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Hand prosthesis controlled by surface electromyography (sEMG) is promising due to the control capabilities and the noninvasive technique that machine learning (ML) offers to help physically disabled people during daily life. Nevertheless, dexterous prostheses are still infrequently popular due to control problems and limited robustness. This paper proposes a new set of time domain (TD) features to improve the EMG pattern recognition performance. The effect of five feature sets is evaluated based on the three classifiers k-nearest neighbor (KNN), linear discriminate analysis (LDA), and support vector machine (SVM). The EMG signals are obtained from database-5 (DB5) of the ninapro project datasets. In this study, the long-term signals of DB5 are segmented into short-term signals to perform short-term recognition. The results showed that the LDA classifier based on the proposed features achieved high classification accuracy for classifing 17 gestures. The LDA classifier achieved about 96.47% compared to 94.12%, and 93.82% for KNN and SVM classifiers, respectively. The results confirm that the suitable features extracted from short term signals with the appropriate classifier, has an important impact on improving the performance of gesture classification.

Background: Actionable feedback from patients after a clinic visit can help inform ways to better deliver patient-centered care. A 2-word assessment may serve as a proxy for lengthy post-visit questionnaires. We tested the use of a 2-word assessment in an outpatient hand clinic. Methods: New patients were asked to provide a 2-word assessment of the following: (1) their physician; (2) their overall experience; and (3) recommendations for improvement and their likelihood to recommend (LTR) after their clinic visit. Sentiment analysis was used to categorize results into positive, neutral, or negative sentiment. Recommendations for improvement were classified into physician issue, system issue, or neither. We evaluated the relationship between LTR status, sentiment, actionable improvement opportunities, and classification (physician issue, system issue, or neither). Recommendations for improvement were classified into themes based on prior literature. Results: Sixty-seven (97.1%) patients noted positive sentiment toward their physician; 67 (97.1%) noted positive sentiment toward their overall experience. About 31% of improvement recommendations were system-based, 5.9% were physician-based, and 62.7% were neither. Patients not LTR were more likely to leave actionable opportunities for improvement than those LTR ( P = .01). Recommendations for improvement were classified into predetermined themes relating to: (1) physician interaction; (2) check-in process; (3) facilities; (4) unnecessary visit; and (5) appointment delays. Conclusion: Patients not likely to recommend provided actionable opportunities for improvement using a simple 2-word assessment. Implementation of a 2-word assessment in a hand clinic can be used to obtain actionable, real-time patient feedback that can inform operational change and improve the patient experience.

Background: Social and demographic factors may influence patient treatment by physicians. This study analyzes the influence of patient sociodemographics on prescription practices among hand surgeons. Methods: We performed a retrospective analysis of all hand surgeries (N = 5278) at a single academic medical center from January 2016 to September 2018. The average morphine milligram equivalent (MME) prescribed following each surgery was calculated and then classified by age, race, sex, type of insurance, and history of substance use or chronic pain. Multivariate linear regression was used to compare MME among groups. Results: Overall, patients with a history of substance abuse were prescribed 31.2 MME more than those without ( P < .0001), and patients with a history of chronic pain were prescribed 36.7 MME more than those without ( P < .0001). After adjusting for these variables and the type of procedure performed, women were prescribed 11.2 MME less than men ( P = .0048), and Hispanics were prescribed 16.6 MME more than whites ( P = .0091) overall. Both Hispanic and black patients were also prescribed more than whites following carpal tunnel release (+19.0 and + 20.0 MME, respectively; P < .001). Patients with private insurance were prescribed 24.5 MME more than those with Medicare ( P < .0001), but 25.0 MME less than those with Medicaid ( P < .0001). There were no differences across age groups. Conclusions: Numerous sociodemographic factors influenced postoperative opioid prescription among hand surgeons at our institution. These findings highlight the importance of establishing more uniform, evidence-based guidelines for postoperative pain management, which may help minimize subjectivity and prevent the overtreatment or undertreatment of pain in certain patient populations.

Background: The Rhode Island State Legislature passed the Uniform Controlled Substances Act in 2016 to limit opioid prescriptions. We aimed to objectively evaluate its effect on opioid prescribing for hand surgery patients and also identify risk factors for prolonged opioid use. Methods: A 6-month period (January-June 2016) prior to passage of the law was compared with a period following its implementation (July-December 2017). Thumb carpometacarpal arthroplasty and distal radius fracture fixation were classified as “major surgery” and carpal tunnel and trigger finger release as “minor surgery.” Prescription Drug Monitoring Database was used to review controlled substances filled during the study periods. Results: A total of 1380 patients met our inclusion criteria, with 644 prelaw and 736 postlaw patients. Patients undergoing “major surgery” saw a significant decrease in the number of pills issued in the first postoperative prescription (41.1 vs 21.0) and a corresponding decrease in morphine milligram equivalents (MMEs) (318.6 vs 159.2 MMEs) after implementation. A 30% decrease in MMEs was also seen in those undergoing “major surgery” in the first 30 days postoperatively (544.7 vs 381.7 MMEs). Risk factors for prolonged opioid use included male sex and preoperative opioid use. Conclusions: In Rhode Island, opioid-limiting legislation resulted in a significant decrease in the number of pills and MMEs of the initial prescription and a 30% decrease in total MMEs in the 30-day postoperative period after “major hand surgery.” Additional research is needed to explore the association between legislation and clinical outcomes.

Background Traditional measures of evaluating scholarly output do not capture the impact social media can provide in disseminating and promoting research. We sought to better understand the level of online attention that high-quality hand research received. Methods Scientific manuscripts published from 2017 in Journal of Hand Surgery (American Volume) ( JHS-A), Journal of Hand Surgery ( European Volume) ( JHS-E), and HAND were recorded. Manuscript characteristics were determined, including the number of citations. Altmetric Attention Score (AAS), a measure of a manuscript’s online attention and impact, was determined, as well as Twitter mentions, Facebook mentions, and news outlet mentions. Spearman rho (ρ) correlation coefficient was used to evaluate the relationship between the number of citations and AAS. Multivariable linear regression analysis was performed to determine which manuscript factors were associated with AAS. Results A total of 323 manuscripts were identified. There was a weak positive correlation between the number of citations and AAS; however, this relationship did not exist for each individual journal. Publication in HAND and JHS-E were associated with lower average manuscript AAS when using JHS-A as the reference group. Two additional factors were also associated with increased manuscript AAS: (1) being a clinical study focused on a specific upper extremity anatomical location; and (2) increasing number of institutions on a study. Conclusions Publication in HAND and JHS-E were associated with lower manuscript AAS when using JHS-A as the reference group, suggesting that HAND and JHS-E have room for improvement in using social media to share their high-quality hand surgery scientific articles.

Background The mismanagement of missing data in large clinical databases may lead to inaccurate findings. The purpose of this study was to demonstrate the effects of missing data on hand surgery research findings using an analysis of postoperative morbidity in patients undergoing hospital-based hand surgery. Methods The National Surgical Quality Improvement Program database was queried for patients undergoing common hand and upper extremity surgery between 2011 and 2016. Major and minor postoperative complications were identified. Demographics, comorbidity, and preoperative laboratory values were identified, and the percentage missing of each was tabulated. To demonstrate how missing data can alter analysis results, these variables were evaluated for an association with major complications using multivariable regression on 3 separate cohorts: (1) all patients; (2) all patients after exclusion of any patient entry with >10% of missing data; and (3) after removal of any patient entry with any missing data. Results Groups 1, 2, and 3 had 48 370, 23 118, and 6280 patients, respectively. There were 14 variables associated with increased odds of major complications in group 1, yet only 10 and 9 variables for groups 2 and 3, respectively. Six variables were associated with increased major complications across all 3 groups, whereas only 1 was associated with decreased odds of major complications across all groups. Conclusions Filtering patient cohorts according to the amount of missing patient information affected analyses of predictors for major complications associated with hospital-based hand surgery. These findings highlight the importance of considering and addressing missing data in large database studies.

Background: To determine if the “unaffected” hand in children with hemiplegic cerebral palsy (CP) is truly unaffected. Methods: We performed a retrospective review of manual dexterity as measured by the Functional Dexterity Test (FDT) in 66 children (39 boys, 27 girls, mean age: 11 years 4 months) with hemiplegic CP. Data were stratified by Manual Ability Classification System (MACS) level, birth weight, and gestational age at birth, and compared with previously published normative values. Results: The FDT speed of the less affected hand is significantly lower than typically developing (TD) children ( P < .001). The development of dexterity is significantly lower than TD children (0.009 vs. 0.036 pegs/s/year, P < .001), with a deficit that increases with age. MACS score, birth weight, and age at gestation are not predictors of dexterity. The dexterity of the less affected hand is poorly correlated with that of the more affected hand. Conclusions: Both dexterity and rate of fine motor skill acquisition in the less affected hand of children with hemiplegic CP is significantly less than that of TD children. The less affected hand should be evaluated and included in comprehensive treatment plans for these children.

Background Instrument oversupply drives cost in the operating room (OR). We review previously reported methodologies for surgical instrument reduction and report a pilot methodology for optimizing instrument supply via ethnographic instrument tracking of thumb carpometacarpal (CMC) arthroplasties. Additionally, we report a cost analysis of instrument oversupply and potential savings of tray optimization methods. Methods Instrument utilization was tracked over 8 CMC arthroplasties conducted by 2 surgeons at an ambulatory surgery center of a large academic hospital. An optimized supply methodology was designed. A cost analysis was conducted using health-system-specific data and previously published research. Results After tracking instrument use in 8 CMC arthroplasties, a cumulative total of 59 out of the 120 instruments in the Hand & Foot (H&F) tray were used in at least 1 case. Two instruments were used in all cases, and another 20 instruments were used in at least 50% of the cases. Using a reduced tray with 59 instruments, potential cost savings for tray reduction in 60 cases were estimated to be $2086 without peel-packing and $2356 with peel-packing. The estimated cost savings were lower than those reported in literature due to a reduced scope and exclusion of OR time cost in the analysis. Conclusions Instrument oversupply drives cost at our institution’s ambulatory surgery center. Ethnography is a cost-effective method to track instrument utilization and determine optimal tray composition for small services but is not scalable to large health systems. The time and cost required to observe sufficient surgeries to enable supply reduction to motivate the need for more efficient methods to determine instrument utility.

Background: Moebius syndrome is a disorder characterized by facial and abducens nerve paralysis. Patients can present a wide range of upper extremity malformations. Literature focused on orthopedic manifestations of Moebius syndrome shows variability in the prevalence and clinical presentation of upper extremity anomalies. The aim of this work is to evaluate the prevalence of upper extremity malformations in patients with Moebius syndrome, clarify its various clinical presentations, and present treatment strategies for their management. Methods: This is a retrospective, cross-sectional study including patients with Moebius syndrome and upper extremity malformations between 2012 and 2019. Data include demographic characteristics, Moebius syndrome subtype, type of malformation, affected extremity, and surgical procedures underwent. Quantitative data were recorded as mean (standard deviation [SD]), and qualitative data were expressed in terms of totals and percentages. Statistical association between Moebius syndrome subtype and development of upper extremity anomalies was evaluated using binary logistic regression. Results: Twenty-five out of 153 patients (16.3%) presented upper extremity malformations (48% male). Mean age of presentation was 9.08 ± 9.43 years. Sixty-eight percent of the malformations were unilateral. The most common presentations included Poland syndrome and simple syndactyly with 8 cases each (32%), followed by 5 cases of brachysyndactyly (20%), 3 cases of amniotic band syndrome (12%), and 1 case of cleft hand (4%). No statistical association was found between Moebius syndrome subtype and odds ratio for development of upper extremity anomalies. Thirteen patients (52%) underwent reconstructive procedures. Conclusion: Poland syndrome and syndactyly are the most common anomalies in patients with Moebius syndrome. Patients may present with a wide range of hand malformations, each patient should be carefully evaluated in order to determine whether surgical treatment is needed and to optimize rehabilitation protocols.

Background: In treating occupational hand injuries under workers’ compensation, the 2 most important goals are to maximize patient function, ideally to preinjury levels, and permit a timely return to work (RTW). The purpose of this study was to determine factors affecting total case length, that is, the total time from injury until primary closure of a patient’s claim, and disposition among patients with hand injuries treated under workers’ compensation. Methods: All cases treated under workers’ compensation by a single fellowship-trained hand surgeon within a single year were retrospectively reviewed. A case is defined as the entire management and treatment of a single patient related to a single occupational injury incident. Independent variables included age, sex, body mass index, comorbidity, occupation, injury pattern, and treatment modality. Dependent variables included treatment duration from injury to case closure and final case disposition (RTW, functional capacity evaluation [FCE], or loss to follow-up [LTFU]). Comparison between groups was accomplished with analysis of variance. Multivariate linear and logistic regression analysis was performed to predict case length and disposition. Results: In all, 447 cases involving a workers’ compensation claim were reviewed. Among these, 75 (16.8%) were LTFU, 24 (5.4%) required an FCE, and 346 (77.4%) an RTW. The RTW cases averaged 138.5 days, whereas those requiring FCE averaged 331.5 days. Compared with average case length, crush injuries (76.8 days. P < .001) and fractures (111.8 days, P = .0224) had significantly shorter time to closure. In a multivariate linear model, cases of soft tissue and nerve injury were associated with longer case lengths, remaining open for an additional 56.8 and 347.1 days, respectively ( P < .001). Each treatment modality studied, therapy, injections, and surgery, was associated with an increase in case length. Conclusions: Cases requiring FCE were open significantly longer than those resulting in RTW. In addition, injury pattern and treatment modality were associated with significant variations in total case length. These results imply that a specific subset of patients, namely those with soft tissue and nerve injuries, may experience delayed resolution among patients treated under a workers’ compensation claim.

This study is an attempt to determine whether the need to get hydropower project appraisals perfectly right during the pre-construction phase, so as to prevent significant overruns along with benefit shortfalls, should supersede the need to deliver projects at the earliest possible time so as to meet the needs of the people. To achieve the study objective, we test whether the Hiding Hand principle is predominantly benevolent or malevolent. We argue that if the Hiding Hand is benevolent, then project stakeholders are better off focusing on the quick delivery of power projects; however, if it is malevolent, then more attention should be given to perfecting project appraisals. It transpires from the statistical analysis that the Benevolent Hiding Hand dominates the Malevolent Hiding Hand in the selected World Bank-financed hydropower projects (33% v. 21%), and that ultimately, 75% of the projects were even more successful than anticipated—while 25% of the projects failed. Our findings further show that while a total loss of 2.335 billion USD in the sampled dams was caused by the Malevolent Hiding Hand, 11.259 billion USD was gained as a result of the Benevolent Hiding Hand. The predominance of the Benevolent Hiding Hand justifies placing some weight on proceeding with hydropower projects that show significant promise even if all the implantation risks are not fully quantified at the appraisal stage, especially in developing countries.

Chronic hand eczema (CHE) is persistent inflammatory dermatitis that may significantly affect the quality of life, with psychosocial effects, impact on school, work, and leisure activities, influence on socioeconomic status, and high health care costs. Pediatric-CHE (P-CHE) has a high prevalence yet has not been extensively studied in children and adolescents. There is minimal published data on P-CHE in North America, and no specific management guidelines. Limited prevalence data show broad ranges (0.9%-4.4%) in preschool and school children, with 1 study stating up to 10.0% 1-year prevalence for ages 16 to 19years. Atopic dermatitis and allergic contact dermatitis appear important in the pathogenesis of this disease process, although there is limited pediatric data assessing disease associations and no standardized methodology for evaluating this disorder. Given the potential life-changing consequences of P-CHE, further research into this disease process is warranted to help generate best therapeutic practices and minimize this disease process' morbidity in adulthood.

Woodworkers commonly perform operations like sawing, chipping, planning, shaping, nailing and drilling in daily work environment. This study focused the consequences of exposure to hand arm vibration among woodworkers working with handheld drill machine. Subjects’ hand grip strength was measured by a digital hand grip dynamometer. The vibration generated by a handheld drill machine was the main concern and hence the same handheld drill machine was used during this study. The results showed that workers exposed to hand arm vibration had higher prevalence of musculoskeletal disorders. Future studies should include other contributing factors also like ergonomic interventions and workers’ postures.

For a robot to pick up an object viewed by a camera, the object’s position in the image coordinate system must be converted to the robot coordinate system. Recently, a neural network-based method was proposed to achieve this task. This methodology can accurately convert the object’s position despite errors and disturbances that arise in a real-world environment, such as the deflection of a robot arm triggered by changes in the robot’s posture. However, this method has some drawbacks, such as the need for significant effort in model selection, hyperparameter tuning, and lack of stability and interpretability in the learning results. To address these issues, a method involving linear and nonlinear regressions is proposed. First, linear regression is employed to convert the object’s position from the image coordinate system to the robot base coordinate system. Next, B-splines-based nonlinear regression is applied to address the errors and disturbances that occur in a real-world environment. Since this approach is more stable and has better calibration performance with interpretability as opposed to the recent method, it is more practical. In the experiment, calibration results were incorporated into a robot, and its performance was evaluated quantitatively. The proposed method achieved a mean position error of 0.5 mm, while the neural network-based method achieved an error of 1.1 mm.

This manuscript investigates the rotational mechanical impedance of the human hand–arm system with respect to vibration excitation around the gripping axis of the hand under the influence of body posture, gripping force, and push force. Knowledge of rotational mechanical impedance is required for deriving models of hand–arm biodynamics. These models are used in the validation of power tools to predict further vibrational human–machine interactions. In the current state of research, such models exist for translational but not rotational vibration excitation. Consequently, this study investigates the properties of a hand–arm system with respect to rotational vibration excitation. In the study, the rotational impedance of the hand–arm systems of 13 adults was measured at various gripping and push forces applied in different body postures. The setup of the test used in this study consisted of a shaker that applied rotational vibrations at certain frequencies to the subjects’ hand–arm systems via a cylindrical handle. The results of the study indicate a spring–damper dynamic of the hand–arm system. The gripping force strongly influences the magnitude of rotational impedance across the frequency spectrum. Regarding push force and posture, no corresponding influence could be determined. The results suggest that the frictional contact between the hand and handle might confer a damping effect.

Second-hand trading platforms are helpful to the recycling of resources. It is important to accelerate the construction of second-hand trading platforms and improve people’s willingness to buy second-hand goods. However, due to the uncertainty of second-hand goods, it is difficult to establish the trust between users and complete second-hand transactions. Nowadays, more and more platforms use community-based governance mechanisms to promote relationships between users. Taking the second-hand trading platform Xianyu as an example, this study explores the influence of three specific community-based mechanisms (interest group, feedback mechanism and dispute resolution mechanism) on trust and transaction intention from three dimensions of relational governance. This study compares the different effect between consumers and prosumers. Based on 721 valid questionnaires, a structural equation model was used to analyze the data. The results show that interest group, feedback mechanism and dispute resolution mechanism all have significant positive effects on trust in sellers and platforms. In addition, the impact of a dispute resolution mechanism on trust in sellers and platforms is higher for prosumers than for consumers. This study extends the previous research on community-based governance, contributes to the design of second-hand trading platforms and promotes more users to participate in recycling economy.

Detailed knowledge of the anatomy and different variations of the superficial branch of the radial nerve could be of great importance not only to anatomists but also to clinicians. A predominant radial nerve supply to the dorsum of the hand is rare. Herein, we present an unusual case of unilateral sensory innervation of the dorsal hand found during routine anatomical dissection of a 72-year-old at death male Caucasian cadaver. We also present a brief discussion of the reported variation and emphasize its potential clinical implications.

This study measured hand and head action strengths of eight typical emotional states using an authentic but implicit emotion elicitation task. Participants listened to and then retold five stories in which eight typical emotional states were experienced by the narrators. The number of hand and head gestures that occur naturally while experiencing an emotional state was used as an index to determine the hand and head action strength of that emotional state. Results showed a larger number of head gestures than hand gestures, suggesting that head action strengths of the eight emotional states are stronger than their hand action strengths. These findings are consistent with the data extracted from Lancaster Sensorimotor Norms (LSN), although the two sets of data were gathered in two completely different experimental conditions and in two different languages. Furthermore, our data showed a prototypical directionality effect for the typical emotional states, specifically, happiness, anger and pride were primarily accompanied by upward gestures but downward gestures for sadness and shame; surprise was primarily accompanied by forward gestures but backward gestures for fear and disgust. Refereed/Peer-reviewed

The aim of this study is to assess the influence of the COVID-19 pandemic on undergraduate students’ knowledge, attitudes, and behaviors on hand and mobile phone hygiene. An anonymous self-reported questionnaire was distributed among 100 Greek male and female undergraduate students of all academic years who attended healthcare as well as non-healthcare curriculums. Descriptive statistics and statistical tests (chi-squared and Wilcoxon signed-rank test) were used (α = 5%). Students provided better responses during COVID-19, compared to the period before the COVID-19 pandemic, concerning their hand washing frequency (p < 0.001), hand washing circumstances, certain hand washing procedures, as well as their mobile phones’ cleaning/disinfection methods and frequency (p < 0.001). Statistically significant differences were observed between males and females in their knowledge, attitudes, and behaviors on hand and mobile phone hygiene, followed by faculty and year of studies. Overall, being a final-year female undergraduate student of health sciences has a positive influence on correct knowledge, attitudes, and behaviors on hand and mobile phone hygiene.

The purpose of this document is to highlight practical recommendations to assist acute-care hospitals in prioritization and implementation of strategies to prevent healthcare-associated infections through hand hygiene. This document updates the Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals through Hand Hygiene, published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.

Health equity requires allocation of resources to eliminate the systematic disparities in health, imposed on marginalized groups, which adversely impact outcomes. A socioecological approach is implemented to elucidate the role of health equity research and policy for underrepresented minority and socioeconomically disadvantaged populations. Through investigation of the individual, community, institution, and public policy, we investigate problems and propose solutions to ensure fair and just treatment of all patients requiring hand surgery.

Socioeconomic status (SES) is an important factor affecting different aspects of human health, including self-care and healthcare service use. The relation between SES and hand injury severity is not well defined; therefore, the present study aimed to investigate the relation between SES and hand injury severity. This cross-sectional descriptive and analytical study included 215 patients with hand injury. Demographic, clinical, and SES-related factors were collected by questionnaire. Injury severity was assessed on Hand Injury Severity Score (HISS). Statistical analysis used the Student t-test, chi-square test and a multinomial regression model to calculate the odds ratio (OR) of each predictive factor. Mean age was 38.02 ± 13.49 years (range, 12-80 years). 73.5% of the participants were men. Patients with low SES were significantly more likely to develop severe hand injury (OR = 5.25 and 9.25 at HISS levels 3 and 4, respectively). In addition, there was a significant association between being born in rural areas and severe (HISS level 3, OR = 2.63) or major (HISS level 4, OR = 2.63) hand injury. Also, major (HISS level 4) hand injuries were significantly more prevalent in patients living in rural areas (OR = 4.23) and those injured in road accidents (OR = 1.98) or practicing sports (OR = 3.51). The study concluded that patients with low SES were 5-10-fold more likely to suffer from severe and major hand injuries, and thus provided valuable information for Iranian policymakers to take preventive measures for hand injuries. It is recommended to improve postoperative care in patients with low SES who underwent hand surgery, take the necessary measures to decrease the incidence of road accident injuries, facilitate early referral of patients with hand injury to trauma centers, and improve postoperative follow-up until full recovery. LEVEL OF EVIDENCE: III.

Phantom limb pain is attributed to abnormal sensorimotor cortical representations, although the causal relationship between phantom limb pain and sensorimotor cortical representations suffers from the potentially confounding effects of phantom hand movements. We developed neurofeedback training to change sensorimotor cortical representations without explicit phantom hand movements or hand-like visual feedback. We tested the feasibility of neurofeedback training in fourteen patients with phantom limb pain. Neurofeedback training was performed in a single-blind, randomized, crossover trial using two decoders constructed using motor cortical currents measured during phantom hand movements; the motor cortical currents contralateral or ipsilateral to the phantom hand (contralateral and ipsilateral training) were estimated from magnetoencephalograms. Patients were instructed to control the size of a disk, which was proportional to the decoding results, but to not move their phantom hands or other body parts. The pain assessed by the visual analogue scale was significantly greater after contralateral training than after ipsilateral training. Classification accuracy of phantom hand movements significantly increased only after contralateral training. These results suggested that the proposed neurofeedback training changed phantom hand representation and modulated pain without explicit phantom hand movements or hand-like visual feedback, thus showing the relation between the phantom hand representations and pain. PERSPECTIVE: Our work demonstrates the feasibility of using neurofeedback training to change phantom hand representation and modulate pain perception without explicit phantom hand movements and hand-like visual feedback. The results enhance the mechanistic understanding of certain treatments, such as mirror therapy, that change the sensorimotor cortical representation.

Vibration exposure from handheld tools can affect the hands with neurological symptoms and vibration-induced Raynaud’s phenomenon (VRP). The underlying pathophysiological mechanisms are not fully known, however, changes in the composition of blood parameters may contribute to VRP with an increase in blood viscosity and inflammatory response. The aim of this study was to examine the effect on blood parameters in capillary blood from fingers that had been exposed to a vibrating hand-held tool. This study involved nine healthy participants who had been exposed to vibration and an unexposed control group of six participants. Capillary blood samples were collected before and after vibration exposure for the exposed group, and repeated samples also from the control group. The exposed groups were exposed to vibration for a 15-min period or until they reached a 5.0 m/s2 vibration dose. Analysis of blood status and differential counting of leucocytes was performed on the capillary blood samples. The results of the blood samples showed an increase in mean value for erythrocyte volume fraction (EVF), hemoglobin, red blood cell count, white blood cell count and neutrophils, as well as a decrease of mean cell volume, mean cell hemoglobin, and mean cell hemoglobin concentration. The increase of EVF and neutrophils was statistically significant for samples taken from the index finger but not the little finger. Even though the study was small it showed that an acute vibration exposure to the hands might increase EVF and neutrophilic granulocytes levels in the capillary blood taken from index fingers.

Human finger joints are conventionally simplified as rigid joints in robotic hand design and biomechanical hand modelling, due to their anatomic and morphologic complexity. However, our understanding of the effect of the finger joint configuration on the resulting hand performance is still primitive. In this study, we systematically investigate the grasping performance of the hands with the conventional rigid joints and the biomechanical flexible joints based on a computational human hand model. The measured muscle electromyography (EMG) and hand kinematic data during grasping are used as inputs for the grasping simulations. The results show that the rigid joint configuration currently used in most robotic hands leads to large reductions in hand contact force, contact pressure and contact area, compared to the flexible joint configuration. The grasping quality could be reduced up to 40% and 36% by the rigid joint configuration in terms of algebraic properties of grasping matrix and finger force limit respectively. Further investigation reveals that these reductions are caused by the weak rotational stiffness of the rigid joint configuration. This study implies that robotic/prosthetic hand performance could be improved by exploiting flexible finger joint design. Hand contact parameters and grasping performance may be underestimated by the rigid joint simplification in human hand modelling.

Objective To investigate the effect of electromyography (EMG)-driven robotic therapy on the recovery of the hand in a stroke case lasting 9 years. Case An 18-year-old patient with hemiparesis due to the ischemic lesion was admitted to our clinic with hand impairment. Fifteen sessions (5 weeks x 3 times) of robotic rehabilitation were applied with the Hand of Hope. Average EMG (mV) of flexor digitorum superficialis (FDS) muscle, average force (N) and the rate of force development (RFD)(N/s) were also assessed before and after the treatment following the 5th and 10th sessions and at the end of treatment. Also, Fugl-Meyer Assessment of Upper Extremity Scale (FMU-UE), Motor Activity Log (MAL), Canadian Occupational Performance Score (COPM) and Visual Analog Scale (VAS) were used for assessment before and after the treatment. Results The average EMG measured from FDS increased from 0.093-0.133 mV. The average force and average RFD increased from 45.6-97.7 and from 135.6-172.6 respectively. While affected and/or unaffected side force ratio increased dramatically from 54%-82%, the FMA-UE score increased from 56-59. The MAL quality of use score increased from 3.93-4.13. Performance and satisfaction scores of COPM changed from 5.25-7.25 and 4.5-8.25 respectively. VAS score for fatigue changed from 6 to 4. Discussion The improvement achieved 9 years later with 15 sessions of rehabilitation suggests that improvement may be possible for chronic stroke patients.

Lateral elbow tendinopathy (LET) is one of the most prevalent work-related musculoskeletal conditions. Management strategies for LET rarely consider patients' work environments and have limited focus on education regarding occupational risk factors. Workplace-based rehabilitation has shown benefits in the return to work processes for injured workers with other health conditions, but no studies have investigated the impact of a workplace-based educational approach in the management of LET.First, to identify the impact of an additional workplace-based educational intervention to standard hand therapy care on the outcomes of pain, grip strength, and function. Second, to identify the effectiveness of standard hand therapy on the same clinical outcomes.A randomized controlled trial.Forty-nine participants were randomized to the control group (n = 25) or intervention group (n == 24). The control group received standard hand therapy for 12 weeks. The intervention group received standard hand therapy for the first 12 weeks plus an additional workplace-based educational intervention, "Working Hands-ED," delivered by a hand therapist. Pain levels for provocative tests, grip strength, and function were measured using a Numeric Rating Scale, Jamar Dynamometer, and the Patient-Rated Tennis Elbow Evaluation questionnaire at baseline, weeks 6 and 12. The Patient-Specific Functional Scale was also used for the intervention group.There were no statistical differences between both groups for all clinical outcomes by 12 weeks (P.05). Pain levels for all provocative tests and Patient-Rated Tennis Elbow Evaluation scores statistically improved within both groups (P.05), however with small effect sizes observed. The Patient-Specific Functional Scale scores statistically improved for the intervention group by 12 weeks (P.05).The addition of a hand therapy workplace-based intervention did not result in superior clinical outcomes for pain, grip strength, and function. The study identified that a multimodal self-management approach used by hand therapists improved their patients' pain and function regardless of whether the education was given in the clinic or the workplace.

Hand drying is one of the most important factors affect hand hygiene. This study was conducted to investigate the effect of hand dryers used in the restrooms located on the food court floors in shopping malls in Turkey on hand hygiene.Hands were washed for at least 20 seconds by following hygienic hand washing procedures of the World Health Organization. Swab samples were taken from the wet hands after hand washing, then from the dry hands, which were dried under the hand dryers and from the air blowing part of the hand dryers. Samples were cultured on agar plates that were directly exposed to the air-blowing part of the hand dryers.It was found that total coliform bacteria were 0.000 colony-forming unit (CFU)/petri in wet and dried hand, 3.437 CFU/petri in blown air and 5.250 CFU/petri in swab samples. Staphylococcus aureus was found to be 0.125, 64.125, 26.375, and 388.750 CFU/petri, respectively. Total bacteria count was found to be 0.687, 48.750, 35.625, and 595.000 CFU/petri, respectively. S. aureus and the total bacterial load were higher in the blower outlet of the hand dryers than washed hand, blown air and dried hand (P.05). The bacteria count in the unfiltered hand dryers was higher than that in the filtered hand dryers (P.05).Using hand dryers would negatively affect hand hygiene even if hands were washed following hygienic hand washing procedures.

Background In 2019, the Hand Therapy Certification Commission (HTCC), in consultation with Scantron Corporation, performed a practice analysis study of hand therapy, the sixth in a series of similar studies performed byHTCC over a 35-year period. Purpose The primary goal of this study was to update and validate the definition and delineation of hand therapy and to ensure that the test content outline for the Hand Therapy Certification Examination (HTCE) reflects the critical tasks, knowledge, and skills required in the practice of hand therapy. Additionally, HTCC explored specific trends in hand therapy practice, compared findings with previous studies, and gathered data about the frequency, criticality, and performance expectations for the use and fabrication of orthoses by hand therapists. Study Design Quantitative Descriptive. Methods More than 40 subject matter experts from the United States and Canada, representing a broad range of experiences and perspectives, developed an updated delineation of the domains, tasks, knowledge, and techniques and tools used in hand therapy practice. A large-scale online survey of all certified hand therapists from the United States, Canada, and other countries was completed to test the profile within the practice of hand therapy. Results This large-scale online survey overwhelmingly validated the profile of hand therapy. The results affirmed the test specifications for the Hand Therapy Certification Examination; affirmed the definition of hand therapy; and refined the scope of hand therapy practice. New data was gathered regarding the use of orthotics in hand therapy. Conclusions This study establishes content validity for the HTCE. It highlights that the specialty of hand therapy is a mature and stable specialty field of occupational therapy and physical therapy. Certified Hand Therapists frequently issue pre-fabricated and fabricate custom orthoses in the course of rehabilitation for clients with hand and arm injuries, and overall consider this a highly critical task in hand therapy practice. Level of Evidence N/A

Hand disinfection plays an important role in infection control. Currently, hand sanitizers containing ethanol and chlorhexidine gluconate as active ingredients are widely used. Most of hand sanitizers have a defined expiration date for use. However, there was no rule about the expiration date after opening defined with the evidence. Therefore, we examined the fluctuation of active ingredients and disinfection effect after opening the bottle.Twelve hand sanitizers from 44 to 921 days after opening set in different places in the hospital were examined and unopened hand sanitizer used as a control. Chlorhexidine gluconate and ethanol of each samples were measured by high performance liquid chromatography and gas chromatography, respectively. The correlation between the concentration of each ingredient obtained and the number of days after opening, bottle weight, storage temperature and humidity was analyzed. A time-kill test based on ASTM E2315-03 was performed to confirm the actual disinfection effect.It was observed that active ingredients had not been decreased up to 921 days after opening and were not affected by storage conditions after opening. In addition, a decrease of disinfection effect was not observed in any sample.We found that hand sanitizers do not need to be discard after a number of days have passed because the active ingredients are retained even after opening in it.

Hand wounds account for 35 to 51% of hand traumas. Damage to underlying anatomical structures depends on the location of the wound. The objective of this study is to describe the topographic distribution of hand wounds allowing for subsequent evaluation of the link between affected surface area and underlying lesion.We retrospectively reviewed the medical records of 1058 patients with a total of 1319 wounds over a period of 2 years. Wound location was described according to the cutaneous projection of IFSSH zones for flexors and extensors. Any associated deep lesions were evaluated. Topographical distribution was modeled graphically using a heat-map. We compared the proportion of underlying lesions between each cutaneous zone. Sub-group analysis for lesions' rate regarding zone groups were performed.58.9% of wounds were located on the palmar surface and 41.1% on the dorsal surface. 71% of wounds affected only the digits. The index finger was the most affected. The most damaged region was zone 2 for palmar wounds and zone 3 for dorsal wounds. 45.5% of wounds resulted in injury to a significant underlying anatomical structure. This frequency was 36.4% and 58.5% for palmar and dorsal wounds respectively. More than 50% of wounds in palmar zone 5 and dorsal zones 1, 3, 5, 6 and 7 presented at least one lesion. A lesion of major structure was more frequently found in palmar zone 5 (p0.001). Dorsally, no zone predominated. Subgroup analysis for dorsal wounds revealed that wounds overlying joints had more major lesions including more tendons injuries and more articular violations with zone 3 presenting a rate of 68%.We provided the first graphical representation for the topographical distribution of hand wounds. Dorsal wounds have a higher association with injury to underlying structures. These results generally support surgical exploration of all hand wounds regardless of their location.IV Study type: Epidemiological study.

Aim: This work presents a method for developing a simplified but efficient model of the complex human hand kinematics with the aim of its implementation in rehabilitation robotics. Material and methods: The approach incorporates modularity by simplifying the available model comprising 24 degrees of freedom (DOFs) to 9 DOFs, with the introduction of additional joint coupling parameters specific to different grasp types. The effect of dependent joints to the ranges-of-motion (ROMs) of the model is investigated and compared to the anatomical one. The index, middle, ring and little finger solutions to forward and inverse kinematics problems are then acquired. The implementation of the model, based on the median male bones dimensions, is made available in the open-source Robot Operating System (ROS) framework. Results: By including additional four inclination angles per finger, the devised kinematic hand model encompasses also finger curvatures, resulting in significant positioning accuracy improvements compared to the conventional model. The used 3D spatial position improvement metrics are the mean absolute (MAE) and mean relative errors (MRE). The dependent joint position MAEs range from 0.22 to 0.34 cm, while MREs range from 2.8 and 3.5 %, whereas the highest absolute and relative errors during fingertip positioning can reach 0.5 cm and 10.5 %, respectively. Conclusion: The performed investigation allowed establishing that by modelling finger curvature and assuring the adaptability of the model to a variety of human hands and rehabilitation modalities through joint dependency, represents the best approach towards a relatively simple and applicable rehabilitation model with functional human-like hand movements., Cilj: U radu se prezentira metoda za razvoj pojednostavljenog ali učinkovitog kinematičkog modela ljudske ruke koji će se implementirati u rehabilitacijskoj robotici. Materijali i metode: Pristup se temelji na pojednostavljenju postojećeg modela koji ima 24 stupnja slobode gibanja (DOF) na 9 DOF-a, uz uvođenje dodatnih konstrukcijskih parametara, specifičnih za različite vrste hvata. Nakon što je istražen utjecaj ovisnih zglobova na raspon pokreta (ROM) modela, te je isti uspoređen s anatomskim modelom, dobivena su rješenja problema inverzne i direktne kinematike kažiprsta, srednjeg prsta, prstenjaka i malog prsta. Implementacija modela, temeljena na dimenzijama muških kostiju koje odgovaraju medijanu muške populacije, ostvarena je pomoću programskog okruženja otvorenog koda Robot Operating System (ROS). Rezultati: Uzimanjem u obzir četiriju dodatnih kutova nagiba po prstu, razvijeni model ruke obuhvaća i zakrivljenost prstiju, što omogućuje povećanje točnosti pozicioniranja u usporedbi s konvencionalnim modelom. Kao mjerila za utvrđivanje povećanja točnosti prostornog pozicioniranja, korištene su srednja apsolutna greška (MAE) i srednja relativna greška (MRE). MAE se, ovisno o položaju zgloba, kreće od 0,22 do 0,34 cm, dok se MRE kreće od 2,8 do 3,5 %. Najveće apsolutne i relativne greške tijekom pozicioniranja vrha prsta mogu, pak, doseći 0,5 cm, odnosno 10,5 %. Zaključak: Zaključuje se da modeliranje zakrivljenosti prsta i osiguranje prilagodljivosti modela različitim pacijentima i rehabilitacijskim modalitetima kroz međuovisnost zglobova, predstavlja najbolji pristup dobivanju relativno jednostavnog, primjenjivog i funkcionalnog modela šake.

Our primary aims were to assess current prevalence of HOA and the disability associated with this condition, in the group usually most affected, i.e., women older than 55.We performed hand radiographs, clinical examination, grip strength measurement, AUSCAN and COCHIN questionnaires in a cohort of postmenopausal women aged at least 55. Radiographic hand OA (RHOA) was defined as at least 2 affected joints among 30, grading 2 or more using the Kellgren Lawrence score but without any HOA symptom. Symptomatic HOA (OA ACR) was defined according to ACR criteria for hand OA. Moderate to severe symptomatic HOA was defined as having OA ACR and AUSCAN total score of43/100.We enrolled 1,189 participants. The mean age was 71.7 years. Inter-reader reliability of radiographs reading was good (ICC = 0.86) and intra-reader reliability was excellent (ICC = 0.97). Among the 1,189 women, 333 (28.0%) had RHOA, 482 (40.5%) patients fulfilled the ACR criteria for symptomatic HOA and 82 of these (17% of OA ACR population) had moderate to severe symptomatic HOA. The prevalence of symptomatic erosive osteoarthritis was 11.8%. Mean AUSCAN and Cochin scores were higher and grip strength lower in patients with symptomatic HOA compared to patient without HOA. Differences were more noticeable in patients with moderate to severe HOA.We have assessed disability associated with HOA in greater detail than previously and found that a third of postmenopausal women had RHOA, two fifths had symptomatic HOA and one sixth of symptomatic patients had moderate to severe HOA related disability and a tenth had symptomatic erosive osteoarthritis, representing a substantial burden of disease in our population-based cohort.

During the COVID-19 pandemic, the U.S. public was encouraged to practice good hand hygiene, such as hand washing or the use of hand sanitizer. Young adults reported lower levels of hand hygiene compared to adults of other ages. The aim of the current study was to test the effectiveness of different messages to promote hand sanitizer use among young adults.Over a 6-week period, we examined whether 3 brief messages (gain-frame, static descriptive norms, dynamic descriptive norms), placed next to sanitizer dispensers in university residence halls, predicted dispenser use in comparison to dispensers with no sign. Amount of sanitizer usage was measured 3 times per week via the weight of dispenser units. We tracked and controlled for the number of positive COVID-19 cases in residence halls because we expected it might influence sanitizer usage.Compared to no signage, dispensers with signs had 35% greater usage, with the static descriptive norms sign associated with greatest usage (46% compared to no sign), although differences did not reach conventional levels of significance. The strongest predictor of sanitizer use was a residence hall's degree of COVID-19 risk based on the hall's case positivity.Dispensers with signs had higher use than those without signs, but this difference was not statistically significant. We conclude that compared to prior research, "nudges" such as evidence-based messaging may have had less of an effect on health behavior engagement due to methodological differences across studies or characteristics of the COVID-19 context. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Hereditary hemochromatosis (HH) causes unbalanced iron deposition in many organs including the joints leading to severe cartilage loss and bone damage in the metacarpophalangeal joints (MCPJ). High-resolution peripheral quantitative computed tomography (HR-pQCT) and its joint space width (JSW) quantification algorithm quantifies in vivo 3D joint morphology. We therefore aimed to (i) determine feasibility and performance of the JSW algorithm in HH, (ii) quantify joint space morphology, and (iii) investigate the relationship between morphological and clinical parameters in HH. Here, we performed an exploratory study on 24 HH patients and sex- and age-matched controls using HR-pQCT imaging of MCPJ. Mineralized bone structure was automatically segmented from the grayscale image data and periosteal surface bone masks and joint space masks were generated. Mean, minimal, and maximal joint space width (JSW; JSW.MIN; JSW.MAX), JSW heterogeneity (JSW.SD), JSW asymmetry (JSW.AS), and joint space volume (JSV) were computed. Demographics and, for HH patients, disease-specific parameters were recorded. Segmentation of JS was very good with 79.7% of MCPJs successfully segmented at first attempt and 20.3% requiring semi-manual correction. HH men showed larger JSV at all MCPs (+ 25.4% p p p = 0.043) at MCP 4 relative to HH women. Compared to controls, both HH men and HH women showed larger JSW.AS and smaller JSW.MIN at all MCP levels, reaching significance for HH men at MCP 2 and 3 (JSW.AS: + 323% p p p = 0.025; JSW.MIN: − 41.8%, p = 0.022). Time since HH diagnosis was correlated positively with MCP 4 JSW.AS and JSW.SD (0.463 ρ p ρ p

BACKGROUND: Wound management is internationally recognised as part of hand therapy practice. However, the role of occupational therapists in this area of upper limb rehabilitation in South Africa is unclear AIM: To develop and validate a survey to examine occupational therapists' wound management practices in hand therapy within the South African context METHODS: A sequential exploratory mixed methods study design was utilised to develop a survey. Thereafter, a panel of 11 occupational therapists with relevant experience in the field rated the relevance of survey items to produce item-content validity indices (I-CVIs RESULTS: An initial survey containing 27 questions containing 214 items was presented for review. Experts rated 171 items (69%) relevant with an I-CVI of 0.90-1.00. A further 32 items (13%) were rated relevant with an ICVI of >0.80

Background Musculoskeletal diseases are a major public health concern among older adults. There has been an increase in the number of studies on pain between men and women, such as knee and lumbar pain. However, there is a dearth of research on pain between men and women in hand disease. This study compared health-related quality of life (HRQOL) between patients with musculoskeletal disorders of the hand and those with disorders of the knee and the lumbar spine. Methods From 2014 to 2018, 5595 adult patients completed a questionnaire on HRQOL. Among these patients, we identified patients with hand disease (n = 1038), knee disease (n = 680), and lumbar spine disease (n = 2021) resulting in a total sample of 3739 patients (1749 men and 1992 women). Patients’ responses to the EuroQol (EQ-5D), the Short Form 12-item Survey (SF-12), and three visual analogue scales (VAS), as different measures of the HRQOL, were evaluated. Results It was found that the EQ-5D index was lowest in the lumbar spine patients, followed by knee and hand patients. The VAS scores were negatively affected in all groups. The EQ-5D index was significantly lower in women than in men only in the hand disease group. Multivariate analysis revealed that for the EQ-5D index, age, gender, and VAS scores for job and activities of daily living were explanatory factors in the hand disease group. Gender was not a significant predictor in the other groups. Conclusions This study demonstrated that pain negatively affected HRQOL, and gender differences in HRQOL were found only in patients with hand disease. Gender differences in HRQOL in patients with hand disease warrant appropriate clinical attention.

Background Acute flexor tendon injuries are challenging injuries for patients, surgeons, and therapists alike. There is ongoing debate about the optimal timing and amount of therapy after these injuries. Purpose We sought to investigate the relationship between hand therapy utilization and reoperation rates after flexor tendon repair and quantify reoperation rates and costs associated with flexor tendon repair. We hypothesize there will be an inverse relationship between the number of hand therapy visits and later reoperation rates and a positive correlation between reoperation rates and total cost of care. Study Design A retrospective cohort study of patients undergoing primary flexor tendon repair was pursued. Methods A commercially available database was utilized to access insurance claims data for 20.9 million patients in the US from 2007 to 2015. Patients undergoing primary flexor tendon repair were included and followed for one year. Patients with fractures, vascular injuries, or digit replantation were excluded. We studied post-operative rehabilitation utilization, reoperation rates, and costs. Chi-Square tests and multivariable logistic regressions were used to assess the relationship between therapy utilization and reoperation rates and costs. Results The one-year reoperation rate was 11.4 percent at a median time of 100.0 days amongst 1,129 patients undergoing primary tendon repair. In multivariable analysis, age between 30 and 59, male sex, and utilization of over 21 therapy sessions were associated with increased odds of reoperation. Mean insurance reimbursement one year following primary flexor repair was $14,533 per patient but $27,870 if patients went on to reoperation. Conclusion Continued therapy utilization after primary flexor tendon repair is an independent predictor of reoperation need. These findings may help surgeons counsel patients who require a large number of visits after flexor tendon repair on when to revisit surgical options.

The objectives of this study are to ascertain the determinants of quality of life (QoL) and hand function among persons with hand osteoarthritis (OA) and to assess the influence of hand function on QoL among persons with OA.Two hundred and four participants in a clinical trial completed the baseline assessment. Demographic, socioeconomic, QoL (AqoL-4D), hand function (Functional Index for Hand Osteoarthritis, FIHOA), pain assessment, radiographic and clinical characteristics of participants were measured using standard methods. Univariate and multivariate analyses were performed to evaluate potential associations.We studied 204 participants (76% female, age 65.63 ± 8.13 years, body mass index 28.7 ± 6.5 kg/mThe results indicate increasing impairment in hand function decreases the QoL of persons with hand OA. Some determinants were significantly associated with hand function and QoL. Determinants related to hand functions may be modifiable. In future, appropriate intervention strategies should be implemented, and further studies should be conducted to identify the effectiveness of those interventions.

Tüketici davranışlarının değişmesiyle birlikte lüks ile ilgili yeni kavramların ortaya çıktığı görülmektedir. Herkese uygun bir lüks seçeneğinin olduğu düşünülecek olursa, tüketicilerin lüks markayı nasıl algıladığı üzerinde de durulması gerekliliği ortaya çıkmaktadır. Bu nedenle, bu çalışmada tüketicilerin lüks marka algısının lüks ürün satın alma niyetine etkileri üzerinde durulmaktadır. Çevrimiçi anket yöntemiyle 426 katılımcıya ulaşılmıştır. Toplanan veri SPSS Amos 24 ile incelenmiştir. Birinci el ve ikinci el lüks ürün satın alan tüketiciler kıyaslanmıştır. Araştırmanın sonucuna göre birinci el lüks ürün satın alan tüketicilerin genel lüks marka algısı, lüks ürün satın alma niyeti, finansal marka algısı ve sosyal marka algısı arasında anlamlı bir ilişki tespit edilmiştir. Fonksiyonel marka algısı ile benzer bir etki görülmemiştir. İkinci el lüks ürün satın alan tüketicilere bakıldığında ise genel lüks marka algısı ile sosyal marka algısı arasında anlamlı bir ilişki tespit edilmesine rağmen fonksiyonel, finansal ve lüks ürün satın alma niyeti arasında benzer etkiye rastlanılmamıştır., With consumer behaviours changing, new notions of luxury appear to be emerging. Given that there is a luxury option that suits everyone, the need to focus on how consumers perceive the luxury brand is emerging. Therefore, this study focuses on the effects of consumers' perception of luxury brands on their intention to buy luxury products. The online survey method reached 426 respondents. Data were examined with SPSS Amos 24. Consumers buying first-hand and second-hand luxury products have been benchmarked. Consumers buying first-hand luxury items, according to the study's conclusion; a meaningful relationship has been identified between general luxury brand perception, intention to buy luxury products, financial brand perception and social brand perception. No similar effect has been seen with functional brand perception. When looking at consumers buying second-hand luxury products, there has been no similar effect between functional, financial and luxury intention to purchase, although there has been a significant association between general luxury brand perception and social brand perception.

Interaction with virtual objects is one of the essential features of Augmented Reality (AR) systems. One of its main issues is how to provide precise manipulation of distant virtual objects in AR. In this work, we explore bare-hand manipulation of distant objects in AR with DOF (degree-of-freedom) separation, motion scaling, and near-field metaphors. We developed two manipulation techniques: the distant widget-based metaphor (DWBM), and the near-field widget-based metaphor (NFWBM). We conducted a user study with 20 participants to compare the two techniques in terms of performance and user experience. We found that NFWBM has faster speed, lower mental effort, better ease-of-use, and a friendlier user experience. However, there is no significant difference in terms of precision; both techniques could manipulate distant objects precisely, with an average position error of less than 0.7 cm and an average orientational error of less than 1 degrees. We also discussed the limitations of this research and directions for future work. Refereed/Peer-reviewed

Background: Determination of sex from mutilated body fragments can perform vital role for identification of departed soul.Forensic authority pacts with human identification from the hand measurements which is of prodigious assessment during tragedies, terror attacks and in criminality. Objective: Present study explored the analytical role of the anthropometric measurements of hand dimensions, find demarking points for male and female, check percentage exactitude of sex determination in Western Indian population. Methods: The study was piloted on a sample of 504 individuals. All the measurements were taken by standard procedure. Discriminant analysis and demarking points were created for all hand measurements. Results: Males have a significantly higher values of all measurements than females. The left-hand length measurement unveiled noteworthy sexual dimorphism index (110.80). The higher value of the demarking point labelled as males. The best sexually dimorphic hand dimensions showed the utmost precision left hand length (95% in the male), followed by right hand length (76.1%). Conclusion: All hand measurements like length, breadth and index are displaying sexual dimorphism, hence they can be used for determination of sex when isolated hand is found.Keywords: Hand measurements; sexual dimorphism; demarking point; discriminant analysis.

To generate a hand-specific reach plan, the brain must integrate hand-specific signals with the desired movement strategy. Although various neurophysiology/imaging studies have investigated hand-target interactions in simple reach-to-target tasks, the whole brain timing and distribution of this process remain unclear, especially for more complex, instruction-dependent motor strategies. Previously, we showed that a pro/anti pointing instruction influences magnetoencephalographic (MEG) signals in frontal cortex that then propagate recurrently through parietal cortex (Blohm G, Alikhanian H, Gaetz W, Goltz HC, DeSouza JF, Cheyne DO, Crawford JD.

This study aims to compare the use of one-per-mil tumescent solution (a mixture of epinephrine and 0.2% lidocaine in a ratio of 1:1,000,000 in normal saline solution) and tourniquet to create clear operative fields and to evaluate the functional outcomes after post burn hand contracture surgery.The subjects of this randomized controlled trial were divided into one-permil tumescent technique and tourniquet group for a similar surgical procedure. Three independent assessors evaluated the clarity of the operative fields through recorded videos for the first 15 min and the first 10-minute of each hour of the surgery. Functional outcome was evaluated at least three months postoperatively using total active and passive motion (TAM and TPM) of each digit. Malondialdehyde (MDA) and tumor necrosis factor alpha (TNF-α) were tested during baseline (5 min before the procedures), ischemia phase, and reperfusion phase (a phase when the blood flow returned to the tissue).35 subjects were included in this study: 17 in the tumescent group and 18 in the tourniquet group. We found a significant difference in the clarity of operative field between tumescent and tourniquet groups, 5 vs 35 bloodless operative fields, respectively (p 0.05). TAM and TPM of each digit before surgery and 3 months postoperatively showed no significant difference between both groups (p 0.05). Furthermore, we found no difference in MDA and TNF-α levels between both groups at their respective phases.The use of one-per-mil tumescent technique does not replace tourniquet use to create bloodless operative fields in burned hand contracture surgery. However, the postoperative functional results were similar in both groups showing that tumescent technique can be used as an alternative to tourniquet without compromising outcomes. The MDA and TNF-α examinations do not provide conclusive outcomes regarding ischemia and reperfusion injury.

The COVID-19 pandemic has resulted in an unprecedented surge in the demand for alcohol-based hand sanitisers (ABHS). The Centre for Disease Control (CDC) and World Health Organisation (WHO) recommend alcohol, i.e., isopropanol or ethanol, at a 60-95% concentration in ABHS for sufficient antiviral protection. Consumers need to be vigilant of substandard hand sanitisers being marketed to the public. The frequent exposure of microorganisms to alcohol concentrations below the recommended range for infection prevention may lead to resistant mutations, and above the range may be ineffective. Therefore, this study aimed to verify the stated alcohol content in hand sanitisers from their respective labels. We analysed 50 hand sanitiser samples available to our region in Durban, KwaZulu-Natal, South Africa, using a Shimadzu GC-MS-QP2010 Ultra equipped with a Zebron ZB-wax capillary column. The hand sanitisers analysed had a range of 44–93% alcohol content. The data from our study also revealed that 32% (16) of hand sanitisers did not adhere to the stated alcohol indicated on their labels. 16% (8) contained >80% and 12% (6) contained

The proliferation of environmental awareness and the growing recognition of the significance of sustainability has resulted in a new trend of retailers embracing secondhand reselling from unsold or unwanted inventories. Their numbers are increasing while also leveraging various business models, strategies, and procedures. This study uses a survey data of 154 responses from retailers of second-hand clothing across four cities in Liberia to evaluate the used clothing sector in the country. Findings from the survey highlight that while the SHC value chain encourages sustainable consumption, it is also a promoter of economic growth, particularly for developing countries emerging from war. Its retail growth potential is closely tied to the level of economic development geared toward supporting subsistence activities. Findings also show that respondents strongly oppose banning the importation of used clothes and the notion that second-hand undergarments pose health challenges. These findings are essential for providing business owners with understanding of the retailing process and how they can strengthen their foothold in the used clothing sector. They also emphasize the used clothing industry’s significance in Liberia and create avenues for future research.