sparse arched eye brows, prominent and wide nasal root, hypertelorism, micrognathia and dysplastic low set ears in addition to widely spaced nipples, bilateral clenched fists, camptodactyly, rocker bottom feet and brittle nails.. Her karyotype revealed 46,XX,add (18)(q23). Comprehensive cytogenomic analysis was performed using multiplex ligation-dependent probe amplification (MLPA), fluorescence in situ hybridization (FISH), and aCGH techniques to determine the parental origin and the possible mechanism responsible for this abnormal karyotype. Both parents had normal karyotypes. MLPA and FISH analysis for the patient revealed deletion of 18q subtelomere, and whole chromosome paint (WCP) associated with inverted DAPI indicated that all the duplicated segments originated from chromosome 18 and there was inversion of 18q segment. Array CGH identified 55.8-Mb duplicated segment and 614-kb deleted terminal 18q. Single nucleotide polymorphism (SNP) analysis for the patient and the parents revealed that the duplicated and deleted 18q regions originated from paternal chromosome 18. These findings suggested that the event occurred during paternal meiosis or early postzygotic stage. The suggested mechanism responsible for this type of rearrangement is nonhomologous end point recombination and U-type exchange.

OnabotulinumtoxinA Treatment in Patients with Upper Limb and Lower Limb Spasticity from the ASPIRE Study

Research Objectives Examine onabotulinumtoxinA utilization in patients with upper limb (UL) and lower limb (LL) spasticity from the Adult Spasticity International Registry (ASPIRE) study to gain real-world insights into the treatment of spastic hemiparesis. Design Prospective, observational registry (NCT01930786). Setting International clinical sites. Participants Adults with spasticity across multiple etiologies. Interventions OnabotulinumtoxinA at the clinician's discretion. Main Outcome Measures OnabotulinumtoxinA utilization and safety data were collected at each treatment session. Patients with spastic hemiparesis were defined as receiving ≥ 1 UL treatment and ≥ 1 LL treatment during the study. Results ASPIRE patients (N=730) were on average 53.6 years old, 52%; female, 77% Caucasian, 37% naive to botulinum toxin(s) for spasticity, and 56% post-stroke. Of N=730, n=284 patients were defined as hemiparetic. In hemiparetic patients treated for UL and LL at the same session (n=275), the mean total dose of onabotulinumtoxinA was 477 U for UL+LL, 257 U for UL, and 220 U for LL. Of n=275 hemiparetic patients, 56%; had a treatment interval of 10-15 weeks, 62% had 5-15 injections/session, and 82% had >5 muscles injected/session. Clenched fist was the most common UL presentation (n=219 patients), with 55% of sessions to the left side only. Equinovarus foot was the most common LL presentation (n=238 patients), with 52% of sessions to the left side only. Of the hemiparetic population (n=284), 115 patients (41%) reported 375 adverse events; 42 patients (15%) reported 80 serious adverse events. No new safety signals were identified. Conclusions This preliminary analysis from ASPIRE provides valuable, real-world evidence on the use of onabotulinumtoxinA to treat patients with combined upper limb and lower limb spasticity. OnabotulinumtoxinA was most frequently utilized to treat clenched fist (UL) and equinovarus foot (LL) in patients with spastic hemiparesis. Author(s) Disclosures Bavikatte: Consultant for Allergan(AbbVie); Francisco: Consulted/research grants from Allergan(AbbVie), Merz, and Ipsen; Esquenazi: Consulted for Allergan(AbbVie), Ipsen, and Merz. Received research grants from Allergan(AbbVie) and Ipsen; Dimyan: None reported; Ngo: None reported; Schwartz: Statistical consultant for Allergan(AbbVie); Zuzek: AbbVie employee; Jost: Speaker/consultant for Allergan(AbbVie), Ipsen, and Merz.

Avoiding Ring Avulsion Injuries With Silicone Rings: A Biomechanical Study

Finger avulsion injuries account for 5% of upper extremity injuries requiring evaluation in an emergency room. They are devastating injuries that require microvascular reconstruction or amputation. As public awareness rises, there is a growing market for silicone rings, with limited data on their ability to prevent ring avulsion injuries. Five cadaver forearms were attached to a custom fixture, allowing for ring avulsion simulations. Specifically designed silicone or metal rings of varying sizes (#4-#11) were assigned to one of five fingers on each forearm, based on fit. The contralateral corresponding finger was tested using a ring of the same size in the other material. A preload of 2 N was applied to each ring, and ultimate failure force was determined by applying an upward force at a loading rate of 500 mm/sec until failure. Additionally, a fifth cadaver forearm was used to determine the ultimate failure force of silicone rings in a clenched fist position. The average ultimate failure force for silicone rings of all sizes was 53.0 N, compared to 495.2 N for metal rings of all sizes. The average ultimate failure force of silicone rings in the clenched fist position was increased across rings of all sizes, with an average of 99.9 N. There were no degloving injuries in the silicone ring avulsion group. Biomechanically, silicone rings have a significantly lower failure force than metal rings and may help prevent ring avulsion injuries. The use of silicone rings should be encouraged in professions where ring avulsion injuries are more likely, such as heavy labor.

Kinematic analysis of two scapholunate ligament reconstruction techniques.

This study compares the kinematic changes after the procedures for scapholunate interosseous ligament (SLIL) reconstruction-the modified Brunelli technique (MBT) and Mark Henry's technique (MHT). Ten cadaveric wrists were used. The scapholunate (SL) interval and angle and radiolunate (RL) angle were recorded using the MicroScribe system. The SL interval was measured by dividing the volar and dorsal portions. Four motions of the wrist were performed-neutral, flexion, extension, and clenched fist (CF) positions-and compared among five conditions: (1) intact wrist, (2) volar SLIL resection, (3) whole SLIL resection, (4) MBT reconstruction, and (5) MHT reconstruction. Under the whole SLIL resection condition, the dorsal SL intervals were widened in all positions. In all positions, the dorsal SL intervals were restored after MBT and MHT. The volar SL interval widened in the extension position after volar SLIL resection. The volar SL interval was not restored in the extension position after MBT and MHT. The SL angle increased in the neutral and CF positions under the whole SLIL resection condition. The SL angle was not restored in the neutral and CF positions after MBT and MHT. The RL angle increased in the neutral and CF positions under the whole SLIL resection condition. The RL angle was not restored in the neutral and CF positions after MBT and MHT. The MBT and MHT may restore the dorsal SL interval. No significant differences in restoration of the SL interval between MBT and MHT were found in the cadaveric models. No significant differences between MBT and MHT were found in the cadaveric models for SLIL reconstruction. When considering the complications due to volar incision and additional procedures in MHT, MBT may be a more efficient technique in terms of operative time and injury of the anterior structures during surgery, but further research is needed.

Charting Change in the City: Urban Political Orders and Urban Political Development

Cities matter. They are often the sites in which the helping hand and the clenched fist of the state makes first contact with the citizen. They are engines of national economic growth and, often, the source of political movements that become national and transnational in scope. Yet, the theoretical tools available to study change at the urban level are limited. This article seeks to address this shortcoming by offering a new account of urban political development. I argue that urban political development is driven by the impact of multiple political orders. My aim is to highlight three apparently contradictory patterns of urban political development: the imposition of urban austerity measures, the rise of the urban carceral state, and the emergence of progressive economic policymaking, such as local minimum wage ordinances. I suggest that these shifts reflect underlying operation and competition among neoliberal, conservative and egalitarian political orders respectively.

Echoing Abundance: Public Art and Mutual Aid in Pandemic New Orleans

Echoing AbundancePublic Art and Mutual Aid in Pandemic New Orleans Gwen Dilworth (bio) New Orleans is a city of murals. The walls of the city—stores, abandoned buildings, electric utility boxes, warehouses, highway underpasses—are swathed in images, stories, and dreams for the city. Just as New Orleans has a distinct sound (to me, of trumpets, car horns, feet stomping, the roar under the elevated I-10 highway), it has a similar optical noise that encompasses the visual landscape. Public art tells the story of New Orleans and its people, at every turn. In the weeks after the initial COVID-19 stay-at-home order was issued in New Orleans, the city went quiet. Gone were the cacophonous sounds of Mardi Gras, replaced with an intense, reverberating quiet. Even Bourbon Street was empty; the city had transformed into a ghost town overnight. New Orleans was struggling. The virus was spreading rapidly across Louisiana, and cases in the city were some of the highest in the nation. The stark inequalities in New Orleans were painfully laid bare for all to see. The underfunded public health infrastructure in the city couldn’t support rising cases. COVID-19 was spreading at rapid speed in jails and prisons. Houseless individuals had no place to isolate. Hopelessness was leaking out everywhere, and the quiet in the city was resounding. Six months later, in December, driving down Washington Avenue near Cajun Seafood, a bright mural emerged in my line of sight. It stands a story high, covering the side of the Fast Stop Meat Market and overlooking an empty parking lot. Three bright fists—blue, purple, and pink—rise out of an alligator-occupied garden. Butterflies flit between the clenched fists, and beneath it, a banner waves, reading: “The People United Will Never Be Defeated” (Figure 1). Observing the mural, completed by artist Zac Maras in July, one can almost hear the echoes of the protests that wrapped through the streets this summer and fall. Following the horrific killing of George Floyd, [End Page 97] protests shattered the reverberating quiet in New Orleans, and residents poured into the streets to advocate for a city without policing, alongside protections for workers, accessible healthcare, and an end to evictions. The butterflies, darting between saturated fists, appear as a symbol of the transformation that might grow from the fertile ground of protest. Maras’s mural stands as a testament to the people of New Orleans coming together to envision and demand change, arms outstretched, united. Click for larger view View full resolution Figure 1. Zac Maras, The People United Will Never Be Defeated, 2020, mural, Washington Avenue, New Orleans. Photograph by the author. New Orleans is, of course, no stranger to catastrophe or hardship. Nor is it a stranger to the values that have kept the city afloat during difficult times: community, care, and connection. New Orleans has a long history of mutual aid, centered around historically Black Mutual Aid and Pleasure Clubs. As the pandemic has reinforced long-existing inequalities in the city, new systems of care have formed to support New Orleans’ most vulnerable residents. Since the pandemic began in March, mutual aid networks have erupted in New Orleans, filling the gaps in community needs and giving neighbors the tools to support one another. These networks have emerged as Facebook groups for individuals to offer or request aid, organizations making and distributing meals to houseless [End Page 98] individuals, and individuals sharing plants and seeds for others to grow their own food. Mutual aid is a political act, not a charitable one. Mutual aid is a project of community care and collective liberation, of working cooperatively to meet the needs of one’s community. Like in many cities across the nation, mutual aid in New Orleans has developed as a radical alternative to abandonment, hopelessness, and despair. Mutual aid operates on the principle that we have the skills and resources to care for one another even when our government can not or will not, and that these acts of care can serve to cultivate abundance and community. These projects begin the work of building a new world where everyone has enough. In New Orleans, public art...

APPLICATION OF FIBONACCI SERIES, GOLDEN PROPORTIONS AND GOLDEN RECTANGLE TO HUMAN HAND USING STATISTICAL ANALYSIS

The Greek letter φ (Phi) represents one of the most mysterious numbers (1.618…) known to humankind. Historical approbation for φhas led to the monikers “The Golden Number” or “The Divine Proportion”. This simple, but inscrutable number, is inseparably linked to the recursive mathematical sequence which produces Fibonacci numbers. The study of the Fibonacci sequence exists in most aspects of life starting from the leaves of a non-flowering plant, design, paintings, animals, and even human body. Despite its wide-spread prevalence and existence, the Fibonacci series and also the Rule of Golden Proportions have not been widely documented within the human body. The main objective of this study is to prove that the length of the human hand bone is in step with the Fibonacci series to spot the degree of movement and variation for every finger. Victimization of the sample z test with 95% confidence interval, this analysis shows that just one of the four bone length ratios contained the ratio phi φ within the 95% confi dence interval and follow the Fibonacci series, that of the little fi nger metacarpal and proximal phalanx in both hands. The largest variability was seen within the little fi nger phalangeal relationships and other fingers will follow mathematical relative series. Due to the relationship with the golden number, it will facilitate in monitoring the individual with an injured hand, especially if injured in small fingers throughout a medical aid, or to identify the cause of the problem of physical functioning of the hands or individual fingers. Hence, it should be helpful for the length of the clenched fist to perform in reconstruction or placement of the prosthesis.