Hand Contact Research Articles

Angular momentum generation and control during a back handspring step out on the balance beam performed by female gymnasts

The back handspring step out (BHS) is a foundational skill in gymnastics balance beam routines that requires the generation of significant sagittal plane angular momentum while tightly regulating frontal plane momentum to control their balance. However, which body segments are critical for generating this momentum and successfully performing the BHS and whether skill level influences this generation remains unknown. Twenty-five gymnasts with a range of skill levels performed a BHS on a balance beam. The BHS was scored, and segmental contributions to whole-body angular momentum were analyzed during the take-off, flight, hand contact and landing phases. Angular momentum has previously been used to assess balance control, where higher ranges of frontal plane angular momentum are indicative of poorer balance control. There were no differences in segmental contributions to angular momentum during the take-off phase between high- and low-scoring groups. However, the low-scoring group had higher trunk contributions to frontal plane angular momentum after the take-off phase. The trailing leg was also found to be a large contributor to frontal plane angular momentum, and thus more likely than the leading leg to cause deviations in balance control. In the sagittal plane, momentum generation and skill level were weakly correlated, suggesting as gymnasts become more skilled, they produce larger sagittal plane motions and are more adept at generating angular momentum. Because the trunk and trailing leg had high contributions to frontal plane angular momentum, controlling the trunk and trailing leg should be a focus in training regimes to improve BHS performance.

Complex Infection-Control Measures with Disinfectant Switch Help the Successful Early Control of Carbapenem-Resistant Acinetobacter baumannii Outbreak in Intensive Care Unit.

A carbapenem-resistant Acinetobacter baumannii (CRAB) outbreak in an intensive care unit (ICU) was contained by an improved infection-control measure that included a disinfectant policy. In our retrospective cohort study, we describe the epidemiological investigations and infection-control measures during this outbreak. Descriptive analysis was used to summarize patient demographics, neurological diseases, surgical treatment, underlying diseases, infection, and outcomes. In December 2023, two CARB-positive patients were observed in the ICU, and four more patients became CRAB-positive in January. During this outbreak, there was an overlap of hospitalization periods among the CRAB-positive patients, and CRAB was isolated from the environment; the isolated CRAB strain was identical. Infection-control measures, including hand hygiene, contact precautions and isolation, surveillance, decolonization, environmental cleaning, and disinfection, were reviewed and modified. The aim of this study was to examine the molecular background of the effectiveness of the disinfectant shift used during successful outbreak control. Experiments were carried out to study the phenotypic sensitivity and genetic background of different disinfectant agents. A thorough analysis of the detected CRAB strain included whole-genome sequencing (WGS), investigation of the qacE and qacEΔ1 genes' relative expression by qPCR after exposure to different disinfectant solutions, as well as an analysis of biofilm formation. WGS analysis of the CRAB strain identified that an ST2 high-risk clone was responsible for the outbreak, which produced OXA-83 and ADC-30 beta-lactamases; in addition, qacE and qacEΔ1 genes were also detected, which confer resistance to disinfectants containing quaternary ammonium compounds (QACs). A qPCR analysis demonstrated that after exposure to different disinfectants, the gene expression levels of qacE and qacEΔ1 increased and correlated with concentrations of QACs of disinfectants. During the outbreak, the standard-of-care QAC-based disinfectant was changed to a mainly alcohol-based agent in the ICU, which contributed to the successful control of this outbreak, and no additional patients were identified with CRAB. We conclude that continuous surveillance and hand hygiene training combined with fast identification and reaction to new cases, as well as an in-depth analysis of multidrug-resistant outbreak strains and investigation of their disinfectant tolerance/resistance during an outbreak, are essential to effectively control the spread of nosocomial pathogens. The smart policy of disinfectant agent selection played a crucial role in controlling the outbreak and ensuring patient safety in the ICU.

Interactions during falls with environmental objects: evidence from real-life falls in long-term care captured on video

BackgroundFalls are the leading cause of injuries in older adults. Environmental objects (such as furniture, walls, and handrails) may act as hazards or facilitators to balance maintenance and safe landing. There is lack of objective evidence on how older adults interact with objects during falls. We addressed this gap by characterizing body part contacts with objects other than the floor during real-life falls in long-term care.MethodsWe analyzed videos of 1759 falls experienced by 584 residents to characterize the prevalence of contacts with objects before, during, and after fall initiation. Using generalized estimating equations, we compared the prevalence of falls with versus without contact to objects after fall initiation. Using linear mixed models, we tested for differences across body parts in the probability of contacting objects after fall initiation.ResultsIn nearly one-third of falls, interactions with objects (e.g., trips over objects, loss of support with objects) or with other people (e.g., being pushed by another person) had a primary role in causing imbalance and initiating the fall. After fall initiation, participants contacted objects in 60% of falls, with intentional hand contacts to objects via reach-to-grasp or bracing being the most common type of interaction (Probability ± SE = 0.32 ± 0.01), followed by unintentional impacts to the torso (0.21 ± 0.01) and head (0.16 ± 0.01). Intentional hand contact to an object was more common during forward than backward falls (p < 0.001), while head and torso contacts to objects were more common during backward and sideways falls than forward falls (multiple p values ≤ 0.003). The hand most often contacted chairs, wheelchairs or couches, followed by tables or counters, walls, other people, walkers, and handrails. The head, torso, and shoulder most often contacted a wall.ConclusionsMost falls in long-term care involved contacts with objects other than the ground, indicating that complex environments often accompany falls in long-term care. Higher probabilities of intentional hand contacts in forward falls, versus unintentional head and torso impacts in backward and sideways falls may reflect the influence of being able to visualize and adjust one’s falling patterns to nearby objects.

Feasibility and Validity of Wearable Sensors for Monitoring Temporal Parameters in Manual Wheelchair Propulsion.

Upper extremity pain and injury are among the most common musculoskeletal complications manual wheelchair users face. Assessing the temporal parameters of manual wheelchair propulsion, such as propulsion duration, cadence, push duration, and recovery duration, is essential for providing a deep insight into the mobility, level of activity, energy expenditure, and cumulative exposure to repetitive tasks and thus providing personalized feedback. The purpose of this paper is to investigate the use of inertial measurement units (IMUs) to estimate these temporal parameters by identifying the start and end time of hand contact with the push-rim during each propulsion cycle. We presented a model based on data collected from 23 participants (14 males and 9 females, including 9 experienced manual wheelchair users) to guarantee the reliability and generalizability of our method. The obtained outcomes from our IMU-based model were then compared against an instrumented wheelchair (SMARTWheel) as a reference criterion. The results illustrated that our model was able to accurately detect hand contact and hand release and predict temporal parameters, including the push duration and recovery duration in manual wheelchair users, with the mean error ± standard deviation of 10 ± 60 milliseconds and -20 ± 80 milliseconds, respectively. The findings of this study demonstrate the potential of hand-mounted IMUs as a reliable and objective tool for analyzing temporal parameters in manual wheelchair propulsion. IMUs offer significant strides towards inclusivity and accessibility due to their portability and user-friendliness and can democratize health monitoring of manual wheelchair users by making it accessible to a broader range of users compared to traditional technologies.

Transfer and recovery of DNA and metal particles: A proof-of-concept application of a parallel strategy by DNA and environmental scanning electron microscopy analysis

According to the principle of Locard “Every contact leaves a trace", when touching a surface, a bi-directional transfer of self and non-self-DNA residing on the hands and touched objects can occur. Metals are commonly encountered in forensic evidence and, during hand contact with these surfaces, a transfer of metal particles could occur together with the transfer of human DNA. This study proposes a proof-concept approach for the original detection of metal particles and touch DNA to track the activity performed by a donor and particularly to assess the metallic substrate touched before the contact with a subsequent surface. To this scope, a scenario of contact events was simulated by three volunteers, who participated in fingerprint deposition firstly on copper and then on plastic and glass surfaces. Twenty-four stubs were collected on the hands of volunteers and the secondary surfaces and then analyzed by environmental scanning electron microscopy (ESEM). DNA was quantified only from copper and plastic surfaces. Ten additional volunteers followed the same protocol of deposition on copper and then on plastic surfaces to evaluate DNA transfer only. On 20 touch DNA samples, the copper surface yielded significantly lower DNA amounts, ranging from 0.001 to 0.129 ng/μl, compared to the secondary touched plastic surface, ranging from 0.007 to 0.362 ng/μl. ESEM-EDS analysis showed that copper particles could be abundantly detected on the hands of the volunteers after contact with the copper surface. Particles containing silicates with copper were shown on plastic, while they were only found in 1/3 of samples on glass. Our proof-of-concept study has shown that ESEM-EDS analysis has the potential to detect copper particles transferred to the hands of volunteers during contact with a copper metallic surface and deposited on secondarily touched items. The results suggest that this original ESEM-DNA parallel approach could potentially allow the tracking of DNA transfer and metal particles at a crime scene, although this represents only a first step and further research on a wider casuistry could help to address the interpretation of results given activity level propositions.

Human dermal exposure to short- and medium-chain chlorinated paraffins: Effect of populations, activities, gender, and haze pollution

Human dermal exposure to chlorinated paraffins (CPs) has not been well documented. Therefore, hand wipes were collected from four occupational populations to analyze short-chain CPs (SCCPs) and medium-chain CPs (MCCPs) in order to estimate dermal uptake and oral ingestion via hand-to-mouth contact. The total CP levels (∑SCCPs and ∑MCCPs) in wipes ranged from 71.4 to 2310 µg/m2 in security guards, 37.6 to 333 µg/m2 in taxi drivers, 20.8 to 559 µg/m2 in office workers, and 20.9 to 932 µg/m2 in undergraduates, respectively. Security guards exhibited the highest levels of ∑SCCPs among four populations (p < 0.01). In undergraduates engaged in outdoor activities, C13 emerged as the most dominant SCCPs homologue group, followed by C12, C11, and C10. The levels of ∑SCCPs and ∑MCCPs in males in light haze pollution were significantly higher than that in heavy haze pollution (p < 0.05). The median estimated dermal absorption dose of SCCPs and MCCPs via hand was 22.2 and 104 ng (kg of bw)−1 day−1, respectively, approximately 1.5 times the oral ingestion [12.3 and 74.4 ng (kg of bw)−1 day−1], suggesting that hand contact is a significant exposure source to humans.

Calibration to Differentiate Power Output by the Manual Wheelchair User from the Pushrim-Activated Power-Assisted Wheel on a Force-Instrumented Computer-Controlled Wheelchair Ergometer

To examine the biomechanical demands of manual wheelchair propulsion, it is crucial to determine the wheelchair user’s (WCU) force for propulsion technique parameter calculation. When using a pushrim-activated power-assisted wheelchair (PAPAW) on a wheelchair ergometer, a combined propulsion force from the WCU and PAPAW is exerted. To understand PAPAW’s assistance and distinguish the WCU’s force application from the force exerted by the PAPAW, both propulsion components must be assessed separately. In this study, a calibration of the PAPAW on an ergometer was developed to achieve this separation. The calibration consists of five steps: (I) Collecting data on force and velocity measured from the ergometer, along with electrical current and velocity from the PAPAW. (II) Synchronizing the velocity signals of the wheelchair ergometer and PAPAW using cross-correlation. (III) Calibrating the PAPAW’s electromotors to convert electrical current (mA) to force (N). A product-specific motor constant of 0.30, provided an average ICC of 0.563, indicating a moderate agreement between the raw ergometer data (N) and the motor constant-converted drive-rim (PAPAW) data (from mA to N). (IV) Subtracting the PAPAW’s force signal from the ergometer’s measured force to isolate forces generated by the WCU. (V) Using markerless motion capture to determine and validate the phase of hand contact with the handrim. This technical note provides an example of PAPAW calibration for researchers and clinicians. It emphasizes the importance of integrating this calibration into the development of PAPAW devices to reveal the complex interaction between PAPAW and WCU during wheelchair propulsion.

Hospital-Associated Transmission of Candida auris from Adult to Pediatric Patient

Background: Candida auris, an emerging multidrug-resistant fungus, is often difficult to control in hospital outbreaks. We report the hospital investigation and findings of a transmission of C. auris from patients hospitalized in an adult unit to a pediatric unit, the first in Maryland. Methods: Between June and September 2023, C. auris was recovered from two patients admitted to an adult Neuroscience Intensive Care Unit (ICU) and a patient admitted to a pediatric ICU. Infection control initiated an investigation involving staff interviews, observations and chart reviews. Cases were defined as any patient with clinical or surveillance cultures growing C. auris. Point prevalence surveillance was conducted by collecting nares and composite axilla/groin swabs from patients on the affected units. Environmental cultures collected using moistened E-Swabs (Copan, Murrieta, CA) from shared supplies were plated on CHROMagar Candida (BD, Sparks, MD). C. auris isolates from patients hospitalized at the facility between February 2022 and October 2023 were analyzed by WGS for relatedness. WGS was performed using Illumina NextSeq 300 bp paired-end sequencing (Illumina, San Diego, CA). Single nucleotide polymorphism (SNP) analysis was performed by comparing raw reads to the reference C. auris B8441 genome for subsequent clustering analysis (Ares Genetics, Vienna, Austria). Results: WGS demonstrated isolates from two adults and one pediatric patient were less than three SNPs different, suggesting a shared isolate. One additional pediatric case was identified from surveillance cultures collected from 27 patients. Investigation into possible transmission routes revealed healthcare personnel serving both units, specifically clinical teams and continuous electroencephalography (cEEG) technologists. Additionally, cEEG equipment was used on both adult and pediatric patients and twelve equipment surface swabs and three samples each of measuring tape and gel were collected. C. auris was not isolated, however sensitivity of environmental sampling is unclear and suspicion for possible fomite/environmental transmission persisted. Other possible transmission routes included gaps in hand hygiene, isolation, disinfection of shared equipment, and reuse of single-use items. Interventions included improving and monitoring infection prevention practices, educating multi-disciplinary personnel and heightened environmental cleaning. Conclusion: This case highlights the feasibility of transmission of C. auris between patients admitted to a geographically distant unit. Our investigation revealed multiple possible routes of transmission including direct contact (from healthcare personnel or equipment) or indirect environmental sources. Prevention of hospital-associated C. auris transmission likely necessitates meticulous adherence to hand hygiene, contact precautions, and careful cleaning and disinfection of patient environments and equipment used by all disciplines.Disclosure: Patricia Simner: Research Contracts: BD Diagnostics, OpGen Inc., Qiagen Sciences Inc, T2 Diagnostics, Accelerate Diagnostics; Research Collaborators:Ares Genetics, CosmosID, IDbyDNA, Illumina; Consulting: OpGen Inc., BD Diagnostics, Shionogi Inc., GeneCapture, Qiagen Sciences Inc, Entasis, Day Zero Diagnostics, Next Gen Diagnostics

Impact of Transitioning to Single-Patient Rooms on Prevention of Multidrug-Resistant Organisms in a Resource-Limited Facility

Background: Healthcare-associated infections (HAI) substantially increase hospital costs and lead to poor patient outcomes, particularly when caused by multidrug-resistant organisms (MDRO). To decrease MDRO transmission, isolation of colonized or infected patients in single rooms is recommended. However, single-patient isolation rooms are expensive to build and often unavailable in resource-limited hospitals. In 2023, an intensive care unit (ICU) at a large Brazilian tertiary hospital relocated from a space with an open floor plan to a newly built location with single-patient rooms. We evaluated the impact of this transition on acquisition of carbapenem-resistant Enterobacterales (CRE) colonization, HAI, and compliance with Hand Hygiene (HH) and Contact Precaution (CP) activities. Methods: We compared rates of CRE colonization acquisition, CRE colonization pressure, HAI, and compliance with HH and CP between pre- (March 1, 2022 – Feb 28, 2023) and post-implementation of single-rooms (March 1, 2023 - October 31, 2023) in a 12-bed surgical ICU. All patients were screened for CRE colonization on admission to the unit and weekly until discharge using rectal swab cultures. Colonization pressure was defined as the ratio of CRE-positive patient-days (PDs) to the total number of PDs. Rates of central-line associated blood-stream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections were monitored. HH and CP compliance were monitored weekly by infection prevention staff outside of the unit. Poisson regression and multiple linear regression were used to compare rates between pre- and post-implementation periods. Results: Healthcare acquisition of CRE colonization remainedstable between pre- and post-implementation (incidence rate ratio: 0.88 (95%CI, 0.73-1.05; P=0.16) despite an increase in CRE colonization pressure of 8.6% over baseline (from 7.84% pre- to 16.39% post-implementation (95% confidence interval [CI], 4.13-12.96%; P=.001)). The latter was driven by reduced turnover of CRE-colonized patients in the post-implementation period (mean patient-day reduced by 10.33; 95%CI, 3.06-17.61; P=0.006). Incidence of HAIs also remained stable (global incidence 3.12 vs 3.30, pre- and post-intervention, respectively; P=0.2). HH compliance was high prior to the transition (95.7%) and increased slightly but not significantly post-intervention (97.5%; P=0.3). CP compliance improved by 9.83%, especially in gown and glove changes after each patient interaction, from 90.62% pre- to 100% post-implementation (95%CI, 1.52-17.22; P=.02). Conclusion The move to an ICU with exclusively single-patient rooms was associated with increase in CP compliance. This could help explain why HAI incidence and healthcare acquisition of CRE colonization remained stable despite a significant increase in CRE colonization pressure.Disclosure: Matias Salomao: Speaker - Cepheid

A Compact Hygiene and Sterilization Prototype to Curb the Outbreak of Covid-19 and Other Contagious Diseases

With the spread of deadly virus such as Covid-19, which is so far incurable and mainly transferrable through touch and contact, only precautionary measures are considered to prevent it. As per the guidelines of WHO, provided for Corona Virus, washing hands and sanitizing them frequently is one of the prime effective solutions. There are hundreds of other contagious diseases that spread through the contact of hands. In addition to that, sterilization of accessories such as mobile phone, keys, wallet etc. with least manual intervention is also need of the time. There are separate systems available in the market but there is no compact system that contains all the necessary features on single platform. Therefore, taking all these factors into consideration, this project proposes a novel design of one-stop compact touch-less station for hand washing, sanitization, and manual sterilization. The hand hygiene prototype works on a very low power of 12v. It avoids contact of people with system to get Water, Soap and Sanitizer. This prototype based on the range of 4cm to 18cm from which 4 to 8cm is for soap, 12 to 14cm for sanitizer and 16 to 18cm for water according to defined ranges the prototype is properly working and it is also showing a 20 second timer after the user takes soap. This prototype may prove to be helpful in controlling the hygiene standards in private as well as public places like Educational Institutes, Hospitals, Malls, Offices, Mosque, Railway Stations and all other places where human intervention is involved. This device is helpful for controlling the blowout of transmittable infections.

Key environmental exposure pathways to antimicrobial resistant bacteria in southern Malawi: A SaniPath approach

Antimicrobial resistance (AMR) poses a severe global health threat, yet the transmission pathways of AMR within communal public environments, where humans and animals interact, remain poorly explored. This study investigated AMR risk pathways, prevalence, and seasonality of extended-spectrum β-lactamase (ESBL) producing E. coli and K. pneumoniae, and observed practices contributing to environmental contamination within urban, peri-urban, and rural Malawi.Using the SaniPath tool, in August 2020, transect walks across three Malawian study sites identified potential AMR exposure pathways, including drains, standing water, soil, and areas of communal hand contact. Subsequently, from September-2020 to August-2021, 1440 environmental samples were collected at critical points along exposure routes (n = 40/month from each site). These underwent microbiological analysis using chromogenic agar techniques to detect the presence of ESBL E. coli and ESBL K. pneumoniae.Results showed the highest ESBL prevalence in urban environments (68.1 %, 95%CI = 0.64–0.72, p < 0.001) with a higher ESBL presence seen in drains (58.8 %, 95%CI = 055–0.62, p < 0.001) and soil (54.1 %, 95%CI = 0.46–0.62, p < 0.001) compared to other pathways. Environmental contamination was attributed to unavailability and poor condition of sanitation and hygiene infrastructure based on key informant interviews with community leaders (n = 9) and confirmed by independent observation. ESBL prevalence varied between seasons (χ2 (2,N = 1440) = 10.89, p = 0.004), with the highest in the hot-dry period (55.8 % (n = 201)). Prevalence also increased with increased rainfall (for ESBL E.coli).We highlight that community environments are likely to be a crucial component in AMR transmission, evident in the abundance of ESBL bacteria in identified exposure pathways. Additionally, poor sanitation infrastructure and practices coupled with seasonal dynamics further affect the presence of ESBLs in communal environments. Therefore, a context appropriate whole system approach that tackles infrastructure and behavioural factors, supported by effective surveillance is required to impact AMR and a range of aligned development challenges in these settings.

BPJDet: Extended Object Representation for Generic Body-Part Joint Detection.

Detection of human body and its parts has been intensively studied. However, most of CNNs-based detectors are trained independently, making it difficult to associate detected parts with body. In this paper, we focus on the joint detection of human body and its parts. Specifically, we propose a novel extended object representation integrating center-offsets of body parts, and construct an end-to-end generic Body-Part Joint Detector (BPJDet). In this way, body-part associations are neatly embedded in a unified representation containing both semantic and geometric contents. Therefore, we can optimize multi-loss to tackle multi-tasks synergistically. Moreover, this representation is suitable for anchor-based and anchor-free detectors. BPJDet does not suffer from error-prone post matching, and keeps a better trade-off between speed and accuracy. Furthermore, BPJDet can be generalized to detect body-part or body-parts of either human or quadruped animals. To verify the superiority of BPJDet, we conduct experiments on datasets of body-part (CityPersons, CrowdHuman and BodyHands) and body-parts (COCOHumanParts and Animals5C). While keeping high detection accuracy, BPJDet achieves state-of-the-art association performance on all datasets. Besides, we show benefits of advanced body-part association capability by improving performance of two representative downstream applications: accurate crowd head detection and hand contact estimation.

Use of Non-Chlorine Sanitizers in Improving Quality and Safety of Marketed Fresh Salad Vegetables

The safety of vegetable food is compromised by various factors, including the inefficient or excessive use of sanitizers. Instances of individuals falling ill after consuming raw vegetables have been reported, with outbreaks of diseases caused by pathogens on fresh vegetables becoming increasingly prevalent globally, attracting significant media coverage and impacting the economic viability of vegetable cultivation. Measures to enhance food safety in postharvest horticultural produce involve controlling microbial proliferation and minimizing cross-contamination. Sanitizers were utilized in the food safety arsenal for a variety of purposes, including pathogen elimination and microbe reduction, hand, tool, and vegetable contact surface cleaning, and produce shelf-life extension. Choosing an appropriate sanitizer for all vegetables is difficult due to a lack of knowledge on which sanitizers are ideal for the many types of vegetables grown on farms under different environmental circumstances. Although chlorine-based sanitizers, such as sodium or calcium hypochlorite, have been widely used for the past 50 years, recent research has revealed that chlorine reacts with an organic compound in fresh vegetables to produce trihalomethane, a carcinogen precursor, and as a result, many countries have prohibited the use of chlorine in all foods. As a result, horticulture research groups worldwide are exploring non-chlorine, ecologically friendly sanitizers for the vegetable industry. They also want to understand more about the present procedures in the vegetable business for employing alternative sanitizers, as well as the efficacy and potential dangers to the food safety of fresh salad vegetables. This review paper presents detailed information on non-chlorine sanitizers, such as their efficacy, benefits, drawbacks, regulatory requirements, and the need for additional research to lower the risk of marketed salad vegetable food safety.

Does Examination Table Paper Use Mitigate the Risk of Disease Transmission in a Family Medicine Clinic?

Reducing examination table paper (ETP) use may help curb carbon emissions from health care. Six participants applied Glo Germ (DMA International) to their hands before a common physical examination (abdominal, cardiorespiratory, hip and knee) both with and without ETP. After each exam, UV light was shined on the exam table and photographs were taken. The number of hand touches on ETP-covered areas and uncovered areas were tallied and compared using t tests. Despite covering more surface area, participants touched areas without ETP significantly more than ETP-covered areas (P <.05). Despite its continued use, patients do not have much hand contact with ETP during common clinical examinations.

Early Intervention Guided by the General Movements Examination at Term Corrected Age-Short Term Outcomes.

The early identification of the former premature neonates at risk of neurologic sequelae could lead to early intervention and a better prognosis. This pilot study aimed to investigate whether the General Movement patterns observed at term-equivalent age in former premature infants could serve as predictors for guiding early intervention and improving prognosis. In a population of 44 premature neonates (mean gestational age 33.59 weeks (+2.43 weeks)) examined at term-equivalent age, 10 neonates with a cramped-synchronized General Movements motor pattern were identified. These neonates were included in an early intervention program consisting of physiotherapy executed both by the therapist and by the parents at home. They were again examined at a corrected age of 12 weeks. The presence or absence of fidgety movements and the MOS-R (motor optimality score revised) was noted. The examinations were performed by certified specialists. Normal fidgety movements and a MOS-R of 20-24 were presented in 9/10 of the former premature infants, with normal foot to foot contact present in 7/10, and normal hand to hand contact present in 5/10. The atypical patterns noted were side to side movements of the head in 5/10, a non-centered head in 9/10, asymmetric tonic neck reflex in 9/10 and jerky movements in 10/10. One patient presented with no fidgety movements and a MOS-R score of 9. Early intervention in our group of patients allowed for an improvement in the neurologic status, demonstrated by the presence of fidgety movements. We suggest that early intervention should be indicated in all premature infants that present with a cramped-synchronized GM pattern during examination at term-equivalent age. However, due to the small sample size, the absence of statistical analysis and a control group, and the limited follow-up period, the conclusions must be approached with caution.

Bee venom acupuncture and herbal medicine for hand eczema: Two case reports and an in vivo study

IntroductionEczema and contact dermatitis are relatively common, non-life-threatening disease, but can reduce the patient's quality-of-life when it becomes chronic. This study describes two cases of bee venom acupuncture (BVA) and herbal medicine (San Wu Huangqin decoction; SWH) co-treatment for hand eczema and contact dermatitis, then confirms the effect of the combination therapy in an in vivo model of eczema. Case presentationA 56-year-old female (case 1) and a 33-year-old male (case 2) presented to the clinic with symptoms of itching and erythema (case 1), and scaliness (case 2) on both hands. Both were diagnosed with hand eczema and contact dermatitis based on examination of the erythema and scaliness. They were treated with BVA and SWH for three months. The lesions were healed and had not recurred after 1 and 3 years of follow-up. A mouse study was conducted by repeated application of 2,4-dinitrochlorobenzene (DNCB) to induce eczema-like contact dermatitis in Balb/c mice. In a DNCB-induced eczema-like contact dermatitis model, BVA and SWH co-administration synergistically improved clinical symptoms seen in eczema. Also, they improved histological changes of the skin, suppressed immune cell infiltration, and decreased inflammatory cytokines and immunoglobulin E in the serum. ConclusionThis study suggests BVA and SWH could be an alternative treatment for eczema and contact dermatitis.

Ergonomic RFID tag placement on surgical instruments- a preliminary user study.

RFID tags on surgical instruments allow tracking of individual instruments. However, the tags on the instruments can restrict the handling, potentially increasing patient risks. Previous studies analyzed hand contact areas to identify potential locations for tags. However, the studies did not conduct interaction tests using instruments equipped with RFID tags, potentially neglecting the influence of haptic perception. In addition, previous studies required time-consuming evaluations by clinicians. Therefore, the present study aims to verify the previous findings in interaction-centered tests with clinicians using real RFID tags on the instruments. Additionally, we had instrument design experts rate RFID tag positions and examined whether they could predict the clinician's preferred tag positions. We found that nearly all RFID tag positions decreased the user satisfaction of clinicians compared to a reference instrument. Compared to previous studies, our study shows that the RFID tag influences the orientations in which an instrument can be comfortably held, which was criticized by clinicians. Instrument design experts could only predict the clinician's preferred tag positions for some instruments. Therefore, we recommend investigating further changes to instrument design, for what the "ideal" positions proposed by the clinicians in this study can provide initial pointers.

Upper and lower limb impact loading during artistic gymnastics foundation floor tumbling skills

AbstractThe floor apparatus is associated with the highest rate of injury for male and female gymnasts in training and competition. This study aims to determine the magnitude of the upper and lower body impact loading when performing foundation floor tumbling skills and sequences. Fourteen sub‐elite artistic gymnasts (male, n = 9; female, n = 5) performed eight tumbling skills and sequences while wearing four inertial measurement units (IMU; upper back, lower back, forearm, and tibia). The peak resultant acceleration (PRA) during all ground contacts was calculated. The forearm and upper back PRA were analyzed for hand contacts, while the lower back and tibia PRA were analyzed for foot contacts. Descriptive statistics (median and inter‐quartile range), Wilcoxon signed‐rank tests and Friedman's ANOVA were calculated between IMU positions and gymnastics skills. Distal IMUs (forearm and tibia) recorded significantly higher loading than proximal IMUs (upper and lower back) for all ground contacts. Proximal IMUs experienced dampening due to shock attenuation properties of the human body, as these positions are located further away from the impact site. Additionally, some foundation skills exposed gymnasts to higher loading when the skill was performed separately, while other skills exposed gymnasts to higher loading when the skill was performed in a tumbling sequence. Training foundation skills separately and as a part of a tumbling sequence exposes the upper and lower body structures to high levels of impact loading. These results can be used by coaches to help in the design of safe training programs.

Fungal flora associated with indian and foreign coins and their potential health risks

Potential role of spread of pathogenic microflora on coins and currency notes has been evaluated in different countries. Notes and currency coins may serve as universal vehicles for transmission of potentially pathogenic microorganisms among persons either directly, through hand to hand contact, or indirectly, through water and food. The Purpose of study was to do qualitative and quantitative analysis of microflora associated with new and old Indian and foreign coins.&#x0D; Results of the study revealed that bacteria were present in most of the coins, more than 40% coins showed presence of fungi like Aspergillus niger, Curvularia lunata, Chaetomium globosum, Fusarium roseum and Trichoderma viride. Fungal species like Aspergillus niger and Fusarium roseum can cause bronchial diseases and may act as potential allergens and few of these are reported to cause skin problems. The use of digital transaction will reduce such harmful transmission of pathogenic microbes. Cleaning the coins with water or UV treatment may reduce the fungal load. But it has to be practised at regular intervals. Total 100 coins were screened of which 20 were foreign coins. Isolation from these coins resulted into 20 cultures and 6 non-sporulating mycelial forms. Oldest coins was 141 years and new coin was of the year 2015. Uncirculated Indian coin of 2003 was also tested for fungal occurrence.

GC-MS Analysis and Study of the Antimicrobial Activity of Citrus paradisi, Citrus aurantifolia, and Citrus sinensis Peel Essential Oils as Hand Sanitizer.

In the setting of healthcare, the use of hand sanitizers and antiseptics for hand hygiene is of paramount importance to avoid transfer of pathogenic microorganism through hand and skin contact. There is an increasing interest in the incorporation of essential oils in hand sanitizer's formula to avoid the adverse effect of conventional hand sanitizers on health. This study aimed to detect the chemical constituents of citrus peel essential oils and study their antimicrobial activity compared with commercial hand sanitizers. The qualitative and quantitative analysis of the hydrodistillated essential oils of peels of grapefruit (Citrus paradisi), lime (Citrus aurantifolia), and orange (Citrus sinensis) were carried out using gas chromatography mass spectroscopy. The disc diffusion method was used to screen the antibacterial activity of the essential oils against Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, Staphylococcus aureus, and Candida albicans compared with a 78% alcohol-based commercial hand sanitizer. The antimicrobial testing results were statistically analyzed. The highest yield percentage of the obtained essential oils was 1.09% obtained by orange oil. The GC-MS analysis indicated that monoterpene and sesquiterpene hydrocarbons occupied the largest portion of the chemical composition of the three essential oils with D-limonene as the most predominant component. All essential oils showed activity against all tested organisms. Lime essential oil showed comparable antimicrobial activity relative to the commercial 78% alcohol hand sanitizer. In conclusion, essential oils obtained from citrus fruit peel represent a rich source of compounds possessing antimicrobial properties and could be an alternative to synthetic antimicrobial agents.