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In this study we describe an adult left first pollical (thumb) proximal phalanx (I2-104) from the Baume de Moula-Guercy (Ardèche, France) and we evaluate its taxonomic status. We first describe this bone in detail, taking into account its pathology, before comparing it, through multivariate analyses, with a diverse sample of recent and fossil humans. Based on metric and morphological comparisons, we show that this phalanx belongs to a Neandertal individual who suffered from osteoarthritis. Osteoarthritis can have different origins, including overuse, degeneration, trauma and infection. Each of these possible etiologies is explored in our study. Although the cause is difficult to identify, the pathology in this individual may represent an inflammatory reaction caused by repeated and intense vibrations provoked by the high-frequency knapping of the left hand over time. [ABSTRACT FROM AUTHOR]

Research on narrative skills in the Malay language is scarce for both typically developing (TD) and children with Developmental Language Disorders (DLD). This study examines the differences in narrative abilities of Malay-speaking school-age children with and without DLD. Fifteen Malay-speaking TD children and 15 children with DLD told four stories elicited using the Multilingual Assessment Instrument for Narrative (MAIN). Group comparisons were conducted in narrative production (story retelling and story generation) as well as in comprehension. We also examined the differences in both groups’ story complexity (e.g. the combination of goals (G), attempts (A) and outcomes (O)). General microstructure features such as the total number of words (TNW), total number of sentences (TNS) and total number of different words (NDW) were also investigated. TD children outperformed children with DLD in both narrative production and comprehension performances. TD children constructed a higher combination of G, A, and O components than children with DLD. Children with DLD frequently produced G, A, and O in isolation in comparison to TD children. In language productivity and lexical complexity, TD children had a significantly higher frequency in TNW and NDW than children with DLD, resulting in longer narratives and higher uses of different words than children with DLD. Distinct differences are found in the narrative profile of TD children and children with DLD. The results are relatively consistent with the findings of similar studies that utilised and adapted the MAIN in other languages. Clinical implications and recommendations are discussed. [ABSTRACT FROM AUTHOR]

Locked metacarpophalangeal joint is an uncommon phenomenon with many possible etiologies. Diagnosis can be difficult because of the many more common pathologies (trigger finger, sagittal band lesion, etc.) that can lead to a clinical picture that may resemble the locked metacarpophalangeal joint. Once the differential diagnoses have been eliminated, the etiology of this blockage must be determined and the surgical procedure must be oriented. The origin of the problem is often difficult to determine, especially since standard imaging tests are often not very informative. Several clinical forms are possible, with blockages in extension or flexion, but which will have a disabling functional impact on the overall function of the hand. Currently, there is no gold standard for the management of this condition. In this study, we performed a review of the literature in order to better understand the different possible etiologies but also to analyze the different diagnostic and therapeutic management. IV. [ABSTRACT FROM AUTHOR]

Four Icelandic narrative texts with historical and thematic ties to the conversion of Norway and the Faroe Islands to Christianity are examined from the vantage-point of converts' prior statements of their belief only in their own might and main. Disillusionment with the 'old gods' is the common reason given for such professed self-reliance, which does not, however, exclude opportunistic assistance from magical objects. Conversion to the Christian religion by an authority figure is largely transactional in nature, with only low-key emotional engagement. The objective of these texts, written some century and a half after their events, is the full discrediting of heathendom and promotion of skepticism of advantage in the existential void of individuality. Life as a Christian appears unchanged for the saga principals and, in a tacit recall of archaic belief, the soul's redemption does not seems to cancel out the body's destiny. The clerical authors of sagas of Icelanders occupied an exposed position comparable to the men of might and main, in that they had to negotiate an accommodation between heathen story-telling matter and its conventions, and a Christian world view. [ABSTRACT FROM AUTHOR]

About one fifth of all sports accidents involve the hand. Many injuries can be diagnosed and treated easily. However, some of them such as fractures of the scaphoid or the hamate of the hamulus are difficult to detect with conventional radiographs and are often missed without a CT scan. Ligament injuries such as the skier's thumb must be recognized and treated properly, often surgically. There are also sport-specific injuries, such as the closed rupture of a flexor tendon pulley in climbers, which otherwise occur rarely and are little known. These topics, pitfalls and tricks will be discussed. [ABSTRACT FROM AUTHOR]

Copyright of Revue Historique (0035-3264) is the property of Presses Universitaires de France and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Historique (0035-3264) is the property of Presses Universitaires de France and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We report the case of a 58-year-old man who sustained an open palmar dislocation of the fifth metacarpophalangeal joint of the little finger secondary to a bicycle accident with an uncommon presentation. These open dislocations have only been reported once in the literature. A palmar and dorsal approach had to be used to completely free the joint from incarcerations and allow complete reduction and repair of the damaged anatomical structures. We then discuss this particular type of dislocation, its pathophysiology and management. [ABSTRACT FROM AUTHOR]

En présence d'une douleur de la main, les causes vasculaires représentent une part importante des motifs de consultation. Leur identification repose sur une analyse clinique rigoureuse, tenant compte du contexte de survenue, de la description précise du phénomène douloureux et des données de l'examen clinique qui permettront d'orienter à bon escient les examens complémentaires. Sur un plan étiologique, les manifestations douloureuses les plus fréquentes sont associées à une variation de la coloration et de la température des extrémités transitoires, réversibles, et définissent les acrosyndromes vasculaires classiques, dits « fonctionnels ». Ils s'opposent fondamentalement aux acrosyndromes « trophiques » qui correspondent à un processus lésionnel de la microcirculation (inflammatoire et/ou thrombotique). La distinction est bien entendu essentielle sur un plan pronostique ; il s'agit du vaste cadre des ischémies digitales. Certaines pathologies vasculaires douloureuses sont plus rares, mais ont une présentation clinique propre qui permet de les évoquer. Enfin, il convient de citer les pathologies douloureuses d'origine extra-vasculaire mais pour lesquelles les signes vasculaires peuvent être au premier plan, telles que les formes atypiques d'algodystrophies ou les dysrégulations microcirculatoires compliquant certaines atteintes neurologiques. In the presence of hand pain, vascular diseases represent an important part of the reasons for consultation. Their identification is based on a rigorous clinical analysis, taking into account the context of occurrence, the precise description of the painful phenomenon and the clinical examination, which will make it possible to orient the complementary examinations wisely. The most frequent painful manifestations are associated with transient variations in the coloring and temperature of the extremities, and define the classic vascular acrosyndromes, known as "functional". They are fundamentally opposed to "trophic" acrosyndromes which correspond to an inflammatory and/or thrombotic process involving the microcirculation. The distinction is of course essential for prognosis. Certain painful vascular pathologies are rarer, but have their own clinical presentation which allows them to be evoked easily. Mention should be made of painful pathologies of extravascular origin but for which vascular signs may be prominent, such as atypical forms of algodystrophy or microcirculatory dysregulation complicating neurological disorders. [ABSTRACT FROM AUTHOR]

L'échochirurgie est en plein essor grâce aux progrès des sondes linéaires à haute fréquence et des écrans d'échographie. Ainsi, la chirurgie du canal carpien est de plus en plus pratiquée sous contrôle échographique. La connaissance de l'échographie musculo-squelettique est un prérequis indispensable. Plusieurs types d'instrumentation et de voies d'abord existent : au poignet ou à la paume, avec couteaux, fil ou crochet... L'anesthésie walant (acronyme de wide awake and local anesthesia with no tourniquet) est particulièrement adaptée à cette technique dans le cadre d'un circuit patient hyper ambulatoire et dans un environnement sécurisé. L'opérateur doit bien sûr avoir une parfaite maîtrise de l'échographie et de la chirurgie avec ses complications per ou postopératoires. Nous allons étudier ici la technique chirurgicale avec ses précautions, contre-indications et complications, mais aussi les conséquences sur les nouveaux types de prise en charge organisationnelle, économique, logistique et environnemental pour la chirurgie du canal carpien. Ultrasound-guided surgery is a new trend stemming from the introduction of high-frequency linear probes and better quality screens. Surgical treatment of carpal tunnel syndrome is increasingly being performed under ultrasound guidance. Knowledge of musculoskeletal ultrasonography is obviously mandatory. Several types of cutting instruments (miniature knife, Gigli saw or hook) and surgical approaches (wrist or palm) have been described. Ultrasonography allows the wide-awake and local anesthesia with no tourniquet (Walant) technique to be used in the context of ambulatory patient care. The practitioner must be aware of all the possible intraoperative and postoperative complications and be able to treat them. The aim of this review is to analyze the surgical ultrasound guided techniques validated in literature. [ABSTRACT FROM AUTHOR]

Les tumeurs glomiques sont rares au niveau de la main. Le diagnostic est évoqué devant une douleur pulpaire vive décrite comme électrique déclenchée par les chocs. Il faut alors rechercher les signes associés : douleur à la pression précise d'une pointe de crayon, tache bleuâtre sous unguéale, dystrophie unguéale et un éventuel bombement visible en cas de tumeur volumineuse. Des radiographies comparatives de profil à la recherche d'une encoche osseuse sur la troisième phalange et une échographie sont souvent pratiquées. Quant à l'IRM éventuellement couplée à une angiographie, elle nous semble réservée pour les formes difficiles ou récidivées. Le traitement est uniquement chirurgical par exérèse et la voie d'abord variable fonction des auteurs. Le soulagement postopératoire est quasi immédiat et il faut prévenir le patient de la possibilité de récidive. Glomus tumours are uncommon in the hand. The diagnosis is made in case of strong fingertip pain described by the patients as electric shock. Associated signs are typical: precise pain set off by the tip of a pen, bluish spot under the nail, onychodystrophy, sometimes swelling in case of bulky tumour. Comparative X-rays in lateral view can show a bony notch in the dorsal part of distal phalanx, and ultrasounds can be useful for the diagnosis. MRI with angiography can be used for further diagnostic studies or for recurrences. The surgical treatment is the only solution and surgical approach depends on the tumour localisation and surgeon preference. The resolution of the symptoms is almost immediate. Recurrences can occur. [ABSTRACT FROM AUTHOR]

L'arthrose digitale a fait l'objet de très nombreuses publications ces dernières années. Dans le domaine de l'imagerie, il faut noter les très nombreux travaux conduits en IRM et en échographie. Ces derniers ont mis en évidence la bonne corrélation entre la présence de synovites et/ou d'un œdème sous chondral et la douleur articulaire arthrosique. L'arthrose digitale a surtout été un véritable laboratoire d'évaluation des biothérapies et des traitements de fond conventionnel des rhumatismes inflammatoires chroniques. Ainsi, pas moins de 6 essais randomisés contrôlés ont évalué l'efficacité symptomatique et pour certains, structurale, des traitements anti-IL-1β, anti-TNF-α ou Ac anti-IL-6R. Globalement, les résultats de ces essais sont décevants, aucun n'ayant démontré une supériorité par rapport au placebo. Il faut aussi citer deux essais négatifs avec l'hydroxychloroquine. Le seul essai finalement positif est celui ayant évalué une petite cortisonothérapie orale (10 mg/j) versus placebo durant 6 semaines chez des patients souffrant d'une arthrose digitale en poussée avec synovite échographique. Ce dernier essai vient confirmer le rôle de l'inflammation au cours de cette affection, mais ne doit évidemment pas inciter à utiliser la cortisone au long cours comme traitement symptomatique. Hand osteoarthritis (OA) has been the subject of numerous publications in recent years, notably in the field of imaging and therapeutics. Several RCTs have assessed the efficacy of biotherapies and conventional DMARDs in patients with symptomatic hand OA. No less than 6 randomized controlled trials have evaluated the symptomatic and, in some cases, structural efficacy of anti-IL-1, anti TNF or anti-IL-6 drugs. Overall, the results of these trials were disappointing, none of them having demonstrated superiority over placebo. There were also two negative trials with hydroxychloroquine. The only trial that was finally positive was the one that evaluated a small oral steroid therapy (10 mg/) versus placebo for 6 weeks in patients with relapsing digital osteoarthritis with ultrasound synovitis. This latest trial confirms the role of inflammation in this condition, but should obviously not encourage the use of long-term cortisone as a symptomatic treatment. [ABSTRACT FROM AUTHOR]

This interview contextualizes the music of Robert Hampson, firstly with the bands Loop and Main (which became a solo project), and then within the area of musique concrète and acousmatic music. Hampson discusses his initial influences and the move from psychedelic post-punk guitar to guitarless abstract sound compositions, and why he has reformed a new version of Loop. [ABSTRACT FROM AUTHOR]

In Switzerland 50% of the people get bitten by an animal once in their lifetime. Almost 20% of all bite injuries lead to infections. All bite wounds should be debrided and irrigated with saline. Primary wound management is critical in terms of reducing the risk of infection. Injuries to the hands and face should be treated by a hand or plastic surgeon. [ABSTRACT FROM AUTHOR]

Copyright of TUBA-KED: Turkish Academy of Sciences, Journal of Cultural Inventory is the property of Turkish Academy of Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The global COVID-19 coronavirus pandemic has infected over 109 million people, leading to over 2 million deaths up to date and still lacking of effective drugs for patient treatment. Here, we screened about 1.8 million small molecules against the main protease (Mpro) and papain like protease (PLpro), two major proteases in severe acute respiratory syndrome-coronavirus 2 genome, and identified 1851Mpro inhibitors and 205 PLpro inhibitors with low nmol/l activity of the best hits. Among these inhibitors, eight small molecules showed dual inhibition effects on both Mpro and PLpro, exhibiting potential as better candidates for COVID-19 treatment. The best inhibitors of each protease were tested in antiviral assay, with over 40% of Mpro inhibitors and over 20% of PLpro inhibitors showing high potency in viral inhibition with low cytotoxicity. The X-ray crystal structure of SARS-CoV-2 Mpro in complex with its potent inhibitor 4a was determined at 1.8 Å resolution. Together with docking assays, our results provide a comprehensive resource for future research on anti-SARS-CoV-2 drug development. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study addresses the acquisition of referential expressions in pre-schoolers’ narratives in Estonian. A total of sixteen 6- to 7-year-old typically developing monolingual Estonian children were tested using the story “Baby Goat” from the Multilingual Assessment Instrument for Narratives (MAIN) (Gagarina, Natalia, Klop, Daleen, Kunnari, Sari, Tantele, Koula, Välimaa, Taina, Balciuniene, Ingrida, Bohnacker, Ute and Walters, Joel. 2012. “MAIN: Multilingual Assessment Instrument for Narratives.” ZAS Papers in Linguistics 56, 1–140, Gagarina, Natalia, Klop, Daleen, Kunnari, Saru, Tantele, Koula, Välimaa, Taina, Bohnacker, Ute and Walters, Joel. 2019. “MAIN: Multilingual assessment instrument for narratives – Revised.” ZAS Papers in Linguistics 63). The objective was to understand how children introduce a new referent and how they maintain referents in their storytelling, and what correlation could be observed between the length of the story and the average length of the reference chain. Qualitative analyses revealed that children generally introduced new referents using bare nouns; they also generally used bare nouns for further reference. NPs consisting of a noun and a determiner were more frequently used for main characters in the story, while bare nouns were preferred for other characters. The influence of the typological character of Estonian can be observed in the use of zero references and pragmatically driven word order in children’s utterances. In general, the length but not the complexity of the story was correlated with the average number of reference units in a chain.

• DIGICOD est la première cohorte hospitalière française prospective observationnelle de patients atteints d'arthrose digitale (AD). • La proportion de patients présentant une AD érosive est élevée dans la cohorte DIGICOD (45,8 %). • La cohorte DIGICOD permettra d'élaborer de nombreux projets de recherche sur l'AD. Malgré la prévalence de l'arthrose digitale (AD), les cohortes prospectives de patients ayant une AD sont rares. Le principal objectif de la cohorte DIGICOD (DIGItal COhort Design) est d'étudier les facteurs cliniques, biologiques, génétiques et d'imagerie prédictifs d'une aggravation après six ans de suivi. DIGICOD est une cohorte prospective hospitalière qui inclut des patients > 35 ans présentant une AD symptomatique selon l'une des deux définitions suivantes : i) AD symptomatique selon les critères ACR pour au moins deux articulations parmi les interphalangiennes proximales et distales ou l'articulation interphalangienne du pouce avec un score de Kellgren-Lawrence (KL) ≥ 2 ; ou ii) AD symptomatique de la base du pouce avec un score de KL ≥ 2. Les principaux critères d'exclusion étaient une arthrite inflammatoire et des arthropathies à cristaux. Le suivi a consisté en évaluations cliniques annuelles, avec des examens d'imagerie (radiographie des mains et des autres articulations atteintes d'arthrose symptomatique) et des prélèvements biologiques tous les trois ans. Les radiographies des mains ont été notées selon le score de KL et les phases anatomiques du score de Verbruggen-Veys. Les visites de suivi sont en cours. Nous présentons ici la méthodologie et les caractéristiques à l'inclusion de la cohorte. Entre avril 2013 et juin 2017, 436 patients atteints d'AD ont été inclus, parmi lesquels 426, dont 357 femmes (84 %), ont été analysés. L'âge moyen ± écart-type était de 66,7 ± 7,3 ans et la durée moyenne de la maladie de 12,6 ± 9,6 ans. Un syndrome métabolique était présent chez 151 patients (36,5 %). La douleur des mains moyenne sur l'échelle visuelle analogique (EVA) de 0 à 100 mm était de 44,4 ± 26,7 mm à l'activité. Le score fonctionnel FIHOA moyen (0–100) était de 19,9 ± 18,6. Un taux sérique élevé de CRP (≥ 5 mg/l) concernait 10 % des patients. Le score de KL moyen (0–128) était de 46,7 ± 18 et le nombre moyen d'articulations ayant un score de KL ≥ 2 était de 15,1 ± 6,3. L'AD érosive (définie par au moins une articulation en phase d'érosion [E] ou de remodelage [R] selon le score de Verbruggen-Veys) concernait 195 patients sur 426 (45,8 %) et le nombre médian (intervalle interquartile) d'articulations érosives était de 3,0 (1,0–5,0). DIGICOD est la première cohorte prospective d'AD bénéficiant d'une évaluation standardisée à long terme sur six ans et incluant des patients atteints d'AD radiologique sévère avec une forte prévalence de l'atteinte érosive. [ABSTRACT FROM AUTHOR]

The principles of mujtahid imams have a special importance for determining the opinions in fiqh. For this purpose, studies on the principles of imams have been performed, and issues such as the positions of imams in the madhhab and the effect of these rules on fiqh have been examined by using the suitable examples with these principles. One of the early Hanafī scholars, Debūsī, who examined the principles of other imams and Imam Zufar is one of the important examples that can be mentioned in this context. Debūsī included eight principles of Imam Zufar in Te’sīsu’n-nazar and mentioned more than eighty secondary examples under the aforementioned principles. In this article, we determined some of the principles reflecting Imam Zufar’s thought of method which are not mentioned by Debūsī, and we tried to demonstrate the extensions of the subject by giving examples from various chapters (bâb) of fiqh. It is concluded that the classical scholars referred to his principles frequently, and they pointed them by using expressions such as “according to the principles of Imam Zufar”, “based to the principles of Imam Zufar” and so on. These determined principles are important in terms of pointing to Imam Zufar’s position in the madhab, his thought on method, his own methodology, and his authority in ijtihad. [ABSTRACT FROM AUTHOR]

Purpose: Report the epidemiological and lesion aspects of hand bone fractures in children. Patients and method: We did a retrospective and descriptive study over a 10-year period. This study involved 222 children under the age of 16 with 261 fracture cases. The parameters studied were frequency, age, sex, mechanism, circumstances of fracture, consultation time, data from standard physical examination and x-ray of the hand, and associated lesions. Results: Hand bone fractures accounted for 6.4% of all fractures in children in our service. The average age of the children was 8.5 years with a standard deviation of 4. There was a male predominance with a sex ratio of 2. Domestic accidents led the way with 44.3% of cases. They were followed by playful accidents with 33.94% of cases. Receiving heavy objects and falling with hand reception were the most common mechanisms. 62.8% of patients consulted within the first 24 hours. All fractures were in the metacarpals and phalanxes with 31% and 69% of cases, respectively. Head and diaphysis fractures each accounted for 28.1% of cases followed by cervical fractures with 27.8%. Non-displaced fractures accounted for 65% of cases. Associated lesions were found in 10 patients. Conclusion: Hand bone fractures are quite common. They often interest the big child in the decoy of a domestic or playful accident, by crushing the hand or falling with reception on the hand. Fractures of the phalanxes are the most common while those of carp are absent. [ABSTRACT FROM AUTHOR]

Closely related Swedish and German both mark information status of referents morphologically, though little is known about its acquisition. This study investigates character introductions in the narratives of 4- and 6-year-old Swedish–German bilinguals (N = 40) in both languages, elicited with MAIN Cat/Dog. We analyse effects of age group, language and animacy (human vs nonhuman characters) on the type of referring expression (indefinite NP and pronoun), as well as effects of language proficiency and exposure on the use of indefinite NPs for each language. We also explore which syntactic constructions indefinite NPs occur in. A significant difference was found between the two age groups, but not between languages. No effect was found of language skills or exposure. Four-year-olds used more pronouns and a lower proportion of indefinite NPs than 6-year-olds. Pronouns were more frequent for the human character than for nonhuman animate characters. Whilst animacy (humanness) promoted the use of pronouns, it did not affect the choice of morphological form for lexical NPs (indefinite/definite). The age groups differed in how indefinite NPs were used. Four-year-olds produced fewer narrative presentations (where a character is introduced as part of a typical story opening, e.g. Once upon a time there was a cat) than 6-year-olds, and more labellings (with only an NP, or a clausal predicative, e.g. That's a cat). Qualitative analyses suggest that the children's indefinite NPs in labelling constructions can be both referential (when setting the narrative scene), and type-denoting (when naming referents in individual pictures). Whilst the children's abilities to introduce story characters develop measurably from 4 to 6 years in Swedish and German, appropriateness of character introductions not only depends on whether an indefinite NP is chosen, but also on the syntactic construction this indefinite NP is used in. [ABSTRACT FROM AUTHOR]

This special issue investigates the use of referential expressions in elicited picture-based narratives by children with and without developmental language disorders, across a range of languages and language combinations. All contributions use the Multilingual Assessment Instrument for Narratives (MAIN, Gagarina et al. 2012, 2019). The studies featured in this issue cover monolingual and bilingual children aged 4–11 years, but focus mainly on age 4–7, a period in a child's life where great strides are made in the development of narrative skills. This collection of papers offers a new perspective on referentiality for several reasons: all studies use the same stimuli and by and large the same procedure for the elicitation of narratives. The stimuli, four picture-based stories, are controlled for comparability of protagonists, plot and story structure. They were designed as a 'visual' representation of a multidimensional model of story grammar. This methodological and theoretical base allows for a comparative investigation of referentiality (including reference introduction, maintenance and reintroduction) in narratives, across languages and populations. This introduction addresses theoretical aspects of referentiality in decontextualised discourse and reviews the literature regarding the impact of language-specific referential systems and the age and path of acquisition in typically developing children and children with developmental language disorders. We also discuss methodological aspects of eliciting referentiality in narratives in detail. This introduction thus seeks explanations for the diverse and sometimes contradictory empirical results regarding children's mastery of referentiality. Finally, an overview of the contributions in the special issue is given. [ABSTRACT FROM AUTHOR]

The results of computational experiments for determining the effect of a mode I surface fatigue crack cross-sectional shape in a rectangular cantilever beam on the characteristics of its free and forced bending vibrations with varying cross-sectional dimensions of the crack and its longitudinal position are presented. Finite-element models of beams with 8-node 3D finite elements were developed for carrying out investigations. Three types of a breathing crack cross-section were considered: rectangular, triangular, and trapezoidal one, with the solution of a contact problem to ensure the non-penetration of crack edges. Plots of relative change in the natural frequency of vibration, the amplitudes of the first and second harmonics and their ratios at the main, super- and subharmonic resonances versus the shape, relative area and location of the crack were obtained. It is shown that when bending vibrations of the beam with a rectangular crack, are excited along the axis Oy, there arise displacements only in the direction of driving force, while in the case of triangular and trapezoidal cracks, there arise additional displacements along the axis of minimum stiffness, Oz. It was found that the change in the natural frequency of the beam, as well as the ratio of the amplitudes of dominant harmonics during the recording of vibrations along the excitation axis at the main, super- and subharmonic resonances increase with increasing relative area of the crack cross-section. Under this condition, their largest value was characteristic of a rectangular crack, and the smallest of a triangular one. It was noted that a characteristic indicator of the asymmetric shape of the crack was the appearance of vibrations in the plane perpendicular to the excitation plane. [ABSTRACT FROM AUTHOR]

Upper limb burn treatment represents a major medical and surgical challenge. Enzymatic escharolysis is a rather new technique to treat thermal burns in an easy and rapid way, as an alternative to the standard of care. The aim of the study was to investigate and describe the efficacy of treatment of upper limb burns with NexoBrid® in a non-burn referral center. All patients suffering from upper limb burns and admitted within 36 hours to the Hand and Microsurgery Unit of the ASST Sette Laghi from December 2016 to June 2018 were enrolled in the study. A retrospective analysis was performed, evaluating time to wound healing, time of hospitalization, and scar aesthetic appearance with patient and observer scar assessment scale (POSAS) and disabilities of the arm, shoulder and hand score (DASH). A total of 18 patients with burns involving the upper limb from December 2016 to June 2018 were treated. The mean TBSA% involved was 3%; 4 out of 18 patients suffered circumferential burns. The mean POSAS score was 14; the mean DASH score at 6-month follow up was 21, while it reduced to 11 at the last follow up visit. Enzymatic escharolysis is a novel, rapid and selective treatment option that allows early physiotherapy with overall satisfying functional results. We believe that enzymatic escharolysis should be considered, in most cases, as the standard of care in the treatment of upper limb burn wounds in non-burn referral centers. [ABSTRACT FROM AUTHOR]

The aim of this study is to describe the management and outcome of surgical treatment for post burn contractures in different parts of the upper extremities in children, and provide a final decision algorithm that can be a useful guide for the Resident regarding surgical approach to contracture management. This was a retrospective study conducted in the Clinic of Plastic and Reconstructive Surgery, Pristina-Kosovo, between 2014-2016. All cases continued check ups in the Gentiana-Grelor private clinic in Pristina until 2019. Followups were conducted for no less than 6 months with respect to the viability and healing of the repaired area. Patients of both genders, aged from 0 months to 18 years with post-burn contracture in upper extremity, were included in the study. For the sake of presentation, we divided them anatomically into four main areas: axilla, elbow, wrist and hand. We start with a reconstructive ladder using skin grafts (STSG, FTSG), and local flaps such as advancement flaps, Z-plasties, V-Y or Y-V advancement flap, abdonimal/groin pedicled flap, cross finger flap, radial forearm flap were used. Patients were called for follow-up lasting a minimum of one to up to three years. The study included 144 patients. Their age ranged from 9 months to 18 years, the mean age being 12 years. Ordering them by location, post-burn contracture percentage in upper extremity in children was 68% on the hands, 18% on the elbows, 8% on the axilla and 6% on the wrist. A classification and treatment algorithm aids in achieving significant improvements in both joint motions and aesthetic deformities. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Complex forearm defects with significant damage to, or loss of skin, tendon, muscle, bone and neurovascular structures represent a great challenge for surgeons. The management of such injuries, whether a result of trauma or tumor resection, is focused on preservation of the damaged limb and restoration of hand function. A multidisciplinary approach combining plastic and orthopedic surgical expertise in a coordinated team is proposed to address these challenging cases. The authors have laid emphasis on adequate debridement for wound bed preparation, bone stabilization and reconstruction for a stable bony framework, vascular repair for early revascularization, musculotendinous and nerve reconstruction as well as vascularized tissue coverage on a case-to-case basis to facilitate optimal functional recovery. They also maintain that besides expedient surgical treatment, early mobilization based on an individualized rehabilitation program as well as psychological and socio-professional support s are necessary means of achieving rapid and successful social integration. [ABSTRACT FROM AUTHOR]

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La main de presse est une pathologie peu fréquente mais grave, nécessitant une prise en charge multidisciplinaire. Nous rapportons le cas d´un patient de 50 ans, victime d´un écrasement par rouleau industriel de la main droite avec atteinte multi-tissulaire (A). La prise en charge en urgence est globale, selon le principe du « tout en un temps avec mobilisation précoce », elle comprend le parage en tissus sains, la stabilisation osseuse, la revascularisation, la suture tendineuse et nerveuse (B). La couverture cutanée est faite par un lambeau inguinal de Mac Gregor sevré à trois semaines (C). À travers ce cas, nous soulignons l´intérêt de la prévention : d´abord primaire, lors de la manipulation, par l´utilisation de pictogramme et secondaire par une prise en charge urgente pluridisciplinaire.

Les lipomes sont très rarement localisés au niveau de la main et au niveau des commissures. On rapporte un cas de lipome géant de la première commissure évoluant depuis 10 ans chez une dame de 71 ans. Malgré la taille de la tumeur, aucun signe de compression nerveuse n´a été signalé par la patiente. La masse a été emportée en bloc sans lésions d´éléments vasculo-nerveux ou tendineux. Les suites opératoires ont été simples, et la patiente a récupéré une bonne mobilité de la main et des doigts.

In the construction industry, gloves provide an important first barrier to protect workers' hands. This study focuses on the evaluation of the design of leather gloves made in Peru against mechanical risks. For this purpose, 16 types of leather gloves were chosen to go through the process of testing their levels of performance in terms of abrasion, tear and puncture resistance under the norm UNE EN 388 :2016 + A1 :2018. In addition to this, 80 Peruvian construction workers were the subject of an anthropometric study by filling a questionnaire to understand their perception of the gloves used in the evaluation. In addition, we conducted an interview with a proper manufacturer of gloves. In conclusion, the gloves used in this study offer less protection in terms of abrasion resistance, are generally made in one-size-to-fit-all and the handling of bricks causes them to quickly wear out. [ABSTRACT FROM AUTHOR]

L'amputation digitale traumatique engendre un handicap sur les plans fonctionnel, esthétique et psychique pour le patient. De telles séquelles post-traumatiques imposent une démarche thérapeutique rigoureuse en vue d'une chirurgie secondaire précoce, idéalement réalisée avant le « deuil » par le patient de son traumatisme initial. Le principe thérapeutique consiste à améliorer la fonction globale de la main avec pour objectif de base d'établir une pince pollici-digitale de qualité, idéalement fine, stable, sensible, forte, mobile et en même temps, si possible, d'améliorer l'aspect esthétique de la main. L'arsenal thérapeutique inclut non seulement les procédés chirurgicaux faisant appel à des ressources locales visant à une meilleure utilisation du capital digital restant, notamment la phalangisation, les techniques d'allongement, d'amputation proximale, de translocation et de redistribution digitale, mais également les procédés qui ont recours à un prélèvement à distance, tels que les techniques ostéoplastiques et les transferts d'orteils. Les auteurs présentent leur approche et leurs indications quant aux différents procédés de chirurgie secondaire après amputation digitale traumatique. Ils concluent qu'une connaissance et une maîtrise parfaite du vaste arsenal thérapeutique disponible, une analyse fine et approfondie des avantages et des inconvénients de chaque technique chirurgicale envisageable, une prise en considération d'éléments tels que l'âge, le sexe, la profession, la main dominante, l'état local de la main mutilée, l'état physique, psychique et le désir du patient sont autant d'éléments indispensables à prendre en compte en vue de définir la meilleure solution thérapeutique possible. Traumatic digit amputation generates functional, aesthetic and psychological disabilities. Such post-traumatic consequences call for a rigorous therapeutic approach, aiming at an early secondary surgical procedure – which is ideally to be performed before the patients psychologically recover from their initial trauma. The therapeutic principle consists in improving the global function of the hand, basically aiming at re-creating a quality pollici-digital pinch, ideally thin, stable, sensitive, strong, mobile enough, but also, when possible, at improving the aesthetic aspect of the hand. The therapeutic arsenal includes not only surgical processes using local ressources in order to improve the allocation of the remaining digital capital such as phalangisation, elongating techniques, proximal amputation, digital translocation and redistribution but also remote processes – such as osteoplastic and toe-to-hand transfer techniques. The authors expose their approach and indications of secondary digit reconstruction procedures in mutilated hand. They conclude that a thorough knowledge and mastery of the vast available therapeutic arsenal, a fine and profound analysis of the benefits and downsides of each available surgical technique, a comprehensive acknowledgement of the patient's personal information such as age, gender, profession, dominant hand, status of the mutilated hand, physical and psychological health as well as patient's desire are all necessary in order to define the best therapeutic strategy for each particular case. [ABSTRACT FROM AUTHOR]

Top Bajocian progressive deposits are marly accumulation and limestone filled with ammonites and other marine fossils that are called ‘Dalichai formation’ with 1420m in thickness. There are erosion and inconsistent boundary that distinct Dalichai formation from Shemshak formation. The boundary of Dalichai and Lar formations is isocline and graded. The presence of Benthic foraminifera, sponge sparkles, and ammonites in the Sharaf section alludes the existence of shallow to deep open marine. Such diagenetic processes as cementation, micritization, porosity, accumulation, iron oxide and bioturbation are observed in Dalichai formation. The carbonates in this formation could have primary aragonitic composition according to the studies on main and secondary elements, carbon and oxygen isotopes, and drawing these values against each other. In such condition, non-marine diagenesis influenced the carbonates mostly. By comparing Sr/Ca and Mn, a semi-closed to open diagenetic environment can be suggested to have impacts on carbonates. Dalichai formation and Lar formation can identify a boundary in 1200m thickness since there are changes in Sr/Ca, Sr/Na, Sr, and carbon and oxygen isotopes to study. Dalichai formation limestone temperature was calculated 32.9 °C. Regarding lithology and analysis of Sharaf section microfacies, three microfacies are specified that appear as deposits in outer ramp. In this study, the model of Homoclinal ramp is suggested to utilize for such formation. Sharaf section Dalichai Formation entails aragonitic mineralogy composition on which burial diagenesis has substantially influenced. [ABSTRACT FROM AUTHOR]

"There is bad blood between psychoanalysis and attachment theory. As with many family feuds, it is hard to identity where the problem began" (Fonagy, 2001, p. 1). The operative word to focus on, one could say is 'family feud, 1 as attachment theory had its roots in psychoanalytic thinking. Bowlby first conceptualized attachment theory in the 1950s (Slade, 2000) and his conceptualization came about from his observation of hospitalized children and delinquent boys all of whom had experienced separations, traumatic loss or abandonment at an early age (Bowlby, 1944; Bowlby & Robertson, 1952). This paper attempts to shed light on how the findings of the attachment theorybased contemporary researches are in fact reinforcing some of the postulates of psychoanalytical developmental theories. [ABSTRACT FROM AUTHOR]

One of the main goals in the rehabilitation process of patients with burn to their hands is their return to society and their professional occupation, which has a direct positive influence on these patients' quality of life. The goal of this research project was to investigate the effect of early intervention with occupational therapy in patients with burns to their hands. The study included 30 patients with second or third degree hand burns. Patients were added to the study 12 days after their burn wounds and grafted areas had healed. They had 3 sessions of occupational therapy per week for 8 weeks. These sessions included active and passive range of motion exercises, active resistive exercises, stretching exercises and practicing activities of daily living. Functionality of the hand was assessed before and after the 8 weeks of occupational therapy using the DASH questionnaire. The average initial DASH score before intervention with occupational therapy was 60.9, and after 8 weeks of occupational therapy it was 33.9 (average difference between the pre-intervention and post-intervention DASH scores is 27 points, p < 0.001). After 8 weeks of occupational therapy, patients performed activities of daily living with a lot less difficulty, and an increase in functionality of the hands was observed. This study suggests that early intervention with rehabilitative therapies is advantageous and may result in improved hand function. [ABSTRACT FROM AUTHOR]

Résumé Introduction En matière de stratégie chirurgicale dans la réanimation fonctionnelle du membre supérieur dans la tétraplégie traumatique, les publications sont rares et les séries sont courtes. Patients et méthode Nous avons analysé l'ensemble des patients opérés par un même chirurgien, le professeur Marc Revol, dans un même hôpital entre 1989 et 2018. L'analyse des dossiers concernait le sexe, le côté atteint et le groupe (classification internationale), l'âge lors de la première intervention, le délai moyen entre l'accident et la première chirurgie, le délai séparant deux interventions et la durée moyenne du programme chirurgical, et enfin la nature exacte de chaque intervention, au niveau du coude, du poignet, des doigts et du pouce. Résultats Au total, 158 dossiers ont été analysés, correspondant à 428 interventions. Certains principes n'ont pas varié avec le temps : le temps d'ouverture de la main précède celui de fermeture, et comprend systématiquement la réalisation de palliatifs intrinsèques par lassos ; la réanimation de la fermeture des doigts (grasp) est systématiquement associée à celle du pouce (grip) et à une ténolyse des fléchisseurs dans la région des lassos. D'autres points ont évolué avec le temps : le moteur de la réanimation de l'extension active du coude est devenu systématiquement le biceps, le transfert du deltoïde étant définitivement abandonné ; le transfert du brachioradialis (BR) sur l'extenseur commun des doigts longs (EDC) et le long extenseur du pouce (EPL) a été abandonné et remplacé par une ténodèse ; pour les groupes 2, 3, 4 et 5, le premier temps d'ouverture de la main a été systématiquement associé au transfert du biceps, abrégeant le programme chirurgical à deux temps au lieu de trois pour chaque membre supérieur ; la ténodèse néo-zélandaise a remplacé les arthrodèses du pouce dans la majorité des cas ; le BR a été épargné chaque fois que possible à partir du groupe 3. Conclusion Pour les groupes 2 à 5, l'évolution des indications a abouti à la stratégie suivante : le 1er temps opératoire associe la réanimation de l'extension du coude par transfert du biceps et le renforcement de l'ouverture de la main. Ce dernier associe 4 lassos, une ténodèse néo-zélandaise sur le pouce, et une ténodèse de l'EDC et de l'EPL sur le rétinaculum. Le 2e temps opératoire associe une réanimation de la flexion des doigts et du pouce par un moteur unique (BR ou ECRL), et une ténolyse fermée des fléchisseurs lorsqu'ils adhèrent dans la région des lassos. Summary Introduction Regarding surgical strategy for upper limb functional rehabilitation in patients with traumatic tetraplegia, there are few publications and the case series are quite small. Patients and method We reviewed all traumatic quadriplegic patients, operated one by one surgeon, professor Marc Revol, for functional surgery of the upper limb in the same department from 1989 to 2018. For each patient, we recorded their gender, their group according to the international classification, their age at the time of the first surgical procedure, the length of time between the accident and the first surgery and between two procedures, the average duration of the whole surgical program, and the surgical technique used for the elbow, the wrist, the long fingers and the thumb. Results We reviewed 158 cases, representing 428 surgical procedures. Some surgical principles have remained unchanged through the years: the hand opening stage comes before the closing one, and systematically includes intrinsic active palliative procedures using lassos; and restoration of long fingers grasping is consistently associated with restoration of thumb gripping and with flexor tendons tenolysis in the lassos region. Other strategic points have evolved over time: restoration of active elbow extension now systematically uses the biceps over the deltoid transfer; brachio radialis (BR) to extensor digitorum communis (EDC) and to extensor pollicis longus (EPL) transfer has been replaced by tenodesis; in groups 2, 3, 4 and 5, the hand opening stage has been consistently associated with the biceps transfer, thus shortening the surgical program to two procedures instead of three for each upper limb; split distal flexor pollicis longus (FPL) tenodesis has replaced thumb arthrodesis; and, whenever it was possible, BR has been spared from group 3 and beyond. Conclusion In groups 2 to 5, the indications have evolved towards the following strategy. The first surgical step includes restoration of elbow extension using biceps transfer and hand opening reinforcement through four lassos, one split distal FPL tenodesis for the thumb, and EDC and EPL tenodesis to the retinaculum. The second surgical procedure consists of restoration of long fingers and thumb flexion using one unique motor (BR or extensor carpi radialis longus), and closed tenolysis of the flexor tendons in case of adhesions in the lassos area. [ABSTRACT FROM AUTHOR]