Open Hand Research Articles

A retrospective study on the clinical profile of patients with open hand injury presenting to the emergency department of a tertiary care center in South India

Background: The human hand is a vital part of our day-to-day activities. Most of the time, our body movements do not cause problems, but it is not surprising that symptoms develop from everyday wear and tear, overuse, or an injury. To reduce this risk, even the smallest hand injuries require proper medical care. Materials and Methods: We conducted a retrospective observational study of all trauma patients with open hand injuries presenting to our emergency department (ED). Details of the incident, injuries, management, and outcome were noted. Results: During the study period of 8 months, we received a total number of 4414 trauma patients to our ED, among which 291 (7%) had hand or upper extremity injuries. Most of these patients had crush injury (33.7%) or cut injuries (27.4%) that are mostly work related. Most of the injuries happened in the active age groups ranging from 0 to 30 years of age where cut injury and crush injury (13%) were the most common, Road traffic accidnets account for (26.3%), whereas cracker burst injuries were the cause in (8.9%). The index finger (17%) is the most commonly injured finger, followed by the thumb (16%). Fractures and amputations of the fingers and hands were seen in (24.7%) and (22.1%), respectively. Other injuries included lacerations (15.3%) and tendon injury (14.2%). Most patients (93%) were taken up for emergency procedures such as wound wash, debridement, suturing, or nailing of the fractures in the ED. Approximately half (48%) of the total patients were admitted in ward and had to undergo major surgical intervention. The rest were either discharged (45%) stable or discharged against medical advice (7%) after the primary care. Conclusions: This study showed the pattern of hand injuries in the children, the young, and the elderly. Public awareness and education, along with needed legislative enforcement for the betterment and well-being of the mass, is needed to prevent the catastrophe since these injuries are prevalent in the productive age groups.

Open Hand Prone as a resource in multimodal claims to interruption

AbstractThis paper examines the Open Hand Prone ‘vertical palm’ as a resource for participants in conversation for displaying their treatment of a co-participant’s – or their own – turn/action as interruptive. Through this practice participants can manage turn-taking by making it relevant for the co-participant to stop talking. The data for this study consist of video-recorded conversations in English and Finnish from domestic and institutional settings, as well as broadcast talk. Using multimodal conversation analysis, this study shows that the gesture occurs in situations involving overlapping/competitive talk or incompatible embodied activities that somehow affect the progressivity of the ongoing talk. This paper complements previous research on gesture studies and interaction by investigating the function these gestures take in stopping/interrupting a co-participant’s turn-at-talk across multiple settings, and by studying how the gesture functions as a part of a practice which has direct social consequences on the local organization of turn-taking.

The multidimensionality of pointing

AbstractThis paper proposes a novel analysis of deictic gestures which yields a taxonomy of manual pointing. ‘Gesture form analysis’ brings into relief the diversity of pointing by considering the imaginary forms necessarily involved in interpreting a gesture. It combines into a single framework insights found in the literature on how the meaning of any gesture is enabled by a series of spatial operations leading from the physical form of the articulators to the form of the target. Seven distinct spatial operations combine to define a gesture type, twenty-seven of which are illustrated with examples from open-data corpora. Most types involve not the prototypical linear vector of pointing, but the plane of an open hand. Not only deictic, but also iconic and other functions are shown to be rooted in imaginary forms and their ability to draw attention to and specify locations, directions, areas and volumes of space.

Acil servise başvuran açık el yaralanmalı hastaların araştırılması

Introduction: Hand injuries are a common condition that causes serious loss of labor and skill function. İn Turkey, studies on the epidemiology and causes of hand injuries is limited. The purpose of this study was to determine the etiology, demographic characteristics, clinical findings and outcomes of patients who applied to emergency department with open hand injury and to obtain data that can be used as a preliminary model for future protective programs.Material and Method: Between January 2010- December 2013, records of 1180 of patients who applied to emergency department for an isolated open hand injury were retrospectively reviewed. The records were examined for age, sex, date of application, occupation, cause of injury, localization or type of injury, medical treatments and outcome.Results: 889 (75.3%) of the patients were male. The average age of the patients included in the study was 32.47 ± 18.51. When the days of injury were examined, injury was generally seen on Friday with 185 patients (15.7%). The main cause of the injuries were 699 (59.2%) home accidents. 103 cases (8.7%) were working in wooden work. The most commonly encountered injury was cuts on skin (50.5%), as observed in 596 cases. 488 (41.4%) of the cases were primary sutured and 788 (66.8%) of the cases were discharged. Conclusion: Patients who are admitted to emergency department due to hand injuries, most of them are young male patients. It is possible to reduce labor and economic losses with early treatment of hand injuries and appropriate rehabilitation. We think that the training of employees in occupational health and the promotion of the use of protective clothes and the strict control mechanism to be created are the main measures.

Inhibition of vection by grasping an object.

The present study investigated whether vection could be modified by an object grasping movement. Twenty-five university students were asked to do one of the following four types of left-hand movements while they were viewing a radial optic flow: (1) grasping the hand-gripper strongly; (2) holding the hand-gripper; (3) clenching fist strongly; and (4) open hand without having anything in their left hands (normal hand condition). The participants' tasks were to keep pressing a button with their right hands while they were perceiving vection. After each trial, they estimated the subjective strength of vection on a 101-point scale. The result showed that the vection was inhibited by strongly grasping the hand-gripper task more than by the other hand movements. Vection could be weakened by the object grasping movement. It might be suggested that vection could be inhibited by the presence of an object being grasped and also by the grasping movement itself. We speculated that the mechanism underlying this inhibition might be related to cognitive pressure, attentional load, power and muscle tonus, and multisensory and proprioception interactions.

Andromonoecy in Gynandropsis gynandra (L.) Briq. (Cleomaceae) and effects on fruit and seed production

Spider plant (Gynandropsis gynandra) is a traditional leafy vegetable widespread in sub-Saharan Africa and tropical Asia that is also valued for its medicinal properties. Developing a breeding program for the species requires detailed knowledge of its phenology, floral morphology and pollination system. This study investigates the effects of floral morphology and pollination mechanisms on the reproductive success in G. gynandra. The experiments were conducted in two locations in Benin. A split-plot design was used with four randomized complete blocks. Three accessions were randomly assigned to the whole plots and five treatments including natural self-pollination, hand self-pollination, geitonogamy, open pollination and hand cross-pollination were randomized over the sub-plots. We observed that individual plant exhibited 70% of staminate (male) flowers and 30% of hermaphrodite flowers. G. gynandra was andromonoecious. Open pollination and hand cross-pollination led to higher fruit and seed set. Natural self-pollination and hand self-pollination resulted in lower fruit and seed production. G. gynandra is a self-compatible and predominantly out-crossing species. Cross-pollination resulted in a significant increase in fruit set. This study set the ground for the development of improved cultivars in G. gynandra.

Abstract: Fasciocutaneous Free Flaps in Extremity Reconstruction: Safety of Re-Elevation

PURPOSE: Free flap-based extremity reconstruction in the settings of chronic osteomyelitis and acute traumatic wounds can be a complex, multi-staged process that requires elevation of the free flap at each stage. Use of fasciocutaneous flaps is a safe and effect option in this situation, and may actually be preferable to muscle or musculocutaneous flaps despite traditional recommendations. Here the authors present their experience in utilizing fasciocutaneous flaps for reconstruction of the lower extremity in the settings of chronic osteomyelitis and acute traumatic wounds. METHODS: A retrospective review of a single-center’s experience with lower extremity fasciocutaneous free flap reconstruction in the setting of chronic osteomyelitis and acute traumatic wounds was performed. Patients were identified from the senior surgeon’s prospective database. Osteomyelitis was diagnosed with tissue culture as well as corresponding radiographic changes. Charts were reviewed for relevant risk factors, operative details, and outcomes. RESULTS: Twenty-one patients underwent reconstruction with free anterolateral thigh fasciocutaneous flaps. Of the fourteen trauma patients, there were seven Gustilo IIIB lower extremity injuries, three open hand or wrist fractures, two degloving injuries of the foot, one crush injury to the foot, and one traumatic hand amputation. Of the seven chronic osteomyelitis patients, the original mechanism of injury leading to chronic osteomyelitis was traumatic bony fracture in five patients and neoplasm excision in two patients. Mean patient age in our series was 44.3 (7 to 80) years. Mean BMI at time of reconstruction was 27.8 kg/m2 (21.5 to 36.5 kg/m2). The average defect size was 270 cm2 (32 cm2 to 525 cm2). The average length of hospital stay was 32 days. Patients required a mean of 3.7 debridements prior to flap reconstruction and a mean of 6.9 surgeries to complete the reconstructive process. The average time from initial debridement to flap was 15.5 days; mean time from flap to final surgery was 122 days. Mean follow-up time period was 10 months. There were two urgent returns to the operating room with two flap losses. Nine flaps were re-elevated 13 times (1 to 4 re-elevations per flap) for flap debulking, draining wound, antibiotic spacer replacement or removal, bone grafting, and ligament or tendon reconstruction; there were no major complications following flap re-elevation. CONCLUSION: Use of fasciocutaneous flaps in lower extremity reconstruction in the settings of chronic osteomyelitis and acute traumatic wounds appears to be safe and effective, even when the flap is subsequently re-elevated during revision surgery. Fasciocutaneous flaps allow for soft tissue coverage and the potential for protective sensation. Despite operating on a Western population with an overweight BMI, it was possible to utilize fasciocutaneous flaps for reconstruction. The optimal time from the initial injury to flap reconstruction may actually be longer than once thought.

Design and Evaluation of a Novel 5 DoF Underactuated Thumb-Exoskeleton

This letter presents the design of a new exoskeleton for thumb. The main feature of this device is a high degree of underactuation. In fact, the five degrees of freedom (dof) of the thumb are actuated by just one linear actuator. Other features of the thumb-exos are its capability of exert only forces normal to the phalanx axis in the contact point, and its adaptability to different finger sizes. In this letter, the spatial kinematic model is described and the link lengths are determined by means of a genetic algorithm (GA) over four basic grasping poses and the open hand pose. Finally, the thumb-exos mechanism was implemented and integrated in a full hand exoskeleton device. Performance of the thumb exoskeleton in terms of adaptation to different objects and hand sizes, and in terms of grasping forces have been evaluated through experiments and measuring muscular activity, grasping pressure and forces at different locations of the mechanism.

Antibiotic susceptibility of bacterial isolates and water quality index of water sourced from closed ground water and open hand dug well in Koko Community, Delta State, Nigeria

Antibiotic susceptibility of bacterial isolates and water quality index of water sourced from closed ground water and open hand dug well in Koko Community, Delta State, Nigeria

Touch the table before the target: contact with an underlying surface may assist the development of precise visually controlled reach and grasp movements in human infants.

Multiple motor channel theory posits that skilled hand movements arise from the coordinated activation of separable neural circuits in parietofrontal cortex, each of which produces a distinct movement and responds to different sensory inputs. Prehension, the act of reaching to grasp an object, consists of at least two movements: a reach movement that transports the hand to a target location and a grasp movement that shapes and closes the hand for target acquisition. During early development, discrete pre-reach and pre-grasp movements are refined based on proprioceptive and tactile feedback, but are gradually coordinated together into a singular hand preshaping movement under feedforward visual control. The neural and behavioural factors that enable this transition are currently unknown. In an attempt to identify such factors, the present descriptive study used frame-by-frame video analysis to examine 9-, 12-, and 15-month-old infants, along with sighted and unsighted adults, as they reached to grasp small ring-shaped pieces of cereal (Cheerios) resting on a table. Compared to sighted adults, infants and unsighted adults were more likely to make initial contact with the underlying table before they contacted the target. The way in which they did so was also similar in that they generally contacted the table with the tip of the thumb and/or pinky finger, a relatively open hand, and poor reach accuracy. Despite this, infants were similar to sighted adults in that they tended to use a pincer digit, defined as the tip of the thumb or index finger, to subsequently contact the target. Only in infants was this ability related to their having made prior contact with the underlying table. The results are discussed in relation to the idea that initial contact with an underlying table or surface may assist infants in learning to use feedforward visual control to direct their digits towards a precise visual target.

‘Le geste architectural’; Symbolism and authority in the case of the Centre Beaubourg

Architecture seems often imbued with the notion of “gesture.” The term is mentioned in abundance both when architecture is seen as a discipline and when it is seen as a social practice. Arguments about it can be found in an artefact as well as in an act of design. In this context it may be revealed as an object to be claimed (i.e., a fetish), or stand for a trace or a carrier of meaning. Thus, in a wider scope, gesture may be discussed as a persistent – if not necessary – theme in the field’s culture. This essay examines “gesture” as a mediator between society (including culture and power) and the practice of architecture. This will be discussed within the framework of the competition for the Centre Beaubourg (later known as Centre Georges Pompidou). The heated discourse revolving around the expression “le geste architectural,” including the proposal to design the building literally as an open hand and thereby as a gesture of offering, will be explored. We will thus show how “gesture” simultaneously creates a multifaceted existence: at once as a token of validity and a symbol of truth and beauty, as well as representing the very danger of banality. Furthermore, we will show how the Centre itself – to which was attributed the character of a feat – becomes a “political gesture” carrying the sperm that spawned the type of “heroic architecture” that is so distinctive to the Fifth Republic. Finally, we will revisit “gesture” as a token taking part in a conundrum where the modern ideal ends up substituting genuineness with genius; and we will see this binary relationship in connection to all the “gestures” we discuss in the case of the Centre Beaubourg. On these premises we will propose that, before we ask to define “gesture” by its content, it is important to see it first and foremost for what it does; namely, that it acts as a nominator, and thereby as a mediator, and even a weaver, of the collective between architecture and society. This shift in perspective is critical, as it reveals that gesture plays a more dynamic role than any doctrine would like to have it. Ultimately, we hope to show that gesture can be seen as taking an integral part in the very fabric of architecture, instead of merely playjng a role in one of its many histories. This essay is based on existing literature as well as original research conducted in the archives of the Centre Georges Pompidou – to which we extend our gratitude for the access.

Electrical stimulation-a mapping system for hand dysfunction in tetraplegia.

Retrospective data analysis OBJECTIVES: To define the distribution of the motor points and excitability of the key wrist and finger actuators in order to detect upper (UMN) and lower motor neuron (LMN) lesions potentially influencing the development of a tenodesis grasp. A rehabilitation centre for spinal cord injuries, Nottwil, Switzerland. Forearm muscles of 32 patients with tetraplegia (AIS A-D) were tested bilaterally with electrical stimulation (ES) to differentiate whether UMN or LMN was present. For testing, a standardised mapping was developed. All patients underwent the same positioning schedule. Sixteen hands developed a tenodesis grasps, 24 hands showed neither shortening nor tightening of the finger flexors. Two patients developed unilateral tenodesis grasp and showed no tightening of the finger flexors on the contralateral hand. Seven patients developed tenodesis grasps symmetrically and bilaterally, whereas one maintained an essentially open hand without tightening of the finger flexors. All hands that developed a tenodesis grasp showed a LMN lesion of the M. extensor digitorum communis (EDC). The frequency of the tenodesis grasp differed significantly between the groups with and without intact reflex arc (p < 0.0001). Surface ES may serve as a diagnostic tool to detect an UMN or LMN lesion of the key actuator muscles affecting the tenodesis grasp. These findings provide information that is essential for the choice of treatment to optimise function of the tetraplegic hand.

Multi-Organ Teratogenesis Sequels of Bigger Size Particles Colloidal Silver in Primate Vertebrates

Back ground: In this most recent, update global arena for consumers products most of the daily applications of bigger silver nano particles (20 to 100 nano meter range) are effected as anti-viral and anti-parasitic agents in clinical medicine and diagnosis which is a positive feedback. However, the major negative feedback of bigger size silver nano particles on human, animal and primate vertebrate body is multisystem teratogenicity focuses. Material and methods: This study was designed to investigate teratogenic effects of bigger size nano silver which is poly vinyl pyrollidone coated and sodium borohydride stabilized. For this we injected its colloidal solution form in to pregnant female Swiss albino mice of different breeding colonies (10 from each group) in repeated oral gavages manner with nanosilver-71-1900.8 nano meter range at a dose of 14, 19 mg/kg/b.w./day with sham control treated by anionic double distilled water for 7-18 gestational days (12 days). Then dead animals are then anaesthetized and operated by ventral laparotomy on day 19. Fetuses were collected for open eye and hand lens morphological verification to locate various teratogenic anomalies. Result: We found multi system teratogenicity in treated group fetuses like Syndactyly, Oligodactyly, Polydactyl, meningo myelocele, closed type neural tube deformity, skeletal deformity like flat ribs, absence of bony segments or cleft, vertebral deformity like scoliosis, absence of long bones or its parts or mal developments or even mal fusion. We also found Central nervous system teratogenic effects like malformation of cerebrum, hippocampus and cerebellum. Histological teratogenic effects are observed in form of honey comb deformity and cell vacuolization in Central nervous system were significantly correlated with oxidative stress. Conclusion: Our findings suggest that bigger size silver nano particles induce an impairment of multi system and Central nervous system functions and teratogenic sequels by increasing oxidative stress and hampering nutrition in those body parts. The use of bigger silver nano particles for medical and diagnostic purposes henceforth requires careful consideration, particularly if it involves exposure of the human multi system and Central nervous system as it may evokes multi system teratogenicity in offspring’s where dose directly proportional to intensity.

Results and complications of superficialis-to-profundus tendon transfer in brain-damaged patients, a series of 26 patients

IntroductionIn hemiplegic patients with a spastic clenched fist deformity, one of the goals of surgery is to address the hygiene, nursing and appearance problems. Transfer of the flexor digitorum superficialis (FDS) to the flexor digitorum profundus (FDP), initially described by Braun and colleagues, opens the non-functional hand in these patients. The primary objective of our study was to confirm the effectiveness of this technique for correcting these deformities. The secondary objectives were to demonstrate potential functional gains and to identify potential complications. Material and methodsA Braun procedure was performed in 26 patients (9 women, 17 men, ranging in age from 36 to 79 years). The overall appearance of the hand was graded using the Keenan classification system. Complications related to the surgery were documented. The hand's function was evaluated with the House score. ResultsThe average follow-up was 47 months. Preoperatively, all patients had a class V hand: severe clenched-fist deformity with zero pulp-to-palm distance. Postoperatively, 10 patients had a type I hand (open hand, with less than 20° spontaneous extension deficit of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints) and 12 patients had a type II hand (20° to 40° spontaneous extension deficit of the MCP and PIP joints). The mean House score for all patients went from 0 to 0.88, and seven patients had functional improvements. Four patients had a forearm supination posture, 10 had intrinsic deformity with spontaneous MCP flexion and 6 had a swan-neck deformity. ConclusionSuperficialis-to-profundus tendon transfer (STP) provides satisfactory outcomes in terms of hand opening, with some patients also experiencing improved hand function. However, the complications cannot be ignored. Level of evidenceIV–retrospective or historical series.

INFORMATION THEORETIC FEATURE PROJECTION FOR SINGLE-TRIAL BRAIN-COMPUTER INTERFACES.

Current approaches on optimal spatio-spectral feature extraction for single-trial BCIs exploit mutual information based feature ranking and selection algorithms. In order to overcome potential confounders underlying feature selection by information theoretic criteria, we propose a non-parametric feature projection framework for dimensionality reduction that utilizes mutual information based stochastic gradient descent. We demonstrate the feasibility of the protocol based on analyses of EEG data collected during execution of open and close palm hand gestures. We further discuss the approach in terms of potential insights in the context of neurophysiologically driven prosthetic hand control.

New reconstruction for bone integration of non-vascularized autogenous bone graft with better bony union and revascularisation.

Phalangeal defects are often seen after tumor resection, infections, and in complex open hand fractures. In many cases, reconstruction is difficult and amputation is performed to avoid prolonged rehabilitation that is often associated with a poor outcome. In these cases, the maintenance of length and function presents a reconstructive challenge. We reviewed 11 patients who underwent extensive phalangeal reconstruction with non-vascularized bone graft from the iliac crest using a key-in-slot-joint technique to provide acceptable function and bony union. In each case, non-vascularized bone graft with a length of 1.4-6.0cm was used to reconstruct the phalanx. Follow-up ranged from 6 weeks to 5 months, and in all cases, there was bony union after 6 weeks. We evaluated range of motion, function, and as well pain and grip strength of the fingers. This case series suggests that a key-in-slot technique allows non-vascularized bone graft to be used in complex large phalangeal bone defects. Due to better bone contact, a sufficient perfusion and revascularisation of the non-vascularized bone graft can be achieved for a quicker and stable bony union. This method appears to be an alternative to amputation in selected cases with a satisfactory soft-tissue envelope.

Perceptions of Corporal Punishment among Creole and Maroon Professionals and Community Members in Suriname

Child discipline is a vital part of child‐rearing in all cultures. The need for child discipline is generally recognised, but considerable debate exists regarding the best methods. Corporal punishment (CP) is a dominant practice in Caribbean cultures. This qualitative study investigated community perceptions of the function, legality and boundaries of CP in child‐rearing practices in Suriname, in which CP is defined as hitting a child on their buttocks or extremities using an open hand. Twelve focus group discussions were conducted with adolescent and adult community members from Creole and Maroon backgrounds, as well as with professionals working with children. ATLAS.ti (version 7.5.4), a qualitative data package, was used to conduct the analyses. This study showed how violent forms of disciplining children are widely accepted and practised in Suriname. CP is considered a necessary and respected form of disciplining children, particularly by parents. Participants know about the existence of the United Nations Convention on the Rights of the Child that has been ratified in Suriname, but there is a lack of knowledge about its content. Developing appropriate policy responses to violence towards children requires understanding of the perception and use of CP. Such knowledge is needed to tackle the invisibility and social acceptance of violence in child discipline.Key Practitioner Messages Under certain circumstances, Corporal Punishment (CP) is accepted and applied in Suriname, despite growing knowledge of its harmful consequences. While participants considered the lawfulness of behaviour, they were primarily interested in the intentions of the caretakers when using CP If these were interpreted ‘in the best interest of the child’, CP was not considered maltreatment. Understanding of what motivates caregivers to use CP helps in developing appropriate policy responses in order to prevent and respond to violence towards children.

Frequency and Outcomes of Anastomotic Leak in Gastrointestinal Surgery at Public Sector Hospital

AbstractObjective: The objective of this study was to find out frequency of anastomotic leak at a hospital and deplore the morbidities, duration of hospital stay.Methods: A total of 102 patients of both genders from 18 – 60 years in age underwent for bowel resection and anastomosis through laparotomy incision at surgical unit one of People’s University of Medical &amp; Health Sciences, Nawabshah, from January 2013 to December 2016 were enrolled in this cross-sectional study. Every patient received appropriate antibiotics for duration according to need post-operatively. Follow-up was every fortnightly for four months to evaluate the primary outcome as prevalence of leak and secondary outcome as morbidities, length of hospital stay incisional hernia and mortality.Results: The results showed that, out of 102 patients underwent open primary hand sewn gastro intestinal anastomosis, 16 (15.68%) were found with anastomotic leak. Among these 16 patients having anatomic leak, 11 (11%) were male &amp; 5 (5%) were female. While, mortality occurred in 05 (5%%) patients.Conclusions: Anastomotic leak following gastrointestinal anastomosis is less complication in this study. Further studies are requested with large data and more follow-ups to ensure the findings of this study at national level.

Diagnostic validity of hand gestures in chest pain of coronary origin

ObjectivesTo determine the frequency of 3 hand gestures by patients with chest pain and determine the diagnostic validity of the gestures in acute coronary syndrome. Patients and methodsA prospective study was conducted on 383 adult patients treated for chest pain in an emergency department. We observed certain hand gestures, previously referred to in the medical literature as characteristic of coronary pain (gesture 1: a clenched fist held over the sternal area or Levine's sign; gesture 2: open hand located over the same area; gesture 3: both hands placed in the center of the chest), as well as other gestures. We analyzed their association with the coronary origin of the pain. ResultsWe confirmed the coronary origin of the pain in 164 (43%) patients (ACS group). The other 219 patients (57%) did not have a coronary origin for the pain (nonACS group). Eighty-nine percent of the patients identified their pain with one of the 3 classical gestures. The most frequent gesture was number 2, both overall (59%) and by group (60% ACS group; 57.5% nonACS group). There was no significant association between the type of gesture and the final diagnosis (p=.172). The greater specificity corresponded to Levine's sign (90%), followed by other gestures (86%) and gesture 3 (81%). ConclusionsAlthough 89% of the patients expressed their chest pain with one of the 3 manual gestures classically associated with coronary pain, none achieved sufficient diagnostic accuracy to be used as indicative of this type of pain.

Offline: Israel and Palestine—a joint search for the truth

Offline: Israel and Palestine—a joint search for the truth