Skilled Hands Research Articles

Biomimetic versus arbitrary motor control strategies for bionic hand skill learning

A long-standing engineering ambition has been to design anthropomorphic bionic limbs: devices that look like and are controlled in the same way as the biological body (biomimetic). The untested assumption is that biomimetic motor control enhances device embodiment, learning, generalization and automaticity. To test this, we compared biomimetic and non-biomimetic control strategies for non-disabled participants when learning to control a wearable myoelectric bionic hand operated by an eight-channel electromyography pattern-recognition system. We compared motor learning across days and behavioural tasks for two training groups: biomimetic (mimicking the desired bionic hand gesture with biological hand) and arbitrary control (mapping an unrelated biological hand gesture with the desired bionic gesture). For both trained groups, training improved bionic limb control, reduced cognitive reliance and increased embodiment over the bionic hand. Biomimetic users had more intuitive and faster control early in training. Arbitrary users matched biomimetic performance later in training. Furthermore, arbitrary users showed increased generalization to a new control strategy. Collectively, our findings suggest that biomimetic and arbitrary control strategies provide different benefits. The optimal strategy is probably not strictly biomimetic, but rather a flexible strategy within the biomimetic-to-arbitrary spectrum, depending on the user, available training opportunities and user requirements.

ERCP-induced perforation: review and revisit after half a century.

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure. We aimed to investigate ERCP-induced perforations at our institution and conduct a comprehensive review of literature on ERCP-induced perforations (EIP) since the introduction of this procedure as a therapeutic intervention. This was a case-control study, in which charts of all patients diagnosed with ERCP-induced duodenal perforation were reviewed and compared to a control group without perforation. Patient's sociodemographic and clinical data, including ERCP procedure-related data, were gathered. A total of 996 ERCP procedures were performed; only 13 patients proved to have EIP. Obstructive jaundice was the most common indication for ERCP. The main predisposing factor was difficult cannulation (P = 0.003). In total, five patients required surgical treatment; the majority of them had type I perforation, whereas type IV was the most common in patients who were treated conservatively. The overall mortality rate was 15%, the surgical group had a slightly higher mortality rate. Fifty years after the introduction of ERCP for therapy, it remains an invasive procedure that carries significant morbidity and mortality, even in skilled hands or at high- volume units. Conservative management of perforation yields favorable outcomes in selected patients.

The efficiency of mirror therapy in peripheral nerve injuries.

The purpose of this study was to investigate the effectiveness of mirror therapy on pain, sensory, and functional development in addition to conventional rehabilitation and occupational practices in patients with a peripheral nerve injury in the hand. Twenty-six patients with peripheral nerve injury in the hand were included in this randomized controlled study between November 2017 and May 2018. The patients were randomly assigned to the mirror group (n=14) and the control (n=12) group. Both groups received conventional therapy in our clinic for 45 min a day during weekdays for six consecutive weeks. The mirror group received an additional 10-15 min of visual mirror therapy. Visual Analog Scale (VAS), Duruöz Hand Index, Quick Disabilities of the Arm, Shoulder, and Hand, Jebsen hand function test, and Semmes-Weinstein monofilament test were used for the assessment of pain, hand function, and sensation of the patients at baseline and after treatment. The handgrip strength of the patients was measured with a dynamometer. A total of 20 patients (17 males, 3 females; mean age 31.9±16.5, range 16 to 65 years) completed the study, with 10 in each group. Statistically significant improvement was detected in hand skill functions, such as page-turning (p=0.004), backgammon packing (p=0.023), and heavy object lifting (p=0.029) in the mirror group. A statistically significant decrease was found in total scores of VAS after treatment in both groups (p<0.05). The results imply that mirror therapy integrated with conventional rehabilitation may aid additional benefits on hand functions in peripheral nerve injury. These results demonstrate that mirror therapy can be used in addition to the rehabilitation program of patients with peripheral nerve injury.

Adults With Cochlear Implants: Residual Hearing, Musical Perception, and Temporal Skills.

The main purpose of the study is to investigate whether the presence of residual hearing before cochlear implantation has an effect on temporal pattern recognition skills and musical perception in adults. The study included adults with cochlear implants who were between the ages of 20 and 45 years. Adults with cochlear implants were divided into two groups: absent (n = 20) and available (n = 20) groups according to residual hearing before implantation. Frequency Pattern and Duration Pattern tests were applied to evaluate temporal pattern recognition, and the "Music-Related Quality of Life Questionnaire" was applied to evaluate musical perceptions. There were no statistically significant differences between the groups in terms of cochlear-implanted hearing thresholds and speech recognition scores, musical perception, and musical activities, according to their residual hearing. On the other hand, the frequency and duration pattern recognition skills were statistically significantly better in adults with residual hearing. Also, statistically significant correlations were obtained in terms of temporal skills and musical perception subskills. The presence of residual hearing before cochlear implantation may affect temporal auditory processing skills. It is concluded that the integration of cochlear implants may affect temporal processing skills in adults as well as quality of life. It is recommended that experts be aware of this issue and pay attention to residual hearing.

Training future leaders: A qualitative study exploring leadership development in predoctoral dental curricula.

Commission on Dental Accreditation (CODA) accreditation standard 2-19 states predoctoral dental schools must assess students' ability to function successfully as the leader of the oral health care team. This study aimed to explore how dental schools incorporate leadership training into their curriculum to better understand the leadership skills students learn, the ways students engage in leadership training, and the opportunities students have to practice leadership skills with their peers. The aim of this 2022 qualitative phenomenology study was to use semi-structured interviews with academic Deans at CODA-accredited dental schools and one subject matter expert to uncover types of cognitive, behavioral, and environmental factors influencing leadership training through the lens of social cognitive theory. All interviews were recorded on Zoom, transcribed, de-identified, and analyzed for recurring themes using NVivo. Eight academic Deans and one subject matter expert participated in the study. Four major themes emerged from the data: leadership is essential for dental professionals, leadership is incorporated into the curricula in diverse ways, students most often engage in leadership training opportunities with dental peers and interprofessional opportunities could be expanded, and dental schools often face barriers to incorporating leadership training. Vertically integrated case presentations and team-based practice management simulations are meaningful leadership development activities. Prominent barriers include time constraints, lack of faculty champions with teaching leadership expertise, and prioritizing the development of hand skills. Standard practices for student leadership development and assessment do not appear to exist across dental school curricula. Findings support the need for a leadership development framework.

Abstract TP89: Participation in Kitchen-Related Tasks Among Stroke Survivors: A Qualitative Study

Background and Aim: Being able to prepare meals and perform kitchen-related tasks is essential for living independently after stroke, yet receiving less attention when compared with other self-care activities such as toileting. This study sought to understand the survivors’ experiences of how they performed kitchen-related tasks after stroke. Methods: A qualitative study with individual, semi-structured interviews were conducted with a convenience sample of adults who had had a first or recurrent ischemic or hemorrhagic stroke for over one year and were living at home. The survivors shared about their participation in kitchen-related tasks after stroke including boiling water for drinking, meal preparation, and kitchen-related cleaning. Non-participant observation of activities performed by the survivor on a random day was conducted. Assistive aids used by the survivors and home modifications made to facilitate them to perform kitchen-related tasks were recorded. All interview data were transcribed verbatim and analyzed thematically. Results: Twenty survivors with a mean age of 61.40 years old (SD=8.52) were interviewed. They had had a stroke for an average of 10 years (SD=7.33). Four main themes were identified: 1) Being able to prepare meals symbolized achievement of independence in daily living and recovery, and eager to be able to do it. 2) Simple cooking or minimal participation in kitchen-related tasks even two to three years after stroke, feeling dependent in choices of food. 3) Common factors affecting their participation included being hesitant, barred by family members, safety concerns, reduced activity tolerance to stand during cooking, and inconvenience or inabilities to perform tasks with one hand such as cutting food, or holding a kettle filled with water. 4) Limited knowledge regarding adaptive tools facilitating their performance of kitchen-related tasks. More suggestions on cost-effective and pragmatic strategies and tools to prepare meals with one hand were desired. Conclusions: The findings suggested that the chronic stroke survivors had inadequate knowledge and skills to perform kitchen-related tasks. Suggestions on appropriate use of adaptive tools for cooking with one hand and innovative skill training are needed.

Effects of noninvasive neuromodulation targeting the spinal cord on early learning of force control by the digits.

Control of finger forces underlies our capacity for skilled hand movements acquired during development and reacquired after neurological injury. Learning force control by the digits, therefore, predicates our functional independence. Noninvasive neuromodulation targeting synapses that link corticospinal neurons onto the final common pathway via spike-timing-dependent mechanisms can alter distal limb motor output on a transient basis, yet these effects appear subject to individual differences. Here, we investigated how this form of noninvasive neuromodulation interacts with task repetition to influence early learning of force control during precision grip. The unique effects of neuromodulation, task repetition, and neuromodulation coinciding with task repetition were tested in three separate conditions using a within-subject, cross-over design (n = 23). We found that synchronizing depolarization events within milliseconds of stabilizing precision grip accelerated learning but only after accounting for individual differences through inclusion of subjects who showed upregulated corticospinal excitability at 2 of 3 time points following conditioning stimulation (n = 19). Our findings provide insights into how the state of the corticospinal system can be leveraged to drive early motor skill learning, further emphasizing individual differences in the response to noninvasive neuromodulation. We interpret these findings in the context of biological mechanisms underlying the observed effects and implications for emerging therapeutic applications.

Self Help Groups Members’ Religious Perception and their Relationship between Financial Literacy and Repayment Intention towards Loan: Considerable Focus on Himachal Pradesh (H.P)

The intent of this study is to create a comprehensive model that can identify various factors and examine the impact of financial literacy on loan repayment intentions among members of SHGs in Himachal Pradesh. A conceptual model has been put forward and its validity has been confirmed. In addition to this, a total of 500 questionnaires were distributed, out of which 372 were considered usable. The stability of the proposed model and the testing of research hypotheses were conducted using structural equation modelling. The findings indicate that financial awareness and financial skills are strong predictors of loan repayment intention among SHG members. On the other hand, financial knowledge and financial skills have a relatively weak influence on loan repayment intentions. The results and observations from the interaction with responders indicate that there is a moderate level of importance placed on financial literacy among members of SHGs. An important factor in reducing the rate of outstanding loans in SHGs is the need for members to enhance their financial understanding.

Successful Awake Caudal Anesthesia for Incarcerated Inguinal Hernia Repair in an Ex-Premature Baby at 8 Weeks of Age.

Introduction: Caudal anesthesia is a standard procedure in pediatric anesthesia because of its excellent safety and success rate. Usually, it is administered after general anesthesia, but in selected neonatal populations, awake caudal anesthesia is a method of choice.&#x0D; Prematurely born, low birth weight neonates are more prone to complications from general anesthesia than term neonates, even after simple surgery. Among these complications, post-operative apnea is the most common.&#x0D; Caudal epidural anesthesia in awake neonates is a recognized technique that enables the avoidance of general anesthesia and the complications associated with it. In skilled hands, it is also theoretically easier to perform consistent caudal anesthesia than an awake subarachnoid block. In our case, we report a successful awake caudal anesthesia in an ex-premature baby in the emergency setting for incarcerated inguinal hernia repair.&#x0D; To our knowledge, this case report on this topic has yet to be published in Armenia.&#x0D; Conclusion: Neuraxial (spinal, epidural, caudal) awake anesthesia is the method of choice for lower abdominal surgery in preterm infants. Both spinal and caudal anesthesia are effective methods; awake caudal anesthesia is a method of choice because of the success rate and lower analgesic requirements in the post-operative period.&#x0D; &#x0D;

Comparison of the effectiveness of virtual reality-based education and conventional teaching methods in dental education: a systematic review

Background and objectivesVirtual reality dental simulators as an educational tool may create specific training conditions for dental students, allowing them to practice dental skills in a safe and controlled condition. This study aimed to investigate the effectiveness of virtual reality-based education in dental education compared to traditional education approaches.MethodsIn this systematic review, four databases (PubMed, Scopus, Web of Science, and Science Direct) were searched until 2023 following PRISMA guidelines. The Quality assessment and risk of bias were assessed by the Cochrane Collaboration Tool for RCTs and GRADE, respectively. Inclusion criteria were restricted to randomized or quasi-randomized trials about virtual reality efficacy in dental education. Two authors independently evaluated the data and reviewed the overall risk of bias for all selected studies. Study design, sample size, hardware, onset time of intervention, duration, and number of procedures performed were among the data extracted.ResultsFrom the 703 titles, 48 full texts were chosen for review, yielding 14 articles for final inclusion. The review of these articles indicated the effective role of virtual reality dental simulators in improving students' knowledge and practical skills.ConclusionsBased on our findings, adding haptic technology to virtual reality can improve students' practical skills, hand skills, theoretical knowledge, self-confidence, and learning environment. Although a fair amount of research needs to be done, notably on cost-effectiveness, student satisfaction, and other potentially adverse effects, virtual reality is a growing phenomenon with immense potential.

Endoscopic Microvascular Decompression.

Microvascular decompression is a widely accepted surgical treatment for compressive cranial nerve pathologies such as trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, and other craniofacial pain syndromes. Endoscopy has risen as a safe and effective minimally invasive tool to optimize microvascular decompression. Endoscopy offers improved visualization, minimizes retraction, and allows for smaller surgical openings compared to traditional microscopic approaches. There are several reports of improved neuralgia outcomes and reduced post-operative complications after endoscopic microvascular decompression. In skilled surgical hands, endoscopy is an excellent option for microvascular decompression as stand-alone tool or adjunct to the microscope. An overview of the history, operative considerations, and techniques is provided in this chapter.

Doing household chores prepares children for life!

Üsküdar University, Faculty of Health Sciences, Deputy Head of Child Development Department, Asst. Prof. Pınar Demir Asma touched upon the development of hand skills in children.

Improving The Fine Motor Ability of Children With Cerebral Palsy Through Contextual Learning Based on Maze Game Media

The Maze game media helps develop children's fine motor abilities, such as flexing fingers and wrists, and fine motor skills linked with the movement skills of both hands, as well as their capacity to combine eye senses and hand activity. This study aims to determine the increase in fine motor skills of children with cerebral palsy through a contextual learning model based on maze game media at 3 to 8 years old at SDLB Type D Disabled Children Foundation, South Jakarta. This research method uses action research. Action research is cycle-oriented research on various actions or interventions carried out by researchers as classroom teachers. The research took place from the design stage to the evaluation of practical classroom interventions regarding teaching and learning activities to enhance the fine motor skills of cerebral palsy-affected students. In the 2021-2022 school year, researchers studied children's fine motor abilities using maze game media. This research consists of three cycles (pre-cycle, cycle 1, and cycle 2). The results of this study indicate that the improvement of fine motor skills of children with cerebral palsy through media-based contextual models maze games are effectively negative or low inclined. This research implies that one of the creative ways to improve fine motor skills is through activities based on contextual learning models based on maze game media. In addition, using maze media can effective communication between class teachers and CP children so that CP children have better concentration and are independent in carrying out their fine motor movements at school and home

Pemanfaatan Limbah Botol Kaca Guna Meningkatkan Kreativitas Keluarga Yang Memiliki Nilai Ekonomis

Waste or also known as rubbish is a problem that is quite complex for the government to handle, especially household waste which is never separated from the use of inorganic or organic materials every day. In maintaining a clean and comfortable environment, especially in the city, especially in Balikpapan, existing waste is separated at disposal. By referring to green environment principles, it is hoped that people will not throw rubbish or waste carelessly or at certain times. Referring to the problem of handling waste made from glass, in this case glass bottle waste, this article examines the use of glass bottle waste to increase family creativity which has economic value. The aim of writing community service is to: 1) Increase the community's sense of awareness in efforts to handle solid waste, in this case glass material waste. 2) Can provide information to the public about how to recycle glass waste. The type of method used is qualitative, document study and narrative in nature. There are various ways of recycling, in the study of community service writing it is how to disseminate useful information to society at the lowest level, namely households. Where waste management can begin to be implemented in the home and family environment, this can of course also be a motivation and build creativity in the skilled hands of children at home. where they can be given an understanding of how to create a clean and comfortable living environment, as well as foster creativity that creates added value that is beneficial from an economic perspective. Treatment for waste management starts from the smallest line, namely the family or household. The application of the go green concept with 3R can be applied in households in waste management, one of which is inorganic waste, namely glass bottles.

Meningkatkan Kemampuan Motorik Halus Melalui Kegiatan Pengolahan Bahan Bekas Pada Anak Usia 5-6 Tahun di TK Aisyiyah Bustanul Athfal Banyuwangi

Fine motor stimulation is an important aspect of early childhood development. If a child has not been able to develop his fine motor skills well, then the child will also experience difficulty in carrying out activities related to hand skills. The aim of this research is to improve fine motor skills through used material processing activities in children aged 5-6 years at the Aisyiyah Bustanul Athfal Kindergarten, Banyuwangi. Specifically, the used material used during the research was waste paper. This type of research is classroom action research. This research was carried out in two cycles and each cycle was held in two meetings. This research was carried out at the Aisyiyah Bustanul Athfal Banyuwangi Kindergarten with research subjects being Group B aged 5-6 years, totaling 16 people. Data collection in this research used observation and documentation techniques. From cycle 1 to cycle II, especially in the "Developing According to Expectations" category which increased from 26.67% to 53.33%. In addition, children who were in the "Undeveloped" category in cycle 1 had reached 0% in cycle 2, showing a positive increase in the fine motor development of group B children aged 5-6 years at the Aisyiyah Bustanul Athfal Banyuwangi Kindergarten. The achievements in cycle 2 were in accordance with the established indicators of success, so that the classroom action research was considered complete and successful in improving children's fine motor skills. Keywords: Fine Motor Skills, Used Materials, ECE

The Relationship between Job Fatigue and Fine Motor Skills in Cable Car Company’s Production Staff

Background and objective: Job fatigue is considered one of the factors affecting the performance and the productivity of workers in work environments. Therefore, the objective of the present study was to investigate the relationship between job fatigue and its dimensions with fine motor skills in the production line workers of Sabzevar Cable Car Company. Participants and methods: One hundred and forty-eight workers of the production line of Sabzevar Car Company were selected as a sample. The level of occupational fatigue of workers was measured using the standard questionnaire of Excessive Occupational Fatigue. In addition, manual and sorting skills of workers were estimated through Board test. In order to analyze the research data, Spearman's correlation coefficient test was used. Results: The results of the Spearman correlation coefficient test showed that there were negative and significant relationships between job fatigue and the components of hand and finger dexterity skill, including manual skills (r = 0.188, P ≤ 0.022) and sorting skill r (r = -0.246, P ≤ 0.003). Also, a statistically significant relationship was observed between the dimensions of fatigue and coping skills (P≤0.05). Conclusion: According to the results of the present research study, we recommend that employers prevent the occurrence of worker fatigue in industrial environments through providing conditions such as shift breaks and performing short-term activities with low intensity. Otherwise, in order to prevent accidents and the production of defective products, tired workers should refrain from performing fine manual activities such as assembling.

ПСИХИКАЛЫҚ ДАМУЫ ТЕЖЕЛГЕН БАЛАЛАРДЫҢ ЛОГИКАСЫН ДАМЫТУ

The article deals with the problem of logic development in children with mental retardation in a comprehensive school, as the modern education system is designed to create conditions that meet the capabilities and needs of students with special educational needs. The development of thinking, including logical thinking, plays a special role in the senior preschool and school age. With the beginning of school, thinking becomes one of the key aspects among other cognitive processes. The lack of consistency of logical thinking leads to the fact that the knowledge acquired by the child turns out to be incomplete, which complicates the learning process and reduces its effectiveness. The greatest difficulties arise in children with mental retardation, who have a lag in visual-figurative and verbal-logical forms of thinking. The practical significance of our research lies in the fact that we have developed a set of joint classes for this category of children, aimed at teaching methods of logical thinking (analysis, comparison, classification, analogy, generalization, establishment of causal relationships), the development of memory, attention, fine motor skills of hands, interest in solving puzzles.

How I do it: Pedal access and pedal loop revascularization for patients with chronic limb-threatening ischemia.

An increasing proportion of patients with chronic limb-threatening ischemia are older and have multiple comorbidities, including diabetes and renal failure. For those who are not candidates for a surgical bypass, this set of patients presents a challenge to vascular surgeons and interventionalists owing to the complex below-the-knee and increasingly below-the-ankle disease pattern that can fail traditional approaches for endovascular intervention. Two techniques, the retrograde pedal access and the pedal-plantar loop technique, can be useful in these settings and in skilled hands can be used safely, with a high technical success rate. In patients with chronic limb-threatening ischemia who are not candidates for a single-segment saphenous vein bypass, the retrograde pedal access technique can be used not only in the setting of failed antegrade treatment, but also primarily when faced with a difficult groin or as an adjunct during a planned antegrade-retrograde intervention. The pedal plantar loop technique allows for retrograde access to tibial vessels without retrograde vessel puncture and additionally offers the ability to treat the pedal-plantar arch, which may have added benefit in wound healing. We describe the tips and tricks for these two techniques used in our limb salvage practice.

Distribution of hand function by age in individuals with Rett syndrome.

To determine the longitudinal distribution of hand function skills in individuals with classic Rett Syndrome (RTT), an X-linked dominant neurodevelopmental disorder, and correlate with MECP2 variants. We conducted a longitudinal study of 946 girls and young women with typical RTT seen between 2006 and 2021 in the US Natural History Study (NHS) featuring a structured clinical evaluation to assess the level of hand function skills. The specific focus in this study was to assess longitudinal variation of hand skills from age 2 through age 18 years in relation to specific MECP2 variant groups. Following the initial regression period, hand function continues to decline across the age spectrum in individuals with RTT. Specific differences are noted with steeper declines in hand function among those with milder variants (Group A: R133C, R294X, R306C, and C-terminal truncations) compared to groups composed of individuals with more severe variants. These temporal variations in hand use represent specific considerations which could influence the design of clinical trials that test therapies aiming to ameliorate specific functional limitations in individuals with RTT. Furthermore, the distinct impact of specific MECP2 variants on clinical severity, especially related to hand use, should be considered in such interventional trials.

Neurosurgical Aspect of Management of Movement Disorders

Background People with movement disorders can experience involuntary movement such as tremor, abnormal posture, slowness, walking difficulty, and stiffness due to neurological conditions. Aim of the Work to conduct a meta-analysis of surgical treatment of patients with movement disorder diseases and help patients for living normal life and performing all sports and hand skill work without any limitation of movement, and improve surgical management, learn indication of surgery, patient selection, techniques, and complications among functional neurosurgeons. Methods Searching procedures will be conducted focusing on the following sources: electronic databases: Medline; 2) Bibliographies and 3) Hand searches of journals: -Online internet search from the electronic database of Medline via PubMed, “Related articles” function will be used to obtain any relevant articles. Additionally, references of the articles included in the analysis were reviewed for any other citations. After screening full text of the included studies the following data was extracted from each primary study: study design, full reference of article including author, year and source, population description: criteria for diagnosis, severity of disease. Intervention: Thalamotomy and DBS alone. Comparative Group (if relevant) and outcome. Results The efficacy in reducing drug-resistant tremor was non-significantly equal among DBS group and thalamotomy group. Cognitive changes were nonsignificantly less among DBS than thalamotomy groups. Gait disturbances were non-significantly lower among DBS than among thalamotomy group. Ataxia risk was non-significantly lower among DBS than among thalamotomy group. Dysarthria risk was non-significantly different among DBS and thalamotomy groups. Hypresthesia risk was non-significantly lower among DBS than among thalamotomy groups. Seizures risk was non-significantly higher among DBS group than among thalamotomy group. Paresis risk was non-significantly lower among DBS than among thalamotomy groups. Psychiatric disturbances risk was non-significantly different among DBS and thalamotomy groups. Intracerebral hemorrhage was significantly lower among DBS than among thalamotomy. That mean DBS is Equal in efficacy and less adverse effects but more expensive than thalamotomy. Conclusion Net result of complications of Thalamic stimulation is less than thalamotomy due to our meta-analysis which show that the incidence of intra cerebral hemorrhage is more in thalamotomy than thalamic stimulation, and the incidence of ataxia, gait disturbance, hypoesthesia and paresis are more in thalamotomy than thalamic stimulation but the incidence of seizers is higher in thalamic stimulation than thalamotomy. But there are another complication which is different in results between both such as dysarthria and psychiatric disturbance.