Shape-estimation of human hand using polymer flex sensor and study of its application to control robot arm

International Nuclear Information System (INIS)

Lee, Jin Hyuck; Kim, Dae Hyun

2015-01-01

Ultrasonic inspection robot systems have been widely researched and developed for the real-time monitoring of structures such as power plants. However, an inspection robot that is operated in a simple pattern has limitations in its application to various structures in a plant facility because of the diverse and complicated shapes of the inspection objects. Therefore, accurate control of the robot is required to inspect complicated objects with high-precision results. This paper presents the idea that the shape and movement information of an ultrasonic inspector's hand could be profitably utilized for the accurate control of robot. In this study, a polymer flex sensor was applied to monitor the shape of a human hand. This application was designed to intuitively control an ultrasonic inspection robot. The movement and shape of the hand were estimated by applying multiple sensors. Moreover, it was successfully shown that a test robot could be intuitively controlled based on the shape of a human hand estimated using polymer flex sensors.

Shape-estimation of human hand using polymer flex sensor and study of its application to control robot arm

Energy Technology Data Exchange (ETDEWEB)

Lee, Jin Hyuck; Kim, Dae Hyun [Seoul National University of Technology, Seoul (Korea, Republic of)

2015-02-15

Ultrasonic inspection robot systems have been widely researched and developed for the real-time monitoring of structures such as power plants. However, an inspection robot that is operated in a simple pattern has limitations in its application to various structures in a plant facility because of the diverse and complicated shapes of the inspection objects. Therefore, accurate control of the robot is required to inspect complicated objects with high-precision results. This paper presents the idea that the shape and movement information of an ultrasonic inspector's hand could be profitably utilized for the accurate control of robot. In this study, a polymer flex sensor was applied to monitor the shape of a human hand. This application was designed to intuitively control an ultrasonic inspection robot. The movement and shape of the hand were estimated by applying multiple sensors. Moreover, it was successfully shown that a test robot could be intuitively controlled based on the shape of a human hand estimated using polymer flex sensors.

Automatic gain control of neural coupling during cooperative hand movements.

Science.gov (United States)

Thomas, F A; Dietz, V; Schrafl-Altermatt, M

2018-04-13

Cooperative hand movements (e.g. opening a bottle) are controlled by a task-specific neural coupling, reflected in EMG reflex responses contralateral to the stimulation site. In this study the contralateral reflex responses in forearm extensor muscles to ipsilateral ulnar nerve stimulation was analyzed at various resistance and velocities of cooperative hand movements. The size of contralateral reflex responses was closely related to the level of forearm muscle activation required to accomplish the various cooperative hand movement tasks. This indicates an automatic gain control of neural coupling that allows a rapid matching of corrective forces exerted at both sides of an object with the goal 'two hands one action'.

Economic Evaluation of a Multifaceted Implementation Strategy for the Prevention of Hand Eczema Among Healthcare Workers in Comparison with a Control Group: The Hands4U Study.

Science.gov (United States)

van der Meer, Esther W C; van Dongen, Johanna M; Boot, Cécile R L; van der Gulden, Joost W J; Bosmans, Judith E; Anema, Johannes R

2016-05-01

The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the control group. Data on hand eczema and costs were collected at baseline and every 3 months. Cost-effectiveness analyses were performed using linear multilevel analyses. The probability of the implementation strategy being cost-effective gradually increased with an increasing willingness-to-pay, to 0.84 at a ceiling ratio of €590,000 per person with hand eczema prevented (societal perspective). The implementation strategy appeared to be not cost-effective in comparison with the control group (societal perspective), nor was it cost-beneficial to the employer. However, this study had some methodological problems which should be taken into account when interpreting the results.

Controller design for Robotic hand through Electroencephalogram

OpenAIRE

Pandelidis P.; Kiriazis N.; Orgianelis K.; Koulios N.

2016-01-01

- This paper deals with the designing, the construction and the control of a robotic hand via an electroencephalogram sensor. First a robotic device that is able to mimic a real human hand is constructed. A PID controller is designed in order to improve the performance of the robotic arm for grabbing objects. Furthermore, a novel design approach is presented for controlling the motion of the robotic arm using signals produced from an innovative electroencephalogram sensor that detects the con...

Control System Design of the YWZ Multi-Fingered Dexterous Hand

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Wenzhen Yang

2012-07-01

Full Text Available The manipulation abilities of a multi-fingered dexterous hand, such as motion in real-time, flexibility, grasp stability etc., are largely dependent on its control system. This paper developed a control system for the YWZ dexterous hand, which had five fingers and twenty degrees of freedom (DOFs. All of the finger joints of the YWZ dexterous handwere active joints driven by twenty micro-stepper motors respectively. The main contribution of this paper was that we were able to use stepper motor control to actuate the hand's fingers, thus, increasing the hands feasibility. Based the actuators of the YWZ dexterous hand, we firstly developed an integrated circuit board (ICB, which was the communication hardware between the personal computer (PC and the YWZ dexterous hand. The ICB included a centre controller, twenty driver chips, a USB port and other electrical parts. Then, a communication procedure between the PC and the ICB was developed to send the control commands to actuate the YWZ dexterous hand. Experiment results showed that under this control system, the motion of the YWZ dexterous hand was real-time; both the motion accuracy and the motion stability of the YWZ dexterous hand were reliable. Compared with other types of actuators related to dexterous hands, such as pneumatic servo cylinder, DC servo motor, shape memory alloy etc., experiment results verified that the stepper motors as actuators for the dexterous handswere effective, economical, controllable and stable.

Controller design for Robotic hand through Electroencephalogram

Directory of Open Access Journals (Sweden)

Pandelidis P.

2016-01-01

Full Text Available - This paper deals with the designing, the construction and the control of a robotic hand via an electroencephalogram sensor. First a robotic device that is able to mimic a real human hand is constructed. A PID controller is designed in order to improve the performance of the robotic arm for grabbing objects. Furthermore, a novel design approach is presented for controlling the motion of the robotic arm using signals produced from an innovative electroencephalogram sensor that detects the concentration of the brain

Position calibration of a 3-DOF hand-controller with hybrid structure

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Zhu, Chengcheng; Song, Aiguo

2017-09-01

A hand-controller is a human-robot interactive device, which measures the 3-DOF (Degree of Freedom) position of the human hand and sends it as a command to control robot movement. The device also receives 3-DOF force feedback from the robot and applies it to the human hand. Thus, the precision of 3-DOF position measurements is a key performance factor for hand-controllers. However, when using a hybrid type 3-DOF hand controller, various errors occur and are considered originating from machining and assembly variations within the device. This paper presents a calibration method to improve the position tracking accuracy of hybrid type hand-controllers by determining the actual size of the hand-controller parts. By re-measuring and re-calibrating this kind of hand-controller, the actual size of the key parts that cause errors is determined. Modifying the formula parameters with the actual sizes, which are obtained in the calibrating process, improves the end position tracking accuracy of the device.

Sensing human hand motions for controlling dexterous robots

Science.gov (United States)

Marcus, Beth A.; Churchill, Philip J.; Little, Arthur D.

1988-01-01

The Dexterous Hand Master (DHM) system is designed to control dexterous robot hands such as the UTAH/MIT and Stanford/JPL hands. It is the first commercially available device which makes it possible to accurately and confortably track the complex motion of the human finger joints. The DHM is adaptable to a wide variety of human hand sizes and shapes, throughout their full range of motion.

Telerobotic control of a dextrous manipulator using master and six-DOF hand-controllers for space assembly and servicing tasks

Science.gov (United States)

O'Hara, John M.

1987-01-01

Two studies were conducted evaluating methods of controlling a telerobot; bilateral force reflecting master controllers and proportional rate six degrees of freedom (DOF) hand controllers. The first study compared the controllers on performance of single manipulator arm tasks, a peg-in-the-hole task, and simulated satellite orbital replacement unit changeout. The second study, a Space Station truss assembly task, required simultaneous operation of both manipulator arms (all 12 DOFs) and complex multiaxis slave arm movements. Task times were significantly longer and fewer errors were committed with the hand controllers. The hand controllers were also rated significantly higher in cognitive and manual control workload on the two-arm task. The master controllers were rated significantly higher in physical workload. There were no significant differences in ratings of manipulator control quality.

A common control signal and a ballistic stage can explain the control of coordinated eye-hand movements.

Science.gov (United States)

Gopal, Atul; Murthy, Aditya

2016-06-01

Voluntary control has been extensively studied in the context of eye and hand movements made in isolation, yet little is known about the nature of control during eye-hand coordination. We probed this with a redirect task. Here subjects had to make reaching/pointing movements accompanied by coordinated eye movements but had to change their plans when the target occasionally changed its position during some trials. Using a race model framework, we found that separate effector-specific mechanisms may be recruited to control eye and hand movements when executed in isolation but when the same effectors are coordinated a unitary mechanism to control coordinated eye-hand movements is employed. Specifically, we found that performance curves were distinct for the eye and hand when these movements were executed in isolation but were comparable when they were executed together. Second, the time to switch motor plans, called the target step reaction time, was different in the eye-alone and hand-alone conditions but was similar in the coordinated condition under assumption of a ballistic stage of ∼40 ms, on average. Interestingly, the existence of this ballistic stage could predict the extent of eye-hand dissociations seen in individual subjects. Finally, when subjects were explicitly instructed to control specifically a single effector (eye or hand), redirecting one effector had a strong effect on the performance of the other effector. Taken together, these results suggest that a common control signal and a ballistic stage are recruited when coordinated eye-hand movement plans require alteration. Copyright © 2016 the American Physiological Society.

Cognitive vision system for control of dexterous prosthetic hands: Experimental evaluation

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Došen Strahinja

2010-08-01

Full Text Available Abstract Background Dexterous prosthetic hands that were developed recently, such as SmartHand and i-LIMB, are highly sophisticated; they have individually controllable fingers and the thumb that is able to abduct/adduct. This flexibility allows implementation of many different grasping strategies, but also requires new control algorithms that can exploit the many degrees of freedom available. The current study presents and tests the operation of a new control method for dexterous prosthetic hands. Methods The central component of the proposed method is an autonomous controller comprising a vision system with rule-based reasoning mounted on a dexterous hand (CyberHand. The controller, termed cognitive vision system (CVS, mimics biological control and generates commands for prehension. The CVS was integrated into a hierarchical control structure: 1 the user triggers the system and controls the orientation of the hand; 2 a high-level controller automatically selects the grasp type and size; and 3 an embedded hand controller implements the selected grasp using closed-loop position/force control. The operation of the control system was tested in 13 healthy subjects who used Cyberhand, attached to the forearm, to grasp and transport 18 objects placed at two different distances. Results The system correctly estimated grasp type and size (nine commands in total in about 84% of the trials. In an additional 6% of the trials, the grasp type and/or size were different from the optimal ones, but they were still good enough for the grasp to be successful. If the control task was simplified by decreasing the number of possible commands, the classification accuracy increased (e.g., 93% for guessing the grasp type only. Conclusions The original outcome of this research is a novel controller empowered by vision and reasoning and capable of high-level analysis (i.e., determining object properties and autonomous decision making (i.e., selecting the grasp type and

Design of a 3-DOF Parallel Hand-Controller

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Chengcheng Zhu

2017-01-01

Full Text Available Hand-controllers, as human-machine-interface (HMI devices, can transfer the position information of the operator’s hands into the virtual environment to control the target objects or a real robot directly. At the same time, the haptic information from the virtual environment or the sensors on the real robot can be displayed to the operator. It helps human perceive haptic information more truly with feedback force. A parallel hand-controller is designed in this paper. It is simplified from the traditional delta haptic device. The swing arms in conventional delta devices are replaced with the slider rail modules. The base consists of two hexagons and several links. For the use of the linear sliding modules instead of swing arms, the arc movement is replaced by linear movement. So that, the calculating amount of the position positive solution and the force inverse solution is reduced for the simplification of the motion. The kinematics, static mechanics, and dynamic mechanics are analyzed in this paper. What is more, two demonstration applications are developed to verify the performance of the designed hand-controller.

Integrated multi-sensory control of space robot hand

Science.gov (United States)

Bejczy, A. K.; Kan, E. P.; Killion, R. R.

1985-01-01

Dexterous manipulation of a robot hand requires the use of multiple sensors integrated into the mechanical hand under distributed microcomputer control. Where space applications such as construction, assembly, servicing and repair tasks are desired of smart robot arms and robot hands, several critical drives influence the design, engineering and integration of such an electromechanical hand. This paper describes a smart robot hand developed at the Jet Propulsion Laboratory for experimental use and evaluation with the Protoflight Manipulator Arm (PFMA) at the Marshall Space Flight Center (MSFC).

Neural-Network Control Of Prosthetic And Robotic Hands

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Buckley, Theresa M.

1991-01-01

Electronic neural networks proposed for use in controlling robotic and prosthetic hands and exoskeletal or glovelike electromechanical devices aiding intact but nonfunctional hands. Specific to patient, who activates grasping motion by voice command, by mechanical switch, or by myoelectric impulse. Patient retains higher-level control, while lower-level control provided by neural network analogous to that of miniature brain. During training, patient teaches miniature brain to perform specialized, anthropomorphic movements unique to himself or herself.

Electromyogram synergy control of a dexterous artificial hand to unscrew and screw objects.

Science.gov (United States)

Kent, Benjamin A; Karnati, Nareen; Engeberg, Erik D

2014-03-21

Due to their limited dexterity, it is currently not possible to use a commercially available prosthetic hand to unscrew or screw objects without using elbow and shoulder movements. For these tasks, prosthetic hands function like a wrench, which is unnatural and limits their use in tight working environments. Results from timed rotational tasks with human subjects demonstrate the clinical need for increased dexterity of prosthetic hands, and a clinically viable solution to this problem is presented for an anthropomorphic artificial hand. Initially, a human hand motion analysis was performed during a rotational task. From these data, human hand synergies were derived and mapped to an anthropomorphic artificial hand. The synergy for the artificial hand is controlled using conventional dual site electromyogram (EMG) signals. These EMG signals were mapped to the developed synergy to control four joints of the dexterous artificial hand simultaneously.Five limb absent and ten able-bodied test subjects participated in a comparison study to complete a timed rotational task as quickly as possible with their natural hands (except for one subject with a bilateral hand absence), eight commercially available prosthetic hands, and the proposed synergy controller. Each test subject used two to four different artificial hands. With the able-bodied subjects, the developed synergy controller reduced task completion time by 177% on average. The limb absent subjects completed the task faster on average than with their own prostheses by 46%. There was a statistically significant improvement in task completion time with the synergy controller for three of the four limb absent participants with integrated prostheses, and was not statistically different for the fourth. The proposed synergy controller reduced average task completion time compared to commercially available prostheses. Additionally, the synergy controller is able to function in a small workspace and requires less physical

The Human Octopus: controlling supernumerary hands with the help of virtual reality

OpenAIRE

Aru, Jaan; Vasser, Madis; Zafra, Raul; Kulu, Sander

2016-01-01

We investigated the "human octopus" phenomenon where subjects controlled virtual supernumerary hands through hand tracking technology and virtual reality. Four experiments were developed to study how subjects (n=10) operate with different number and behaviour of supernumerary hands. The behaviours involved inserting movement delays to the virtual hands and adjusting their movement scale or position. It was found that having more hands to operate with does not necessarily mean higher success r...

Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study.

Science.gov (United States)

Horváth, Katalin; Kulisch, Ágota; Németh, András; Bender, Tamás

2012-05-01

To evaluate the effectiveness of thermal mineral water compared with magnetotherapy without balneotherapy as control, in the treatment of hand osteoarthritis. Randomized controlled single-blind follow-up study. Rheumatology specialist clinic of Gunaras Health Spa. Patients between 50 and 70 years of age with hand osteoarthritis, randomly assigned into three groups. The subjects in the first two groups bathed in thermal mineral water of two different temperatures (36°C and 38°C) for three weeks five times a week for 20 minutes a day and received magnetotherapy to their hands three times weekly. The third group received only magnetotherapy. Visual analogue scale scores, handgrip strength, pinchgrip strength, the number of swollen and tender joints of the hand, the duration of morning joint stiffness, Health Assessment Questionnaire, and Short Form-36 questionnaire. The study parameters were administered at baseline, immediately after treatment and after 13 weeks. The study included 63 patients. Statistically significant improvement was observed in several studied parameters after the treatment and during the follow-up study in the thermal water groups versus the control group. The 38°C thermal water treatment significantly improved the pinch strength of the right hand (0.6 (95% confidence interval (CI) 0.2 to 1.1) vs. 0.03 (95% CI -0.3 to 0.4), P magnetotherapy improved the pain and function as well as the quality of life in patients with hand osteoarthritis.

An Analysis of Intrinsic and Extrinsic Hand Muscle EMG for Improved Pattern Recognition Control.

Science.gov (United States)

Adewuyi, Adenike A; Hargrove, Levi J; Kuiken, Todd A

2016-04-01

Pattern recognition control combined with surface electromyography (EMG) from the extrinsic hand muscles has shown great promise for control of multiple prosthetic functions for transradial amputees. There is, however, a need to adapt this control method when implemented for partial-hand amputees, who possess both a functional wrist and information-rich residual intrinsic hand muscles. We demonstrate that combining EMG data from both intrinsic and extrinsic hand muscles to classify hand grasps and finger motions allows up to 19 classes of hand grasps and individual finger motions to be decoded, with an accuracy of 96% for non-amputees and 85% for partial-hand amputees. We evaluated real-time pattern recognition control of three hand motions in seven different wrist positions. We found that a system trained with both intrinsic and extrinsic muscle EMG data, collected while statically and dynamically varying wrist position increased completion rates from 73% to 96% for partial-hand amputees and from 88% to 100% for non-amputees when compared to a system trained with only extrinsic muscle EMG data collected in a neutral wrist position. Our study shows that incorporating intrinsic muscle EMG data and wrist motion can significantly improve the robustness of pattern recognition control for application to partial-hand prosthetic control.

Virtual Control of Prosthetic Hand Based on Grasping Patterns and Estimated Force from Semg

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Zhu Gao-Ke

2016-01-01

Full Text Available Myoelectric prosthetic hands aim to serve upper limb amputees. The myoelectric control of the hand grasp action is a kind of real-time or online method. Thus it is of great necessity to carry on a study of online prosthetic hand electrical control. In this paper, the strategy of simultaneous EMG decoding of grasping patterns and grasping force was realized by controlling a virtual multi-degree-freedom prosthetic hand and a real one-degree-freedom prosthetic hand simultaneously. The former realized the grasping patterns from the recognition of the sEMG pattern. The other implemented the grasping force from sEMG force decoding. The results show that the control method is effective and feasible.

Real-Time Control of an Exoskeleton Hand Robot with Myoelectric Pattern Recognition.

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Lu, Zhiyuan; Chen, Xiang; Zhang, Xu; Tong, Kay-Yu; Zhou, Ping

2017-08-01

Robot-assisted training provides an effective approach to neurological injury rehabilitation. To meet the challenge of hand rehabilitation after neurological injuries, this study presents an advanced myoelectric pattern recognition scheme for real-time intention-driven control of a hand exoskeleton. The developed scheme detects and recognizes user's intention of six different hand motions using four channels of surface electromyography (EMG) signals acquired from the forearm and hand muscles, and then drives the exoskeleton to assist the user accomplish the intended motion. The system was tested with eight neurologically intact subjects and two individuals with spinal cord injury (SCI). The overall control accuracy was [Formula: see text] for the neurologically intact subjects and [Formula: see text] for the SCI subjects. The total lag of the system was approximately 250[Formula: see text]ms including data acquisition, transmission and processing. One SCI subject also participated in training sessions in his second and third visits. Both the control accuracy and efficiency tended to improve. These results show great potential for applying the advanced myoelectric pattern recognition control of the wearable robotic hand system toward improving hand function after neurological injuries.

Research of a New 6-Dof Force Feedback Hand Controller System

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Xin Gao

2014-01-01

Full Text Available The field of teleoperation with force telepresence has expanded its scope to include manipulation at different scales and in virtual worlds, and the key component of which is force feedback hand controller. This paper presents a novel force feedback hand controller system, including a 3-dof translational and 3-dof rotational hand controllers, respectively, to implement position and posture teleoperation of the robot end effector. The 3-dof translational hand controller adopts innovative three-axes decoupling structure based on the linear motor; the 3-dof rotational hand controller adopts serial mechanism based on three-axes intersecting at one point, improving its overall stiffness. Based on the kinematics, statics, and dynamics analyses for two platforms separately, the system applies big closed-loop force control method based on the zero force/torque, improving the feedback force/torque accuracy effectively. Experimental results show that self-developed 6-dof force feedback hand controller has good mechanical properties. The translational hand controller has the following advantages: simple kinematics solver, fast dynamic response, and better than 0.05 mm accuracy of three-axis end positioning, while the advantages of the rotational hand controller are wide turning space, larger than 1 Nm feedback, greater than 180 degrees of operating space of three axes, respectively, and high operation precision.

The Mirrored Hand Illusion: I Control, So I Possess?

Science.gov (United States)

Zhou, Aibao; Zhang, Yanchi; Yin, Yulong; Yang, Yang

2015-01-01

Certain situations may not only cause people to misjudge external information but also distort people's perception of themselves. The present study is the first to report the mirrored hand illusion which could be generated when the experimenter imitated the fist-clenching movements of the subject synchronously. The subjects formed the illusion that the experimenter's hand was "something I can control" when being imitated synchronously. In addition, a sense of ownership over the alien hand was established by integrating multisensory signals and comparing these signals with preexisting body presentations. This method might represent a new avenue for research on the formation of self-consciousness. © The Author(s) 2015.

49 CFR 236.207 - Electric lock on hand-operated switch; control.

Science.gov (United States)

2010-10-01

..., AND APPLIANCES Automatic Block Signal Systems Standards § 236.207 Electric lock on hand-operated switch; control. Electric lock on hand-operated switch shall be controlled so that it cannot be unlocked... 49 Transportation 4 2010-10-01 2010-10-01 false Electric lock on hand-operated switch; control...

Myoelectric control of prosthetic hands: state-of-the-art review

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Geethanjali P

2016-07-01

Full Text Available Purushothaman Geethanjali School of Electrical Engineering Department of Control and Automation VIT University, Vellore, Tamil Nadu, India Abstract: Myoelectric signals (MES have been used in various applications, in particular, for identification of user intention to potentially control assistive devices for amputees, orthotic devices, and exoskeleton in order to augment capability of the user. MES are also used to estimate force and, hence, torque to actuate the assistive device. The application of MES is not limited to assistive devices, and they also find potential applications in teleoperation of robots, haptic devices, virtual reality, and so on. The myoelectric control-based prosthetic hand aids to restore activities of daily living of amputees in order to improve the self-esteem of the user. All myoelectric control-based prosthetic hands may not have similar operations and exhibit variation in sensing input, deciphering the signals, and actuating prosthetic hand. Researchers are focusing on improving the functionality of prosthetic hand in order to suit the user requirement with the different operating features. The myoelectric control differs in operation to accommodate various external factors. This article reviews the state of the art of myoelectric prosthetic hand, giving description of each control strategy. Keywords: EMG, assistive device, amputee, myoelectric control, electric powered, body ­powered, bioelectric signal control

Mechanical design and control of a new myoelectric hand prosthesis

NARCIS (Netherlands)

Peerdeman, B.; Stramigioli, Stefano; Hekman, Edsko E.G.; Brouwer, Dannis Michel; Misra, Sarthak

2011-01-01

The development of modern, myoelectrically controlled hand prostheses can be difficult, due to the many requirements its mechanical design and control system need to fulfill [1]. The hand should be controllable with few input signals, while being able to perform a wide range of motions. It should be

Principal components analysis based control of a multi-dof underactuated prosthetic hand

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Magenes Giovanni

2010-04-01

Full Text Available Abstract Background Functionality, controllability and cosmetics are the key issues to be addressed in order to accomplish a successful functional substitution of the human hand by means of a prosthesis. Not only the prosthesis should duplicate the human hand in shape, functionality, sensorization, perception and sense of body-belonging, but it should also be controlled as the natural one, in the most intuitive and undemanding way. At present, prosthetic hands are controlled by means of non-invasive interfaces based on electromyography (EMG. Driving a multi degrees of freedom (DoF hand for achieving hand dexterity implies to selectively modulate many different EMG signals in order to make each joint move independently, and this could require significant cognitive effort to the user. Methods A Principal Components Analysis (PCA based algorithm is used to drive a 16 DoFs underactuated prosthetic hand prototype (called CyberHand with a two dimensional control input, in order to perform the three prehensile forms mostly used in Activities of Daily Living (ADLs. Such Principal Components set has been derived directly from the artificial hand by collecting its sensory data while performing 50 different grasps, and subsequently used for control. Results Trials have shown that two independent input signals can be successfully used to control the posture of a real robotic hand and that correct grasps (in terms of involved fingers, stability and posture may be achieved. Conclusions This work demonstrates the effectiveness of a bio-inspired system successfully conjugating the advantages of an underactuated, anthropomorphic hand with a PCA-based control strategy, and opens up promising possibilities for the development of an intuitively controllable hand prosthesis.

Hand Motion-Based Remote Control Interface with Vibrotactile Feedback for Home Robots

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Juan Wu

2013-06-01

Full Text Available This paper presents the design and implementation of a hand-held interface system for the locomotion control of home robots. A handheld controller is proposed to implement hand motion recognition and hand motion-based robot control. The handheld controller can provide a ‘connect-and-play’ service for the users to control the home robot with visual and vibrotactile feedback. Six natural hand gestures are defined for navigating the home robots. A three-axis accelerometer is used to detect the hand motions of the user. The recorded acceleration data are analysed and classified to corresponding control commands according to their characteristic curves. A vibration motor is used to provide vibrotactile feedback to the user when an improper operation is performed. The performances of the proposed hand motion-based interface and the traditional keyboard and mouse interface have been compared in robot navigation experiments. The experimental results of home robot navigation show that the success rate of the handheld controller is 13.33% higher than the PC based controller. The precision of the handheld controller is 15.4% more than that of the PC and the execution time is 24.7% less than the PC based controller. This means that the proposed hand motion-based interface is more efficient and flexible.

Control model for dampening hand vibrations using information of internal and external coordinates.

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Shunta Togo

Full Text Available In the present study, we investigate a control mechanism that dampens hand vibrations. Here, we propose a control method with two components to suppress hand vibrations. The first is a passive suppression method that lowers the joint stiffness to passively dampen the hand vibrations. The second is an active suppression method that adjusts an equilibrium point based on skyhook control to actively dampen the hand vibrations. In a simulation experiment, we applied these two methods to dampen hand vibrations during the shoulder's horizontal oscillation. We also conducted a measurement experiment wherein a subject's shoulder was sinusoidally oscillated by a platform that generated horizontal oscillations. The results of the measurement experiments showed that the jerk of each part of the arm in a task using a cup filled with water was smaller than the shoulder jerk and that in a task with a cup filled with stones was larger than the shoulder jerk. Moreover, the amplitude of the hand trajectory in both horizontal and vertical directions was smaller in a task using a cup filled with water than in a task using a cup filled with stones. The results of the measurement experiments were accurately reproduced by the active suppression method based on skyhook control. These results suggest that humans dampen hand vibrations by controlling the equilibrium point through the information of the external workspace and the internal body state rather than by lowering joint stiffness only by using internal information.

Evaluating EMG Feature and Classifier Selection for Application to Partial-Hand Prosthesis Control

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Adenike A. Adewuyi

2016-10-01

Full Text Available Pattern recognition-based myoelectric control of upper limb prostheses has the potential to restore control of multiple degrees of freedom. Though this control method has been extensively studied in individuals with higher-level amputations, few studies have investigated its effectiveness for individuals with partial-hand amputations. Most partial-hand amputees retain a functional wrist and the ability of pattern recognition-based methods to correctly classify hand motions from different wrist positions is not well studied. In this study, focusing on partial-hand amputees, we evaluate (1 the performance of non-linear and linear pattern recognition algorithms and (2 the performance of optimal EMG feature subsets for classification of four hand motion classes in different wrist positions for 16 non-amputees and 4 amputees. Our results show that linear discriminant analysis and linear and non-linear artificial neural networks perform significantly better than the quadratic discriminant analysis for both non-amputees and partial-hand amputees. For amputees, including information from multiple wrist positions significantly decreased error (p<0.001 but no further significant decrease in error occurred when more than 4, 2, or 3 positions were included for the extrinsic (p=0.07, intrinsic (p=0.06, or combined extrinsic and intrinsic muscle EMG (p=0.08, respectively. Finally, we found that a feature set determined by selecting optimal features from each channel outperformed the commonly used time domain (p<0.001 and time domain/autoregressive feature sets (p<0.01. This method can be used as a screening filter to select the features from each channel that provide the best classification of hand postures across different wrist positions.

The first step in infection control is hand hygiene.

Science.gov (United States)

Canham, Leslie

2011-01-01

A dental health care worker (DHCW) has an obligation to prevent the spread of health care associated infections. Adhering to proper hand hygiene procedures, selecting appropriate hand hygiene products and the use of gloves are all important elements of infection control. The CDC Guidelines for Hand Hygiene state that improved hand hygiene practices can reduce transmission of pathogenic microorganisms to patients and personnel in health care settings. DHCWs must also protect themselves by recognizing pitfalls such as irritants or allergies that may pose obstacles to proper hand hygiene. Occupational irritants and allergies can be caused by frequent hand washing, exposure to hand hygiene products, exposure to chemicals and shear forces associated with wearing or removing gloves. Since the primary defense against infection and transmission of pathogens is healthy, unbroken skin, DHCWs must take steps to ensure that their skin remains healthy and intact. These steps include evaluating different types of hand hygiene products, lotions and gloves for the best compatibility. If the DHCW sees a breakdown of his or her skin barrier, steps should be taken to determine the cause and remedy. Remedies can include the use of alcohol-based hand sanitizers containing emollients and moisturizers and regular use of a medical grade hand lotion. The bottom line: healthy skin protects you at work and at home. Selection and use of appropriate hand hygiene products, including moisturizers, are an essential part ofa dental office infection control program. My coworker lost the use of her thumb for several months due to complications of a staph infection. She was unable to work and found even simple tasks such as closing a button hard to do. Think of how difficult your work would be if something happened to your hands. Injury, irritation or allergies could alter your ability to work or even perform routine tasks. Our hands provide us with the ability to work in clinical dentistry. It makes

A synergy-based hand control is encoded in human motor cortical areas

Science.gov (United States)

Leo, Andrea; Handjaras, Giacomo; Bianchi, Matteo; Marino, Hamal; Gabiccini, Marco; Guidi, Andrea; Scilingo, Enzo Pasquale; Pietrini, Pietro; Bicchi, Antonio; Santello, Marco; Ricciardi, Emiliano

2016-01-01

How the human brain controls hand movements to carry out different tasks is still debated. The concept of synergy has been proposed to indicate functional modules that may simplify the control of hand postures by simultaneously recruiting sets of muscles and joints. However, whether and to what extent synergic hand postures are encoded as such at a cortical level remains unknown. Here, we combined kinematic, electromyography, and brain activity measures obtained by functional magnetic resonance imaging while subjects performed a variety of movements towards virtual objects. Hand postural information, encoded through kinematic synergies, were represented in cortical areas devoted to hand motor control and successfully discriminated individual grasping movements, significantly outperforming alternative somatotopic or muscle-based models. Importantly, hand postural synergies were predicted by neural activation patterns within primary motor cortex. These findings support a novel cortical organization for hand movement control and open potential applications for brain-computer interfaces and neuroprostheses. DOI: http://dx.doi.org/10.7554/eLife.13420.001 PMID:26880543

Fusion of hard and soft control strategies for the robotic hand

CERN Document Server

Chen, Cheng-Hung

2018-01-01

Long considered the stuff of science fiction, a prosthetic hand capable of fully replicating all of that appendage's various functions is closer to becoming reality than ever before. This book provides a comprehensive report on exciting recent developments in hybrid control techniques—one of the most crucial hurdles to be overcome in creating smart prosthetic hands. Coauthored by two of the world's foremost pioneering experts in the field, Fusion of Hard and Soft Control Strategies for the Robotic Hand treats robotic hands for multiple applications. It begins with an overview of advances in main control techniques that have been made over the past decade before addressing the military context for affordable robotic hand technology with tactile and/or proprioceptive feedback for hand amputees. Kinematics, homogene us transformations, inverse and differential kinematics, trajectory planning, and dynamic models of two-link thumb and three-link index finger are discussed in detail. The remainder of the book is...

Structural Integration and Control of Peerless Human-like Prosthetic Hand

Science.gov (United States)

Dave, Ankit; Muthu, P.; Karthikraj, V.; Latha, S.

2018-04-01

Limb damage can create severe disturbance in movement and operative abilities wherein the prosthetic rehabilitation has the potential to replace function and enhance the quality of life. This paper presents a humanlike prosthetic hand using such unique design concept of hand model using artificial bones, ligaments, and tendons controlled using Arduino. Amongst various platforms available, Arduino is known for its adaptability, adoration and low cost. The design of prosthetic hand has a unique structure with all carpal, metacarpal, and phalanges which are bones of the hand. These bones are attached to each other following the pattern of human hand using the polymeric rubber as a functioning ligament. Furthermore, this structure of finger is driven by tendons attached to all fingers and passes through the ligaments working as pulley resulting in more degrees of freedom. The motor can twitch the tendons to achieve the action of fingers. Thus the servos, controlled by an Arduino, are used to regulate the movement mechanism of the prosthetic hand.

[Study on an Exoskeleton Hand Function Training Device].

Science.gov (United States)

Hu, Xin; Zhang, Ying; Li, Jicai; Yi, Jinhua; Yu, Hongliu; He, Rongrong

2016-02-01

Based on the structure and motion bionic principle of the normal adult fingers, biological characteristics of human hands were analyzed, and a wearable exoskeleton hand function training device for the rehabilitation of stroke patients or patients with hand trauma was designed. This device includes the exoskeleton mechanical structure and the electromyography (EMG) control system. With adjustable mechanism, the device was capable to fit different finger lengths, and by capturing the EMG of the users' contralateral limb, the motion state of the exoskeleton hand was controlled. Then driven by the device, the user's fingers conducting adduction/abduction rehabilitation training was carried out. Finally, the mechanical properties and training effect of the exoskeleton hand were verified through mechanism simulation and the experiments on the experimental prototype of the wearable exoskeleton hand function training device.

Real-time myoelectric control of a multi-fingered hand prosthesis using principal components analysis

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Matrone Giulia C

2012-06-01

Full Text Available Abstract Background In spite of the advances made in the design of dexterous anthropomorphic hand prostheses, these sophisticated devices still lack adequate control interfaces which could allow amputees to operate them in an intuitive and close-to-natural way. In this study, an anthropomorphic five-fingered robotic hand, actuated by six motors, was used as a prosthetic hand emulator to assess the feasibility of a control approach based on Principal Components Analysis (PCA, specifically conceived to address this problem. Since it was demonstrated elsewhere that the first two principal components (PCs can describe the whole hand configuration space sufficiently well, the controller here employed reverted the PCA algorithm and allowed to drive a multi-DoF hand by combining a two-differential channels EMG input with these two PCs. Hence, the novelty of this approach stood in the PCA application for solving the challenging problem of best mapping the EMG inputs into the degrees of freedom (DoFs of the prosthesis. Methods A clinically viable two DoFs myoelectric controller, exploiting two differential channels, was developed and twelve able-bodied participants, divided in two groups, volunteered to control the hand in simple grasp trials, using forearm myoelectric signals. Task completion rates and times were measured. The first objective (assessed through one group of subjects was to understand the effectiveness of the approach; i.e., whether it is possible to drive the hand in real-time, with reasonable performance, in different grasps, also taking advantage of the direct visual feedback of the moving hand. The second objective (assessed through a different group was to investigate the intuitiveness, and therefore to assess statistical differences in the performance throughout three consecutive days. Results Subjects performed several grasp, transport and release trials with differently shaped objects, by operating the hand with the myoelectric

Economic Evaluation of a Multifaceted Implementation Strategy for the Prevention of Hand Eczema Among Healthcare Workers in Comparison with a Control Group: The Hands4U Study.

NARCIS (Netherlands)

Van Der Meer, Esther W C; van Dongen, J.M.; Boot, C.R.; van der Gulden, J.W.; Bosmans, J.E.; Anema, J.R.

2016-01-01

The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the

Economic Evaluation of a Multifaceted Implementation Strategy for the Prevention of Hand Eczema Among Healthcare Workers in Comparison with a Control Group: The Hands4U Study

NARCIS (Netherlands)

Meer, E.W. van der; Dongen, J.M. van; Boot, C.R.; Gulden, J.W.J. van der; Bosmans, J.E.; Anema, J.R.

2016-01-01

The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the

Prevention of hand eczema among Danish hairdressing apprentices: an intervention study

DEFF Research Database (Denmark)

Bregnhøj, Anne; Menné, Torkil; Johansen, Jeanne Duus

2012-01-01

for this study and delivered by teachers specially trained in the prevention of hand eczema; the other half received normal training and served as a control group. All apprentices completed self-administered questionnaires including questions regarding hand eczema, use of gloves and degree of wet work, and were...... used gloves during wet work procedures and significantly fewer developed hand eczema compared with apprentices from the control group (p=0.04). A logistic regression model showed that atopic dermatitis had a significant influence on the development of hand eczema in the cohort irrespective...... of the intervention.ConclusionsWe were able to increase the use of gloves and reduce the incidence of hand eczema in hairdressing apprentices by implementing a training program in hairdressing schools....

Viability of Controlling Prosthetic Hand Utilizing Electroencephalograph (EEG) Dataset Signal

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Miskon, Azizi; A/L Thanakodi, Suresh; Raihan Mazlan, Mohd; Mohd Haziq Azhar, Satria; Nooraya Mohd Tawil, Siti

2016-11-01

This project presents the development of an artificial hand controlled by Electroencephalograph (EEG) signal datasets for the prosthetic application. The EEG signal datasets were used as to improvise the way to control the prosthetic hand compared to the Electromyograph (EMG). The EMG has disadvantages to a person, who has not used the muscle for a long time and also to person with degenerative issues due to age factor. Thus, the EEG datasets found to be an alternative for EMG. The datasets used in this work were taken from Brain Computer Interface (BCI) Project. The datasets were already classified for open, close and combined movement operations. It served the purpose as an input to control the prosthetic hand by using an Interface system between Microsoft Visual Studio and Arduino. The obtained results reveal the prosthetic hand to be more efficient and faster in response to the EEG datasets with an additional LiPo (Lithium Polymer) battery attached to the prosthetic. Some limitations were also identified in terms of the hand movements, weight of the prosthetic, and the suggestions to improve were concluded in this paper. Overall, the objective of this paper were achieved when the prosthetic hand found to be feasible in operation utilizing the EEG datasets.

Design and implementation of adaptive inverse control algorithm for a micro-hand control system

Directory of Open Access Journals (Sweden)

Wan-Cheng Wang

2014-01-01

Full Text Available The Letter proposes an online tuned adaptive inverse position control algorithm for a micro-hand. First, the configuration of the micro-hand is discussed. Next, a kinematic analysis of the micro-hand is investigated and then the relationship between the rotor position of micro-permanent magnet synchronous motor and the tip of the micro-finger is derived. After that, an online tuned adaptive inverse control algorithm, which includes an adaptive inverse model and an adaptive inverse control, is designed. The online tuned adaptive inverse control algorithm has better performance than the proportional–integral control algorithm does. In addition, to avoid damaging the object during the grasping process, an online force control algorithm is proposed here as well. An embedded micro-computer, cRIO-9024, is used to realise the whole position control algorithm and the force control algorithm by using software. As a result, the hardware circuit is very simple. Experimental results show that the proposed system can provide fast transient responses, good load disturbance responses, good tracking responses and satisfactory grasping responses.

Feasibility and efficacy of a robotic device for hand rehabilitation in hemiplegic stroke patients: a randomized pilot controlled study.

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Vanoglio, Fabio; Bernocchi, Palmira; Mulè, Chiara; Garofali, Francesca; Mora, Chiara; Taveggia, Giovanni; Scalvini, Simonetta; Luisa, Alberto

2017-03-01

The purpose of the study was to evaluate the feasibility and efficacy of robot-assisted hand rehabilitation in improving arm function abilities in sub-acute hemiplegic patients. Randomized controlled pilot study. Inpatient rehabilitation centers. Thirty hemiplegic stroke patients (Ashworth spasticity index hand training with Gloreha, a hand rehabilitation glove that provides computer-controlled, repetitive, passive mobilization of the fingers, with multisensory feedback. Patients in the CG received the same amount of time in terms of conventional hand rehabilitation. Hand motor function (Motricity Index, MI), fine manual dexterity (Nine Hole Peg Test, NHPT) and strength (Grip and Pinch test) were measured at baseline and after rehabilitation, and the differences, (Δ) mean(standard deviation), compared between groups. Results Twenty-seven patients concluded the program: 14 in the TG and 13 in the CG. None of the patients refused the device and only one adverse event of rheumatoid arthritis reactivation was reported. Baseline data did not differ significantly between the two groups. In TG, ΔMI 23(16.4), ΔNHPT 0.16(0.16), ΔGRIP 0.27(0.23) and ΔPINCH 0.07(0.07) were significantly greater than in CG, ΔMI 5.2(9.2), ΔNHPT 0.02(0.07), ΔGRIP 0.03(0.06) and ΔPINCH 0.02(0.03)] ( p=0.002, p=0.009, p=0.003 and p=0.038, respectively). Gloreha Professional is feasible and effective in recovering fine manual dexterity and strength and reducing arm disability in sub-acute hemiplegic patients.

Closed-loop control of grasping with a myoelectric hand prosthesis: which are the relevant feedback variables for force control?

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Ninu, Andrei; Dosen, Strahinja; Muceli, Silvia; Rattay, Frank; Dietl, Hans; Farina, Dario

2014-09-01

In closed-loop control of grasping by hand prostheses, the feedback information sent to the user is usually the actual controlled variable, i.e., the grasp force. Although this choice is intuitive and logical, the force production is only the last step in the process of grasping. Therefore, this study evaluated the performance in controlling grasp strength using a hand prosthesis operated through a complete grasping sequence while varying the feedback variables (e.g., closing velocity, grasping force), which were provided to the user visually or through vibrotactile stimulation. The experiments were conducted on 13 volunteers who controlled the Otto Bock Sensor Hand Speed prosthesis. Results showed that vibrotactile patterns were able to replace the visual feedback. Interestingly, the experiments demonstrated that direct force feedback was not essential for the control of grasping force. The subjects were indeed able to control the grip strength, predictively, by estimating the grasping force from the prosthesis velocity of closing. Therefore, grasping without explicit force feedback is not completely blind, contrary to what is usually assumed. In our study we analyzed grasping with a specific prosthetic device, but the outcomes are also applicable for other devices, with one or more degrees-of-freedom. The necessary condition is that the electromyography (EMG) signal directly and proportionally controls the velocity/grasp force of the hand, which is a common approach among EMG controlled prosthetic devices. The results provide important indications on the design of closed-loop EMG controlled prosthetic systems.

A Prosthetic Hand Body Area Controller Based on Efficient Pattern Recognition Control Strategies.

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Benatti, Simone; Milosevic, Bojan; Farella, Elisabetta; Gruppioni, Emanuele; Benini, Luca

2017-04-15

Poliarticulated prosthetic hands represent a powerful tool to restore functionality and improve quality of life for upper limb amputees. Such devices offer, on the same wearable node, sensing and actuation capabilities, which are not equally supported by natural interaction and control strategies. The control in state-of-the-art solutions is still performed mainly through complex encoding of gestures in bursts of contractions of the residual forearm muscles, resulting in a non-intuitive Human-Machine Interface (HMI). Recent research efforts explore the use of myoelectric gesture recognition for innovative interaction solutions, however there persists a considerable gap between research evaluation and implementation into successful complete systems. In this paper, we present the design of a wearable prosthetic hand controller, based on intuitive gesture recognition and a custom control strategy. The wearable node directly actuates a poliarticulated hand and wirelessly interacts with a personal gateway (i.e., a smartphone) for the training and personalization of the recognition algorithm. Through the whole system development, we address the challenge of integrating an efficient embedded gesture classifier with a control strategy tailored for an intuitive interaction between the user and the prosthesis. We demonstrate that this combined approach outperforms systems based on mere pattern recognition, since they target the accuracy of a classification algorithm rather than the control of a gesture. The system was fully implemented, tested on healthy and amputee subjects and compared against benchmark repositories. The proposed approach achieves an error rate of 1.6% in the end-to-end real time control of commonly used hand gestures, while complying with the power and performance budget of a low-cost microcontroller.

In a demanding task, three-handed manipulation is preferred to two-handed manipulation.

Science.gov (United States)

Abdi, Elahe; Burdet, Etienne; Bouri, Mohamed; Himidan, Sharifa; Bleuler, Hannes

2016-02-25

Equipped with a third hand under their direct control, surgeons may be able to perform certain surgical interventions alone; this would reduce the need for a human assistant and related coordination difficulties. However, does human performance improve with three hands compared to two hands? To evaluate this possibility, we carried out a behavioural study on the performance of naive adults catching objects with three virtual hands controlled by their two hands and right foot. The subjects could successfully control the virtual hands in a few trials. With this control strategy, the workspace of the hands was inversely correlated with the task velocity. The comparison of performance between the three and two hands control revealed no significant difference of success in catching falling objects and in average effort during the tasks. Subjects preferred the three handed control strategy, found it easier, with less physical and mental burden. Although the coordination of the foot with the natural hands increased trial after trial, about two minutes of practice was not sufficient to develop a sense of ownership towards the third arm.

Early intensive hand rehabilitation after spinal cord injury ("Hands On": a protocol for a randomised controlled trial

Directory of Open Access Journals (Sweden)

Hsueh Ya-Seng

2011-01-01

Full Text Available Abstract Background Loss of hand function is one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation. Methods/design A multicentre randomised controlled trial will be undertaken. Seventy-eight participants with recent tetraplegia (C2 to T1 motor complete or incomplete undergoing inpatient rehabilitation will be recruited from seven spinal cord injury units in Australia and New Zealand and will be randomised to a control or experimental group. Control participants will receive usual care. Experimental participants will receive usual care and an 8-week program of intensive unilateral hand training using an instrumented exercise workstation and functional electrical stimulation. Participants will drive the functional electrical stimulation of their target hands via a behind-the-ear bluetooth device, which is sensitive to tooth clicks. The bluetooth device will enable the use of various manipulanda to practice functional activities embedded within computer-based games and activities. Training will be provided for one hour, 5 days per week, during the 8-week intervention period. The primary outcome is the Action Research Arm Test. Secondary outcomes include measurements of strength, sensation, function, quality of life and cost effectiveness. All outcomes will be taken at baseline, 8 weeks, 6 months and 12 months by assessors blinded to group allocation. Recruitment commenced in December 2009. Discussion The results of this trial will determine the effectiveness of an 8-week program of intensive hand training with functional electrical stimulation. Trial registration NCT01086930 (12th March 2010 ACTRN12609000695202 (12th August 2009

Early intensive hand rehabilitation after spinal cord injury ("Hands On"): a protocol for a randomised controlled trial.

Science.gov (United States)

Harvey, Lisa A; Dunlop, Sarah A; Churilov, Leonid; Hsueh, Ya-Seng Arthur; Galea, Mary P

2011-01-17

Loss of hand function is one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation. A multicentre randomised controlled trial will be undertaken. Seventy-eight participants with recent tetraplegia (C2 to T1 motor complete or incomplete) undergoing inpatient rehabilitation will be recruited from seven spinal cord injury units in Australia and New Zealand and will be randomised to a control or experimental group. Control participants will receive usual care. Experimental participants will receive usual care and an 8-week program of intensive unilateral hand training using an instrumented exercise workstation and functional electrical stimulation. Participants will drive the functional electrical stimulation of their target hands via a behind-the-ear bluetooth device, which is sensitive to tooth clicks. The bluetooth device will enable the use of various manipulanda to practice functional activities embedded within computer-based games and activities. Training will be provided for one hour, 5 days per week, during the 8-week intervention period. The primary outcome is the Action Research Arm Test. Secondary outcomes include measurements of strength, sensation, function, quality of life and cost effectiveness. All outcomes will be taken at baseline, 8 weeks, 6 months and 12 months by assessors blinded to group allocation. Recruitment commenced in December 2009. The results of this trial will determine the effectiveness of an 8-week program of intensive hand training with functional electrical stimulation. NCT01086930 (12th March 2010)ACTRN12609000695202 (12th August 2009).

Concept for a large master/slave-controlled robotic hand

Science.gov (United States)

Grissom, William A.; Abdallah, Mahmoud A.; White, Carl L.

1988-01-01

A strategy is presented for the design and construction of a large master/slave-controlled, five-finger robotic hand. Each of the five fingers will possess four independent axes each driven by a brushless DC servomotor and, thus, four degrees-of-freedom. It is proposed that commercially available components be utilized as much as possible to fabricate a working laboratory model of the device with an anticipated overall length of two-to-four feet (0.6 to 1.2 m). The fingers are to be designed so that proximity, tactile, or force/torque sensors can be imbedded in their structure. In order to provide for the simultaneous control of the twenty independent hand joints, a multilevel master/slave control strategy is proposed in which the operator wears a specially instrumented glove which produces control signals corresponding to the finger configurations and which is capable of conveying sensor feedback signals to the operator. Two dexterous hand master devices are currently commercially available for this application with both undergoing continuing development. A third approach to be investigated for the master control mode is the use of real-time image processing of a specially patterned master glove to provide the respective control signals for positioning the multiple finger joints.

A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home.

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Sandora, Thomas J; Taveras, Elsie M; Shih, Mei-Chiung; Resnick, Elissa A; Lee, Grace M; Ross-Degnan, Dennis; Goldmann, Donald A

2005-09-01

Good hand hygiene may reduce the spread of infections in families with children who are in out-of-home child care. Alcohol-based hand sanitizers rapidly kill viruses that are commonly associated with respiratory and gastrointestinal (GI) infections. The objective of this study was to determine whether a multifactorial campaign centered on increasing alcohol-based hand sanitizer use and hand-hygiene education reduces illness transmission in the home. A cluster randomized, controlled trial was conducted of homes of 292 families with children who were enrolled in out-of-home child care in 26 child care centers. Eligible families had > or =1 child who was 6 months to 5 years of age and in child care for > or =10 hours/week. Intervention families received a supply of hand sanitizer and biweekly hand-hygiene educational materials for 5 months; control families received only materials promoting good nutrition. Primary caregivers were phoned biweekly and reported respiratory and GI illnesses in family members. Respiratory and GI-illness-transmission rates (measured as secondary illnesses per susceptible person-month) were compared between groups, adjusting for demographic variables, hand-hygiene practices, and previous experience using hand sanitizers. Baseline demographics were similar in the 2 groups. A total of 1802 respiratory illnesses occurred during the study; 443 (25%) were secondary illnesses. A total of 252 GI illnesses occurred during the study; 28 (11%) were secondary illnesses. The secondary GI-illness rate was significantly lower in intervention families compared with control families (incidence rate ratio [IRR]: 0.41; 95% confidence interval [CI]: 0.19-0.90). The overall rate of secondary respiratory illness was not significantly different between groups (IRR: 0.97; 95% CI: 0.72-1.30). However, families with higher sanitizer usage had a marginally lower secondary respiratory illness rate than those with less usage (IRR: 0.81; 95% CI: 0.65-1.09). A

Case-Cohort Studies: Design and Applicability to Hand Surgery.

Science.gov (United States)

Vojvodic, Miliana; Shafarenko, Mark; McCabe, Steven J

2018-04-24

Observational studies are common research strategies in hand surgery. The case-cohort design offers an efficient and resource-friendly method for risk assessment and outcomes analysis. Case-cohorts remain underrepresented in upper extremity research despite several practical and economic advantages over case-control studies. This report outlines the purpose, utility, and structure of the case-cohort design and offers a sample research question to demonstrate its value to risk estimation for adverse surgical outcomes. The application of well-designed case-cohort studies is advocated in an effort to improve the quality and quantity of observational research evidence in hand and upper extremity surgery. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Glycemic Control, Hand Activity, and Complexity of Biological Signals in Diabetes Mellitus

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Hsien-Tsai Wu

2017-01-01

Full Text Available Both glycemic control and handgrip strength affect microvascular function. Multiscale entropy (MSE of photoplethysmographic (PPG pulse amplitudes may differ by diabetes status and hand activity. Of a middle-to-old aged and right-handed cohort without clinical cardiovascular disease, we controlled age, sex, and weight to select the unaffected (no type 2 diabetes, n=36, the well-controlled diabetes (HbA1c < 8%, n=22, and the poorly controlled diabetes (HbA1c ≥ 8%, n=22 groups. MSEs were calculated from consecutive 1,500 PPG pulse amplitudes of bilateral index fingertips. The small-,  medium-, and large-scale MSEs were defined as the average of scale 1 (MSE1, scales 2–4 (MSE2–4, and scales 5–10 (MSE5–10, respectively. Intra- and intergroups were compared by one- and two-sample t-tests, respectively. The dominant hand MSE5–10 was lower in the poorly controlled diabetes group than the well-controlled diabetes and the unaffected (1.28 versus 1.52 and 1.56, p=0.019 and 0.001, resp. groups, whereas the nondominant hand MSE5–10 was lower in the well- and poorly controlled diabetes groups than the unaffected group (1.35 and 1.29 versus 1.58, p=0.008 and 0.005, resp.. The MSE1 of dominant hand was higher than that of nondominant hand in the well-controlled diabetes (1.35 versus 1.10, p=0.048. In conclusion, diabetes status and hand dominance may affect the MSE of PPG pulse amplitudes.

A Control Strategy with Tactile Perception Feedback for EMG Prosthetic Hand

Directory of Open Access Journals (Sweden)

Changcheng Wu

2015-01-01

Full Text Available To improve the control effectiveness and make the prosthetic hand not only controllable but also perceivable, an EMG prosthetic hand control strategy was proposed in this paper. The control strategy consists of EMG self-learning motion recognition, backstepping controller with stiffness fuzzy observation, and force tactile representation. EMG self-learning motion recognition is used to reduce the influence on EMG signals caused by the uncertainty of the contacting position of the EMG sensors. Backstepping controller with stiffness fuzzy observation is used to realize the position control and grasp force control. Velocity proportional control in free space and grasp force tracking control in restricted space can be realized by the same controller. The force tactile representation helps the user perceive the states of the prosthetic hand. Several experiments were implemented to verify the effect of the proposed control strategy. The results indicate that the proposed strategy has effectiveness. During the experiments, the comments of the participants show that the proposed strategy is a better choice for amputees because of the improved controllability and perceptibility.

A Prospective Controlled Trial of an Electronic Hand Hygiene Reminder System.

Science.gov (United States)

Ellison, Richard T; Barysauskas, Constance M; Rundensteiner, Elke A; Wang, Di; Barton, Bruce

2015-12-01

Background.  The use of electronic hand hygiene reminder systems has been proposed as an approach to improve hand hygiene compliance among healthcare workers, although information on efficacy is limited. We prospectively assessed whether hand hygiene activities among healthcare workers could be increased using an electronic hand hygiene monitoring and reminder system. Methods.  A prospective controlled clinical trial was conducted in 2 medical intensive care units (ICUs) at an academic medical center with comparable patient populations, healthcare staff, and physical layout. Hand hygiene activity was monitored concurrently in both ICUs, and the reminder system was installed in the test ICU. The reminder system was tested during 3 administered phases including: room entry/exit chimes, display of real-time hand hygiene activity, and a combination of the 2. Results.  In the test ICU, the mean number of hand hygiene events increased from 1538 per day at baseline to 1911 per day (24% increase) with the use of a combination of room entry/exit chimes, real-time displays of hand hygiene activity, and manager reports (P performance returned to baseline (1473 hand hygiene events per day) during the follow-up phase. There was no significant change in hand hygiene activity in the control ICU during the course of the trial. Conclusions.  In an ICU setting, an electronic hand hygiene reminder system that provided real-time feedback on overall unit-wide hand hygiene performance significantly increased hand hygiene activity.

Development of five-finger robotic hand using master-slave control for hand-assisted laparoscopic surgery.

Science.gov (United States)

Yoshida, Koki; Yamada, Hiroshi; Kato, Ryu; Seki, Tatsuya; Yokoi, Hiroshi; Mukai, Masaya

2016-08-01

This study aims to develop a robotic hand as a substitute for a surgeon's hand in hand-assisted laparoscopic surgery (HALS). We determined the requirements for the proposed hand from a surgeon's motions in HALS. We identified four basic behaviors: "power grasp," "precision grasp," "open hand for exclusion," and "peace sign for extending peritoneum." The proposed hand had the minimum necessary DOFs for performing these behaviors, five fingers as in a human's hand, a palm that can be folded when a surgeon inserts the hand into the abdomen, and an arm for adjusting the hand's position. We evaluated the proposed hand based on a performance test and a physician's opinions, and we confirmed that it can grasp organs.

A Prospective Controlled Trial of an Electronic Hand Hygiene Reminder System

Science.gov (United States)

Ellison, Richard T.; Barysauskas, Constance M.; Rundensteiner, Elke A.; Wang, Di; Barton, Bruce

2015-01-01

Background. The use of electronic hand hygiene reminder systems has been proposed as an approach to improve hand hygiene compliance among healthcare workers, although information on efficacy is limited. We prospectively assessed whether hand hygiene activities among healthcare workers could be increased using an electronic hand hygiene monitoring and reminder system. Methods. A prospective controlled clinical trial was conducted in 2 medical intensive care units (ICUs) at an academic medical center with comparable patient populations, healthcare staff, and physical layout. Hand hygiene activity was monitored concurrently in both ICUs, and the reminder system was installed in the test ICU. The reminder system was tested during 3 administered phases including: room entry/exit chimes, display of real-time hand hygiene activity, and a combination of the 2. Results. In the test ICU, the mean number of hand hygiene events increased from 1538 per day at baseline to 1911 per day (24% increase) with the use of a combination of room entry/exit chimes, real-time displays of hand hygiene activity, and manager reports (P hand hygiene to room entry/exit events also increased from 26.1% to 36.6% (40% increase, P hand hygiene events per day) during the follow-up phase. There was no significant change in hand hygiene activity in the control ICU during the course of the trial. Conclusions. In an ICU setting, an electronic hand hygiene reminder system that provided real-time feedback on overall unit-wide hand hygiene performance significantly increased hand hygiene activity. PMID:26430698

An elicitation study of critical care nurses' salient hand hygiene beliefs.

Science.gov (United States)

Piras, Susan E; Lauderdale, Jana; Minnick, Ann

2017-10-01

To describe critical care nurses' hand hygiene attitudinal, normative referent, and control beliefs. Hand hygiene is the primary strategy to prevent healthcare-associated infections. Social influence is an underdeveloped hand hygiene strategy. This qualitative descriptive study was conducted with 25 ICU nurses in the southeastern United States. Data were collected using the Nurses' Salient Belief Instrument. Thematic analysis generated four themes: Hand Hygiene is Protective; Nurses look to Nurses; Time-related Concerns; and Convenience is Essential. Nurses look to nurses as hand hygiene referents and believe hand hygiene is a protective behaviour that requires time and functional equipment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of prosthesis use on the capability to control myoelectric robotic prosthetic hands.

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Atzori, Manfredo; Hager, Anne-Gabrielle Mittaz; Elsig, Simone; Giatsidis, Giorgio; Bassetto, Franco; Muller, Henning

2015-08-01

The natural control of robotic prosthetic hands with non-invasive techniques is still a challenge: myoelectric prostheses currently give some control capabilities; the application of pattern recognition techniques is promising and recently started to be applied in practice but still many questions are open in the field. In particular, the effects of clinical factors on movement classification accuracy and the capability to control myoelectric prosthetic hands are analyzed in very few studies. The effect of regularly using prostheses on movement classification accuracy has been previously studied, showing differences between users of myoelectric and cosmetic prostheses. In this paper we compare users of myoelectric and body-powered prostheses and intact subjects. 36 machine-learning methods are applied on 6 amputees and 40 intact subjects performing 40 movements. Then, statistical analyses are performed in order to highlight significant differences between the groups of subjects. The statistical analyses do not show significant differences between the two groups of amputees, while significant differences are obtained between amputees and intact subjects. These results constitute new information in the field and suggest new interpretations to previous hypotheses, thus adding precious information towards natural control of robotic prosthetic hands.

Inspections of Hand Washing Supplies and Hand Sanitizer in Public Schools

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Ramos, Mary M.; Blea, Mary; Trujillo, Rebecca; Greenberg, Cynthia

2010-01-01

Hand washing and hand antisepsis are proven infection control measures in the school setting, yet barriers such as lack of soap, paper towels, and hand sanitizer can hinder compliance. This pilot study measured the prevalence of hand cleaning supplies in public schools. Ten school districts (93 schools) participated in school nurse inspections. In…

Effects of hand-training in persons with myotonic dystrophy type 1--a randomised controlled cross-over pilot study.

Science.gov (United States)

Aldehag, Anna; Jonsson, Hans; Lindblad, Jan; Kottorp, Anders; Ansved, Tor; Kierkegaard, Marie

2013-10-01

To investigate the effects of a hand-training programme on grip, pinch and wrist force, manual dexterity and activities of daily living, in adults with myotonic dystrophy type 1 (DM1). In this randomised controlled trial with a crossover design, 35 adults with DM1 were, after stratification for grip force, assigned by lot to two groups. Group A started with 12 weeks of hand training, while group B had no intervention. After a wash-out period of 12 weeks, where none received training, the order was reversed. The Grippit® was used as primary outcome measure and the hand-held Microfet2™ myometer, the Purdue Pegboard, the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS) were secondary outcome measures. Assessments were performed before and after training and control periods, i.e. four times altogether. Ten persons dropped out and 13 had acceptable adherence. Intention-to-treat analyses revealed significant intervention effects for isometric wrist flexor force (p = 0.048), and for COPM performance (p = 0.047) and satisfaction (p = 0.027). On an individual level, improvements were in general showed after a training period. The hand-training programme had positive effects on wrist flexor force and self-perception of occupational performance, and of satisfaction with performance. No evident detrimental effects were shown. Myotonic dystrophy type 1 (DM1) is a slowly progressive neuromuscular disease characterised by myotonia and muscle weakness and wasting. People with DM1 are often concerned about their ability to carry out ADL and to participate in, e.g. work, sports and hobbies when they gradually become weaker. This pilot study showed that a hand-training programme improved wrist flexor force and self-perception and satisfaction of occupational performance. Resistance training of hand muscles with a silicon-based putty can be a therapy option for people with DM1 in clinical practise.

Integrated, multidisciplinary care for hand eczema: design of a randomized controlled trial and cost-effectiveness study

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Boot Cécile RL

2009-12-01

Full Text Available Abstract Background The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity loss and sick leave. Usual care is suboptimal, due to a lack of optimal instruction and coordination of care, and communication with the general practitioner/occupational physician and people involved at the workplace. Therefore, an integrated, multidisciplinary intervention involving a dermatologist, a care manager, a specialized nurse and a clinical occupational physician was developed. This paper describes the design of a study to investigate the effectiveness and cost-effectiveness of integrated care for hand eczema by a multidisciplinary team, coordinated by a care manager, consisting of instruction on avoiding relevant contact factors, both in the occupational and in the private environment, optimal skin care and treatment, compared to usual, dermatologist-led care. Methods The study is a multicentre, randomized, controlled trial with an economic evaluation alongside. The study population consists of patients with chronic, moderate to severe hand eczema, who visit an outpatient clinic of one of the participating 5 (three university and two general hospitals. Integrated, multidisciplinary care, coordinated by a care manager, including allergo-dermatological evaluation by a dermatologist, occupational intervention by a clinical occupational physician, and counselling by a specialized nurse on optimizing topical treatment and skin care will be compared with usual care by a dermatologist. The primary outcome measure is the cumulative difference in reduction of the clinical severity score HECSI between the groups. Secondary outcome measures are the patient's global assessment, specific quality of life with regard to the hands, generic quality

Strengthening and stretching for rheumatoid arthritis of the hand (SARAH: design of a randomised controlled trial of a hand and upper limb exercise intervention - ISRCTN89936343

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Adams Jo

2012-11-01

Full Text Available Abstract Background Rheumatoid Arthritis (RA commonly affects the hands and wrists with inflammation, deformity, pain, weakness and restricted mobility leading to reduced function. The effectiveness of exercise for RA hands is uncertain, although evidence from small scale studies is promising. The Strengthening And Stretching for Rheumatoid Arthritis of the Hand (SARAH trial is a pragmatic, multi-centre randomised controlled trial evaluating the clinical and cost effectiveness of adding an optimised exercise programme for hands and upper limbs to best practice usual care for patients with RA. Methods/design 480 participants with problematic RA hands will be recruited through 17 NHS trusts. Treatments will be provided by physiotherapists and occupational therapists. Participants will be individually randomised to receive either best practice usual care (joint protection advice, general exercise advice, functional splinting and assistive devices or best practice usual care supplemented with an individualised exercise programme of strengthening and stretching exercises. The study assessors will be blinded to treatment allocation and will follow participants up at four and 12 months. The primary outcome measure is the Hand function subscale of the Michigan Hand Outcome Questionnaire, and secondary outcomes include hand and wrist impairment measures, quality of life, and resource use. Economic and qualitative studies will also be carried out in parallel. Discussion This paper describes the design and development of a trial protocol of a complex intervention study based in therapy out-patient departments. The findings will provide evidence to support or refute the use of an optimised exercise programme for RA of the hand in addition to best practice usual care. Trial registration Current Controlled Trials ISRCTN89936343

The effectiveness of origami on overall hand function after injury: A pilot controlled trial

OpenAIRE

Wilson, L; Roden, P; Taylor, Y; Marston, L

2008-01-01

This pilot study measured the effectiveness of using origami to improve the overall hand function of outpatients attending an NHS hand injury unit. The initiative came from one of the authors who had used origami informally in the clinical setting and observed beneficial effects. These observed effects were tested experimentally. The design was a pilot non-randomised controlled trial with 13 participants. Allocation of the seven control group members was based on patient preference. The exper...

Task-oriented training with computer gaming in people with rheumatoid arthritisor osteoarthritis of the hand: study protocol of a randomized controlled pilot trial.

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Srikesavan, Cynthia Swarnalatha; Shay, Barbara; Robinson, David B; Szturm, Tony

2013-03-09

Significant restriction in the ability to participate in home, work and community life results from pain, fatigue, joint damage, stiffness and reduced joint range of motion and muscle strength in people with rheumatoid arthritis or osteoarthritis of the hand. With modest evidence on the therapeutic effectiveness of conventional hand exercises, a task-oriented training program via real life object manipulations has been developed for people with arthritis. An innovative, computer-based gaming platform that allows a broad range of common objects to be seamlessly transformed into therapeutic input devices through instrumentation with a motion-sense mouse has also been designed. Personalized objects are selected to target specific training goals such as graded finger mobility, strength, endurance or fine/gross dexterous functions. The movements and object manipulation tasks that replicate common situations in everyday living will then be used to control and play any computer game, making practice challenging and engaging. The ongoing study is a 6-week, single-center, parallel-group, equally allocated and assessor-blinded pilot randomized controlled trial. Thirty people with rheumatoid arthritis or osteoarthritis affecting the hand will be randomized to receive either conventional hand exercises or the task-oriented training. The purpose is to determine a preliminary estimation of therapeutic effectiveness and feasibility of the task-oriented training program. Performance based and self-reported hand function, and exercise compliance are the study outcomes. Changes in outcomes (pre to post intervention) within each group will be assessed by paired Student t test or Wilcoxon signed-rank test and between groups (control versus experimental) post intervention using unpaired Student t test or Mann-Whitney U test. The study findings will inform decisions on the feasibility, safety and completion rate and will also provide preliminary data on the treatment effects of the task

Visual control improves the accuracy of hand positioning in Huntington’s disease

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Emilia J. Sitek

2017-08-01

Full Text Available Background: The study aimed at demonstrating dependence of visual feedback during hand and finger positioning task performance among Huntington’s disease patients in comparison to patients with Parkinson’s disease and cervical dystonia. Material and methods: Eighty-nine patients participated in the study (23 with Huntington’s disease, 25 with Parkinson’s disease with dyskinesias, 21 with Parkinson’s disease without dyskinesias, and 20 with cervical dystonia, scoring ≥20 points on Mini-Mental State Examination in order to assure comprehension of task instructions. Neurological examination comprised of the motor section from the Unified Huntington’s Disease Rating Scale for Huntington’s disease, the Unified Parkinson’s Disease Rating Scale Part II–IV for Parkinson’s disease and the Toronto Western Spasmodic Torticollis Rating Scale for cervical dystonia. In order to compare hand position accuracy under visually controlled and blindfolded conditions, the patient imitated each of the 10 examiner’s hand postures twice, once under the visual control condition and once with no visual feedback provided. Results: Huntington’s disease patients imitated examiner’s hand positions less accurately under blindfolded condition in comparison to Parkinson’s disease without dyskinesias and cervical dystonia participants. Under visually controlled condition there were no significant inter-group differences. Conclusions: Huntington’s disease patients exhibit higher dependence on visual feedback while performing motor tasks than Parkinson’s disease and cervical dystonia patients. Possible improvement of movement precision in Huntington’s disease with the use of visual cues could be potentially useful in the patients’ rehabilitation.

A Biomechanical Model for the Development of Myoelectric Hand Prosthesis Control Systems

NARCIS (Netherlands)

Peerdeman, B.; van Baal, D.W.; Boere, Daphne; Kallenberg, L.A.C.; Stramigioli, Stefano; Misra, Sarthak

2010-01-01

Advanced myoelectric hand prostheses aim to reproduce as much of the human hand's functionality as possible. Development of the control system of such a prosthesis is strongly connected to its mechanical design; the control system requires accurate information on the prosthesis' structure and the

Musculoskeletal model-based control interface mimics physiologic hand dynamics during path tracing task

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Crouch, Dustin L.; (Helen Huang, He

2017-06-01

Objective. We investigated the feasibility of a novel, customizable, simplified EMG-driven musculoskeletal model for estimating coordinated hand and wrist motions during a real-time path tracing task. Approach. A two-degree-of-freedom computational musculoskeletal model was implemented for real-time EMG-driven control of a stick figure hand displayed on a computer screen. After 5-10 minutes of undirected practice, subjects were given three attempts to trace 10 straight paths, one at a time, with the fingertip of the virtual hand. Able-bodied subjects completed the task on two separate test days. Main results. Across subjects and test days, there was a significant linear relationship between log-transformed measures of accuracy and speed (Pearson’s r  =  0.25, p  bodied subjects in 8 of 10 trials. For able-bodied subjects, tracing accuracy was lower at the extremes of the model’s range of motion, though there was no apparent relationship between tracing accuracy and fingertip location for the amputee. Our result suggests that, unlike able-bodied subjects, the amputee’s motor control patterns were not accustomed to the multi-joint dynamics of the wrist and hand, possibly as a result of post-amputation cortical plasticity, disuse, or sensory deficits. Significance. To our knowledge, our study is one of very few that have demonstrated the real-time simultaneous control of multi-joint movements, especially wrist and finger movements, using an EMG-driven musculoskeletal model, which differs from the many data-driven algorithms that dominate the literature on EMG-driven prosthesis control. Real-time control was achieved with very little training and simple, quick (~15 s) calibration. Thus, our model is potentially a practical and effective control platform for multifunctional myoelectric prostheses that could restore more life-like hand function for individuals with upper limb amputation.

Design and control of five fingered under-actuated robotic hand

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Sahoo, Biswojit; Parida, Pramod Kumar

2018-04-01

Now a day's research regarding humanoid robots and its application in different fields (industry, household, rehabilitation and exploratory) is going on entire the globe. Among which a challenging topic is to design a dexterous robotic hand which not only can perform as a hand of a robot but also can be used in re habilitation. The basic key concern is a dexterous robot hand which can be able to mimic the function of biological hand to perform different operations. This thesis work is regarding design and control of a under-actuated robotic hand consisting of four under actuated fingers (index finger, middle finger, little finger and ring finger ) , a thumb and a dexterous palm which can copy the motions and grasp type of human hand which having 21degrees of freedom instead of 25Degree Of Freedom.

Finger functionality and joystick design for complex hand control

NARCIS (Netherlands)

Grinten, M.P. van der; Krause, F.

2006-01-01

Joysticks and similar multi-directional controls are increasingly applied in machines, instruments and consumer goods. Operational complexity rises through miniaturization and additional control functions on the joystick. With this the effort for the finger, hand and arm, and for the perceptive and

The efficacy of peloid therapy in management of hand osteoarthritis: a pilot study

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Kasapoğlu Aksoy, Meliha; Altan, Lale; Eröksüz, Rıza; Metin Ökmen, Burcu

2017-12-01

Hand osteoarthritis (OA) is associated with pain, reduced grip strength, loss of range of motion (ROM), and joint stiffness, leading to impaired hand function and difficulty in performance of daily living activities. Mud bath therapy has been reported to play a primary role in the prevention and management of OA. Thus, we planned to conduct a study aimed at investigating the effects of peloid therapy on pain, functional state, grip strength, and the quality of life and performing a comparative analysis of the outcomes of peloid therapy. In this randomized, controlled, single-blind, pilot study, patients ( n = 33) underwent peloid therapy over 2 weeks, 5 sessions a week, for a total of 10 sessions and home exercise program in group 1. Patients in group 2 (control, n = 30) received only the same home exercise program as in group 1. Patients were evaluated just before, and 2 and 6 weeks after the start of the study with Visual Analogue Scale (VAS), Australian/Canadian Hand Osteoarthritis Index (AUSCAN), Health Assessment Questionnaire (HAQ), hand grip strength (HGS), and pinch strength (PS). Statistically significant improvements were observed in all parameters assessed at week 2 and week 6 in the group 1 ( p management of symptomatic osteoarthritis of the hand and may provide effective pain control and improvements in the hand functions, quality of life, and grip strength.

Constraint Study for a Hand Exoskeleton: Human Hand Kinematics and Dynamics

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Fai Chen Chen

2013-01-01

Full Text Available In the last few years, the number of projects studying the human hand from the robotic point of view has increased rapidly, due to the growing interest in academic and industrial applications. Nevertheless, the complexity of the human hand given its large number of degrees of freedom (DoF within a significantly reduced space requires an exhaustive analysis, before proposing any applications. The aim of this paper is to provide a complete summary of the kinematic and dynamic characteristics of the human hand as a preliminary step towards the development of hand devices such as prosthetic/robotic hands and exoskeletons imitating the human hand shape and functionality. A collection of data and constraints relevant to hand movements is presented, and the direct and inverse kinematics are solved for all the fingers as well as the dynamics; anthropometric data and dynamics equations allow performing simulations to understand the behavior of the finger.

Design and validation of a morphing myoelectric hand posture controller based on principal component analysis of human grasping.

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Segil, Jacob L; Weir, Richard F ff

2014-03-01

An ideal myoelectric prosthetic hand should have the ability to continuously morph between any posture like an anatomical hand. This paper describes the design and validation of a morphing myoelectric hand controller based on principal component analysis of human grasping. The controller commands continuously morphing hand postures including functional grasps using between two and four surface electromyography (EMG) electrodes pairs. Four unique maps were developed to transform the EMG control signals in the principal component domain. A preliminary validation experiment was performed by 10 nonamputee subjects to determine the map with highest performance. The subjects used the myoelectric controller to morph a virtual hand between functional grasps in a series of randomized trials. The number of joints controlled accurately was evaluated to characterize the performance of each map. Additional metrics were studied including completion rate, time to completion, and path efficiency. The highest performing map controlled over 13 out of 15 joints accurately.

Effect of clinical parameters on the control of myoelectric robotic prosthetic hands.

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Atzori, Manfredo; Gijsberts, Arjan; Castellini, Claudio; Caputo, Barbara; Hager, Anne-Gabrielle Mittaz; Elsig, Simone; Giatsidis, Giorgio; Bassetto, Franco; Müller, Henning

2016-01-01

Improving the functionality of prosthetic hands with noninvasive techniques is still a challenge. Surface electromyography (sEMG) currently gives limited control capabilities; however, the application of machine learning to the analysis of sEMG signals is promising and has recently been applied in practice, but many questions still remain. In this study, we recorded the sEMG activity of the forearm of 11 male subjects with transradial amputation who were mentally performing 40 hand and wrist movements. The classification performance and the number of independent movements (defined as the subset of movements that could be distinguished with >90% accuracy) were studied in relationship to clinical parameters related to the amputation. The analysis showed that classification accuracy and the number of independent movements increased significantly with phantom limb sensation intensity, remaining forearm percentage, and temporal distance to the amputation. The classification results suggest the possibility of naturally controlling up to 11 movements of a robotic prosthetic hand with almost no training. Knowledge of the relationship between classification accuracy and clinical parameters adds new information regarding the nature of phantom limb pain as well as other clinical parameters, and it can lay the foundations for future "functional amputation" procedures in surgery.

Robot training for hand motor recovery in subacute stroke patients: A randomized controlled trial.

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Orihuela-Espina, Felipe; Roldán, Giovana Femat; Sánchez-Villavicencio, Israel; Palafox, Lorena; Leder, Ronald; Sucar, Luis Enrique; Hernández-Franco, Jorge

2016-01-01

Evidence of superiority of robot training for the hand over classical therapies in stroke patients remains controversial. During the subacute stage, hand training is likely to be the most useful. To establish whether robot active assisted therapies provides any additional motor recovery for the hand when administered during the subacute stage (robot based therapies for hand recovery will show significant differences at subacute stages. A randomized clinical trial. A between subjects randomized controlled trial was carried out on subacute stroke patients (n = 17) comparing robot active assisted therapy (RT) with a classical occupational therapy (OT). Both groups received 40 sessions ensuring at least 300 repetitions per session. Treatment duration was (mean ± std) 2.18 ± 1.25 months for the control group and 2.44 ± 0.88 months for the study group. The primary outcome was motor dexterity changes assessed with the Fugl-Meyer (FMA) and the Motricity Index (MI). Both groups (OT: n = 8; RT: n = 9) exhibited significant improvements over time (Non-parametric Cliff's delta-within effect sizes: dwOT-FMA = 0.5, dwOT-MI = 0.5, dwRT-FMA = 1, dwRT-MI = 1). Regarding differences between the therapies; the Fugl-Meyer score indicated a significant advantage for the hand training with the robot (FMA hand: WRS: W = 8, p hand prehension for RT with respect to OT but failed to reach significance (MI prehension: W = 17.5, p = 0.080). No harm occurred. Robotic therapies may be useful during the subacute stages of stroke - both endpoints (FM hand and MI prehension) showed the expected trend with bigger effect size for the robotic intervention. Additional benefit of the robotic therapy over the control therapy was only significant when the difference was measured with FM, demanding further investigation with larger samples. Implications of this study are important for decision making during therapy administration and resource allocation. Copyright © 2016 Hanley

A new approach of active compliance control via fuzzy logic control for multifingered robot hand

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Jamil, M. F. A.; Jalani, J.; Ahmad, A.

2016-07-01

Safety is a vital issue in Human-Robot Interaction (HRI). In order to guarantee safety in HRI, a model reference impedance control can be a very useful approach introducing a compliant control. In particular, this paper establishes a fuzzy logic compliance control (i.e. active compliance control) to reduce impact and forces during physical interaction between humans/objects and robots. Exploiting a virtual mass-spring-damper system allows us to determine a desired compliant level by understanding the behavior of the model reference impedance control. The performance of fuzzy logic compliant control is tested in simulation for a robotic hand known as the RED Hand. The results show that the fuzzy logic is a feasible control approach, particularly to control position and to provide compliant control. In addition, the fuzzy logic control allows us to simplify the controller design process (i.e. avoid complex computation) when dealing with nonlinearities and uncertainties.

A four-axis hand controller for helicopter flight control

Science.gov (United States)

Demaio, Joe

1993-01-01

A proof-of-concept hand controller for controlling lateral and longitudinal cyclic pitch, collective pitch and tail rotor thrust was developed. The purpose of the work was to address problems of operator fatigue, poor proprioceptive feedback and cross-coupling of axes associated with many four-axis controller designs. The present design is an attempt to reduce cross-coupling to a level that can be controlled with breakout force, rather than to eliminate it entirely. The cascaded design placed lateral and longitudinal cyclic in their normal configuration. Tail rotor thrust was placed atop the cyclic controller. A left/right twisting motion with the wrist made the control input. The axis of rotation was canted outboard (clockwise) to minimize cross-coupling with the cyclic pitch axis. The collective control was a twist grip, like a motorcycle throttle. Measurement of the amount of cross-coupling involved in pure, single-axis inputs showed cross coupling under 10 percent of full deflection for all axes. This small amount of cross-coupling could be further reduced with better damping and force gradient control. Fatigue was not found to be a problem, and proprioceptive feedback was adequate for all flight tasks executed.

Efficacy of Moringa oleifera leaf powder as a hand-washing product: a crossover controlled study among healthy volunteers.

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Torondel, Belen; Opare, David; Brandberg, Bjorn; Cobb, Emma; Cairncross, Sandy

2014-02-14

Moringa oleifera is a plant found in many tropical and subtropical countries. Many different uses and properties have been attributed to this plant, mainly as a nutritional supplement and as a water purifier. Its antibacterial activity against different pathogens has been described in different in vitro settings. However the potential effect of this plant leaf as a hand washing product has never been studied. The aim of this study is to test the efficacy of this product using an in vivo design with healthy volunteers. The hands of fifteen volunteers were artificially contaminated with Escherichia coli. Moringa oleifera leaf powder was tested as a hand washing product and was compared with reference non-medicated liquid soap using a cross over design following an adaptation of the European Committee for Standardization protocol (EN 1499). In a second part of tests, the efficacy of the established amount of Moringa oleifera leaf powder was compared with an inert powder using the same protocol. Application of 2 and 3 g of dried Moringa oleifera leaf powder (mean log10-reduction: 2.44 ± 0.41 and 2.58 ± 0.34, respectively) was significantly less effective than the reference soap (3.00 ± 0.27 and 2.99 ± 0.26, respectively; p Moringa oleifera (2 and 3 g) but using a wet preparation, was also significantly less effective than reference soap (p Moringa oleifera powder in dried or wet preparation (mean log10-reduction: 2.70 ± 0.27 and 2.91 ± 0.11, respectively) compared with reference soap (2.97 ± 0.28). Application of calcium sulphate inert powder was significantly less effective than the 4 g of Moringa oleifera powder (p Moringa oleifera powder in dried and wet application had the same effect as non-medicated soap when used for hand washing. Efficacious and available hand washing products could be useful in developing countries in controlling pathogenic organisms that are transmitted through contaminated hands.

Dexterous Control of Seven Functional Hand Movements Using Cortically-Controlled Transcutaneous Muscle Stimulation in a Person With Tetraplegia

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Samuel C. Colachis

2018-04-01

Full Text Available Individuals with tetraplegia identify restoration of hand function as a critical, unmet need to regain their independence and improve quality of life. Brain-Computer Interface (BCI-controlled Functional Electrical Stimulation (FES technology addresses this need by reconnecting the brain with paralyzed limbs to restore function. In this study, we quantified performance of an intuitive, cortically-controlled, transcutaneous FES system on standardized object manipulation tasks from the Grasp and Release Test (GRT. We found that a tetraplegic individual could use the system to control up to seven functional hand movements, each with >95% individual accuracy. He was able to select one movement from the possible seven movements available to him and use it to appropriately manipulate all GRT objects in real-time using naturalistic grasps. With the use of the system, the participant not only improved his GRT performance over his baseline, demonstrating an increase in number of transfers for all objects except the Block, but also significantly improved transfer times for the heaviest objects (videocassette (VHS, Can. Analysis of underlying motor cortex neural representations associated with the hand grasp states revealed an overlap or non-separability in neural activation patterns for similarly shaped objects that affected BCI-FES performance. These results suggest that motor cortex neural representations for functional grips are likely more related to hand shape and force required to hold objects, rather than to the objects themselves. These results, demonstrating multiple, naturalistic functional hand movements with the BCI-FES, constitute a further step toward translating BCI-FES technologies from research devices to clinical neuroprosthetics.

Beneficial effects of an investigational wristband containing Synsepalum dulcificum (miracle fruit) seed oil on the performance of hand and finger motor skills in healthy subjects: A randomized controlled preliminary study.

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Gorin, Steven; Wakeford, Charles; Zhang, Guodong; Sukamtoh, Elvira; Matteliano, Charles Joseph; Finch, Alfred Earl

2018-02-01

Miracle fruit (Synsepalum dulcificum) seed oil (MFSO) contains phytochemicals and nutrients reported to affect musculoskeletal performance. The purpose of this study was to assess the safety and efficacy of a compression wristband containing MFSO on its ability to measurably improve the hand and finger motor skills of participants. Healthy right-handed participants (n = 38) were randomized in this double-blind, placebo-controlled study of MFSO and vehicle wristbands. Subjects wore the wristband on their left hand 4-6 weeks and then only on their right hand 2-4 weeks; the contralateral untreated hand served as an additional control. Twelve hand/finger motor skills were measured using quantitative bio-instrumentation tests, and subject self-assessment questionnaires were conducted. With each hand, in 9/12 tests, the MFSO group showed a clinically meaningful average improvement compared with an average worsening in the vehicle group. Statistical superiority to the control treatment group was exhibited in 9/12 tests for each hand (p motor skills. Use of the MFSO wristband may improve an individual's manual dexterity skills and ability to maintain this performance. Copyright © 2017 The Authors Phytotherapy Research Published by John Wiley & Sons Ltd.

Neural manual vs. robotic assisted mobilization to improve motion and reduce pain hypersensitivity in hand osteoarthritis: study protocol for a randomized controlled trial.

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Villafañe, Jorge Hugo; Valdes, Kristin; Imperio, Grace; Borboni, Alberto; Cantero-Téllez, Raquel; Galeri, Silvia; Negrini, Stefano

2017-05-01

[Purpose] The aim of the present study is to detail the protocol for a randomised controlled trial (RCT) of neural manual vs. robotic assisted on pain in sensitivity as well as analyse the quantitative and qualitative movement of hand in subjects with hand osteoarthritis. [Subjects and Methods] Seventy-two patients, aged 50 to 90 years old of both genders, with a diagnosis of hand Osteoarthritis (OA), will be recruited. Two groups of 36 participants will receive an experimental intervention (neurodynamic mobilization intervention plus exercise) or a control intervention (robotic assisted passive mobilization plus exercise) for 12 sessions over 4 weeks. Assessment points will be at baseline, end of therapy, and 1 and 3 months after end of therapy. The outcomes of this intervention will be pain and determine the central pain processing mechanisms. [Result] Not applicable. [Conclusion] If there is a reduction in pain hypersensitivity in hand OA patients it can suggest that supraspinal pain-inhibitory areas, including the periaqueductal gray matter, can be stimulated by joint mobilization.

Working hard to make a simple definition of synergies. Comment on: "Hand synergies: Integration of robotics and neuroscience for understanding the control of biological and artificial hands" by Marco Santello et al.

Science.gov (United States)

Alessandro, Cristiano; Oliveira Barroso, Filipe; Tresch, Matthew

2016-07-01

The paper ;Hand synergies: Integration of robotics and neuroscience for understanding the control of biological and artificial hands; [1] presents a comprehensive review of the work carried out as part of the EU funded project ;The Hand Embodied;. The work uses the concept of ;synergy; to study the neuromuscular control of the human hand and to design novel robotics systems. The project has been very productive and has made important contributions. We are therefore confident that it will lead to further advancements and experiments in the future.

Hand Hygiene, Cohorting, or Antibiotic Restriction to Control Outbreaks of Multidrug-Resistant Enterobacteriaceae.

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Pelat, Camille; Kardaś-Słoma, Lidia; Birgand, Gabriel; Ruppé, Etienne; Schwarzinger, Michaël; Andremont, Antoine; Lucet, Jean-Christophe; Yazdanpanah, Yazdan

2016-03-01

The best strategy for controlling extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) transmission in intensive care units (ICUs) remains elusive. We developed a stochastic transmission model to quantify the effectiveness of interventions aimed at reducing the spread of ESBL-PE in an ICU. We modeled the evolution of an outbreak caused by the admission of a single carrier in a 10-bed ICU free of ESBL-PE. Using data obtained from recent muticenter studies, we studied 26 strategies combining different levels of the following 3 interventions: (1) increasing healthcare worker compliance with hand hygiene before and after contact with a patient; (2) cohorting; (3) reducing antibiotic prevalence at admission with or without reducing antibiotherapy duration. Improving hand hygiene compliance from 55% before patient contact and 60% after patient contact to 80% before and 80% after patient contact reduced the nosocomial incidence rate of ESBL-PE colonization by 91% at 90 days. Adding cohorting to hand hygiene improvement intervention decreased the proportion of ESBL-PE acquisitions by an additional 7%. Antibiotic restriction had the lowest impact on the epidemic. When combined with other interventions, it only marginally improved effectiveness, despite strong hypotheses regarding antibiotic impact on transmission. Our results suggest that hand hygiene is the most effective intervention to control ESBL-PE transmission in an ICU.

A community-randomised controlled trial promoting waterless hand sanitizer and handwashing with soap, Dhaka, Bangladesh.

Science.gov (United States)

Luby, Stephen P; Kadir, Mohammad Abdul; Yushuf Sharker, M A; Yeasmin, Farzana; Unicomb, Leanne; Sirajul Islam, M

2010-12-01

To pilot two intensive hand hygiene promotion interventions, one using soap and one using a waterless hand sanitizer, in low-income housing compounds in Dhaka, Bangladesh and assess subsequent changes in handwashing behaviour and hand microbiology. Fieldworkers randomized 30 housing compounds: 10 received handwashing promotion with free soap, 10 received handwashing promotion with free waterless hand sanitizer and 10 were non-intervention controls. Fieldworkers assessed handwashing behaviour by structured observation and collected hand rinse specimens. At baseline, compound residents washed their hands with soap 26% of the time after defecation and 30% after cleaning a child's anus but hands with soap after faecal contact (85-91%), before preparing food (26%) and before eating (26%). Compounds that received waterless hand sanitizer cleansed their hands more commonly than control compounds that used soap (10.4%vs. 2.3%), but less commonly than soap intervention compounds used soap (25%). Post-intervention hand rinse samples from soap and sanitizer compounds had lower concentrations of faecal indicator bacteria compared with baseline and control compounds. Waterless hand sanitizer was readily adopted by this low-income community and reduced hand contamination but did not improve the frequency of handwashing compared with soap. Future deployments of waterless hand sanitizers may improve hand hygiene more effectively by targeting settings where soap and water is unavailable. © 2010 Blackwell Publishing Ltd.

Feasibility study of a hand guided robotic drill for cochleostomy.

Science.gov (United States)

Brett, Peter; Du, Xinli; Zoka-Assadi, Masoud; Coulson, Chris; Reid, Andrew; Proops, David

2014-01-01

The concept of a hand guided robotic drill has been inspired by an automated, arm supported robotic drill recently applied in clinical practice to produce cochleostomies without penetrating the endosteum ready for inserting cochlear electrodes. The smart tactile sensing scheme within the drill enables precise control of the state of interaction between tissues and tools in real-time. This paper reports development studies of the hand guided robotic drill where the same consistent outcomes, augmentation of surgeon control and skill, and similar reduction of induced disturbances on the hearing organ are achieved. The device operates with differing presentation of tissues resulting from variation in anatomy and demonstrates the ability to control or avoid penetration of tissue layers as required and to respond to intended rather than involuntary motion of the surgeon operator. The advantage of hand guided over an arm supported system is that it offers flexibility in adjusting the drilling trajectory. This can be important to initiate cutting on a hard convex tissue surface without slipping and then to proceed on the desired trajectory after cutting has commenced. The results for trials on phantoms show that drill unit compliance is an important factor in the design.

Inexpensive and Time-Efficient Hand Hygiene Interventions Increase Elementary School Children's Hand Hygiene Rates

Science.gov (United States)

Snow, Michelle; White, George L.; Kim, Han S.

2008-01-01

Routine hand hygiene has been cited by the World Health Organization and the Centers for Disease Control and Prevention as a cost-effective and important hygiene measure in preventing the spread of infectious diseases. Several studies have explored children's hand hygiene habits, effects of scheduled hand hygiene, hand hygiene environmental…

Hand Hygiene With Alcohol-Based Hand Rub: How Long Is Long Enough?

Science.gov (United States)

Pires, Daniela; Soule, Hervé; Bellissimo-Rodrigues, Fernando; Gayet-Ageron, Angèle; Pittet, Didier

2017-05-01

BACKGROUND Hand hygiene is the core element of infection prevention and control. The optimal hand-hygiene gesture, however, remains poorly defined. OBJECTIVE We aimed to evaluate the influence of hand-rubbing duration on the reduction of bacterial counts on the hands of healthcare personnel (HCP). METHODS We performed an experimental study based on the European Norm 1500. Hand rubbing was performed for 10, 15, 20, 30, 45, or 60 seconds, according to the WHO technique using 3 mL alcohol-based hand rub. Hand contamination with E. coli ATCC 10536 was followed by hand rubbing and sampling. A generalized linear mixed model with a random effect on the subject adjusted for hand size and gender was used to analyze the reduction in bacterial counts after each hand-rubbing action. In addition, hand-rubbing durations of 15 and 30 seconds were compared to assert non-inferiority (0.6 log10). RESULTS In total, 32 HCP performed 123 trials. All durations of hand rubbing led to significant reductions in bacterial counts (Phand rubbing were not significantly different from those obtained after 30 seconds. The mean bacterial reduction after 15 seconds of hand rubbing was 0.11 log10 lower (95% CI, -0.46 to 0.24) than after 30 seconds, demonstrating non-inferiority. CONCLUSIONS Hand rubbing for 15 seconds was not inferior to 30 seconds in reducing bacterial counts on hands under the described experimental conditions. There was no gain in reducing bacterial counts from hand rubbing longer than 30 seconds. Further studies are needed to assess the clinical significance of our findings. Infect Control Hosp Epidemiol 2017;38:547-552.

Development of Hand Grip Assistive Device Control System for Old People through Electromyography (EMG) Signal Acquisitions

OpenAIRE

Khamis Herman; Mohamaddan Shahrol; Komeda Takashi; Alias Aidil Azli; Tanjong Shirley Jonathan; Julai Norhuzaimin; Hashim Nurul ‘Izzati

2017-01-01

The hand grip assistive device is a glove to assist old people who suffer from hand weakness in their daily life activities. The device earlier control system only use simple on and off switch. This required old people to use both hand to activate the device. The new control system of the hand grip assistive device was developed to allow single hand operation for old people. New control system take advantages of electromyography (EMG) and flex sensor which was implemented to the device. It wa...

Integration of robotics and neuroscience beyond the hand: What kind of synergies?. Comment on "Hand synergies: Integration of robotics and neuroscience for understanding the control of biological and artificial hands" by Marco Santello et al.

Science.gov (United States)

d'Avella, Andrea

2016-07-01

Santello et al. [1] review an impressive amount of work on the control of biological and artificial hands that demonstrates how the concept of synergies can lead to a successful integration of robotics and neuroscience. Is it possible to generalize the same approach to the control of biological and artificial limbs and bodies beyond the hand? The human hand synergies that appear most relevant for robotic hands are those defined at the kinematic level, i.e. postural synergies [2]. Postural synergies capture the geometric relations among the many joints of the hand and allow for a low dimensional characterization and synthesis of the static hand postures involved in grasping and manipulating a large set of objects. However, many other complex motor skills such as walking, reaching, throwing, and catching require controlling multi-articular time-varying trajectories rather than static postures. Dynamic control of biological and artificial limbs and bodies, especially when geometric and inertial parameters are uncertain and the joints are compliant, poses great challenges. What kind of synergies might simplify the dynamic control of motor skills involving upper and lower limbs as well as the whole body?

Improving physician hand hygiene compliance using behavioural theories: a study protocol

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Squires Janet E

2013-02-01

Full Text Available Abstract Background Healthcare-associated infections affect 10% of patients in Canadian acute-care hospitals and are significant and preventable causes of morbidity and mortality among hospitalized patients. Hand hygiene is among the simplest and most effective preventive measures to reduce these infections. However, compliance with hand hygiene among healthcare workers, specifically among physicians, is consistently suboptimal. We aim to first identify the barriers and enablers to physician hand hygiene compliance, and then to develop and pilot a theory-based knowledge translation intervention to increase physicians’ compliance with best hand hygiene practice. Design The study consists of three phases. In Phase 1, we will identify barriers and enablers to hand hygiene compliance by physicians. This will include: key informant interviews with physicians and residents using a structured interview guide, informed by the Theoretical Domains Framework; nonparticipant observation of physician/resident hand hygiene audit sessions; and focus groups with hand hygiene experts. In Phase 2, we will conduct intervention mapping to develop a theory-based knowledge translation intervention to improve physician hand hygiene compliance. Finally, in Phase 3, we will pilot the knowledge translation intervention in four patient care units. Discussion In this study, we will use a behavioural theory approach to obtain a better understanding of the barriers and enablers to physician hand hygiene compliance. This will provide a comprehensive framework on which to develop knowledge translation interventions that may be more successful in improving hand hygiene practice. Upon completion of this study, we will refine the piloted knowledge translation intervention so it can be tested in a multi-site cluster randomized controlled trial.

The effect of improved hand hygiene on nosocomial MRSA control.

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Marimuthu, Kalisvar; Pittet, Didier; Harbarth, Stephan

2014-01-01

The purpose of this review is to examine studies that have assessed the association between hand hygiene enhancement and methicillin-resistant Staphylococcus aureus (MRSA) rates and to explore controversies surrounding this association. Many studies have been published confirming the link between improved hand hygiene compliance and reduction in MRSA acquisition and infections, including bacteremia. These studies have also shown the cost-beneficial nature of these programmes. Despite considerable research some issues remain unanswered still, including the temporal relationship between hand hygiene enhancement strategies and decrease in MRSA rates, association between hand hygiene enhancement and MRSA-related surgical site infections, diminishing effect of hand hygiene compliance on MRSA rates after reaching a threshold and the role of instituting contact precautions in the setting of low MRSA rates and sufficient hand hygiene compliance. In conclusion, enhancement of hand hygiene compliance has been shown to reduce MRSA rates; however, some open issues warrant further investigation.

Bacteriological aspects of hand washing: A key for health promotion and infections control

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Ramezan Ali Ataee

2017-01-01

Full Text Available The aim of this review is to show the historical aspects of hands washing for healthy life and explains how can reduce the transmission of community-acquired infectious agents by healthcare workers and patients. This review article is prepared based on available database. The key words used were hands washing, risk assessment, hands hygiene, bacterial flora, contamination, infection, nosocomial, tap water, sanitizer, bacterial resistance, hands bacterial flora, washing methods, antiseptics, healthcare workers, healthcare personnel, from PubMed, ScienceDirect, Embase, Scopus, Web of Sciences, and Google Scholar. Data were descriptively analyzed. The insistence on hand washing has a history of 1400 years. The research results indicate that the bacteria released from the female washed hands in wet and dry condition was lower than from the male′s hands with a significance level (3 CFU vs. 8 CFU; confidence interval 95%, P ≤ 0.001. The valuable results of the study indicated that released amount of bacterial flora from wet hands is more than 10 times in compared to dry hands. In addition, established monitoring systems for washing hands before and after patient′s manipulation as well as after toilet were dominant indices to prevent the transfer of infectious agents to the patients. Increasing awareness and belief of the healthcare workers have shown an important role by about 30% reduction in the transfection. Hand washing could reduce the episodes of transmission of infectious agents in both community and healthcare settings. However, hand washing is an important key factor to prevent transmission of infectious agents to patients. There is no standard method for measuring compliance. Thus, permanent monitoring of hand washing to reduce the transmission of infections is crucial. Finally, the personnel must believe that hand washing is an inevitable approach to infection control.

The Clinical Assessment Study of the Hand (CAS-HA: a prospective study of musculoskeletal hand problems in the general population

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Marshall Michelle

2007-08-01

Full Text Available Abstract Background Pain in the hand affects an estimated 12–21% of the population, and at older ages the hand is one of the most common sites of pain and osteoarthritis. The association between symptomatic hand osteoarthritis and disability in everyday life has not been studied in detail, although there is evidence that older people with hand problems suffer significant pain and disability. Despite the high prevalence of hand problems and the limitations they cause in older adults, little attention has been paid to the hand by health planners and policy makers. We plan to conduct a prospective, population-based, observational cohort study designed in parallel with our previously reported cohort study of knee pain, to describe the course of musculoskeletal hand problems in older adults and investigate the relative merits of different approaches to classification and defining prognosis. Methods/Design All adults aged 50 years and over registered with two general practices in North Staffordshire will be invited to take part in a two-stage postal survey. Respondents to the survey who indicate that they have experienced hand pain or problems within the previous 12 months will be invited to attend a research clinic for a detailed assessment. This will consist of clinical interview, hand assessment, screening test of lower limb function, digital photography, plain x-rays, anthropometric measurement and brief self-complete questionnaire. All consenting clinic attenders will be followed up by (i general practice medical record review, (ii repeat postal questionnaire at 18-months, and (iii repeat postal questionnaire at 3 years. Discussion This paper describes the protocol for the Clinical Assessment Study of the Hand (CAS-HA, a prospective, population-based, observational cohort study of community-dwelling older adults with hand pain and hand problems based in North Staffordshire.

Feasibility Study of a Hand Guided Robotic Drill for Cochleostomy

Directory of Open Access Journals (Sweden)

Peter Brett

2014-01-01

Full Text Available The concept of a hand guided robotic drill has been inspired by an automated, arm supported robotic drill recently applied in clinical practice to produce cochleostomies without penetrating the endosteum ready for inserting cochlear electrodes. The smart tactile sensing scheme within the drill enables precise control of the state of interaction between tissues and tools in real-time. This paper reports development studies of the hand guided robotic drill where the same consistent outcomes, augmentation of surgeon control and skill, and similar reduction of induced disturbances on the hearing organ are achieved. The device operates with differing presentation of tissues resulting from variation in anatomy and demonstrates the ability to control or avoid penetration of tissue layers as required and to respond to intended rather than involuntary motion of the surgeon operator. The advantage of hand guided over an arm supported system is that it offers flexibility in adjusting the drilling trajectory. This can be important to initiate cutting on a hard convex tissue surface without slipping and then to proceed on the desired trajectory after cutting has commenced. The results for trials on phantoms show that drill unit compliance is an important factor in the design.

Hand osteoarthritis: Clinical and imaging study

African Journals Online (AJOL)

Abir Naguib

2011-09-09

Sep 9, 2011 ... Methods: This study was carried out on thirty patients with primary hand OA, and fifteen healthy subjects .... history about their hand condition including morning stiffness, ..... They found the US method of direct visualiza-.

Robotic hand project

OpenAIRE

Karaçizmeli, Cengiz; Çakır, Gökçe; Tükel, Dilek

2014-01-01

In this work, the mechatronic based robotic hand is controlled by the position data taken from the glove which has flex sensors mounted to capture finger bending of the human hand. The angular movement of human hand’s fingers are perceived and processed by a microcontroller, and the robotic hand is controlled by actuating servo motors. It has seen that robotic hand can simulate the movement of the human hand that put on the glove, during tests have done. This robotic hand can be used not only...

Development of Hand Grip Assistive Device Control System for Old People through Electromyography (EMG Signal Acquisitions

Directory of Open Access Journals (Sweden)

Khamis Herman

2017-01-01

Full Text Available The hand grip assistive device is a glove to assist old people who suffer from hand weakness in their daily life activities. The device earlier control system only use simple on and off switch. This required old people to use both hand to activate the device. The new control system of the hand grip assistive device was developed to allow single hand operation for old people. New control system take advantages of electromyography (EMG and flex sensor which was implemented to the device. It was programmed into active and semi-active mode operation. EMG sensors were placed on the forearm to capture EMG signal of Flexor Digitorum Profundus muscle to activate the device. Flex sensor was used to indicate the finger position and placed on top of the finger. The signal from both sensors then used to control the device. The new control system allowed single hand operation and designed to prevent user from over depended on the device by activating it through moving their fingers.

Access to hands-on mathematics measurement activities using robots controlled via speech generating devices: three case studies.

Science.gov (United States)

Adams, Kim; Cook, Al

2014-07-01

To examine how using a robot controlled via a speech generating device (SGD) influences the ways students with physical and communication limitations can demonstrate their knowledge in math measurement activities. Three children with severe physical disabilities and complex communication needs used the robot and SGD system to perform four math measurement lessons in comparing, sorting and ordering objects. The performance of the participants was measured and the process of using the system was described in terms of manipulation and communication events. Stakeholder opinions were solicited regarding robot use. Robot use revealed some gaps in the procedural knowledge of the participants. Access to both the robot and SGD was shown to provide several benefits. Stakeholders thought the intervention was important and feasible for a classroom environment. The participants were able to participate actively in the hands-on and communicative measurement activities and thus meet the demands of current math instruction methods. Current mathematics pedagogy encourages doing hands-on activities while communicating about concepts. Adapted Lego robots enabled children with severe physical disabilities to perform hands-on length measurement activities. Controlling the robots from speech generating devices (SGD) enabled the children, who also had complex communication needs, to reflect and report on results during the activities. By using the robots combined with SGDs, children both exhibited their knowledge of and experienced the concepts of mathematical measurements.

Use of alcohol hand sanitizer as an infection control strategy in an acute care facility.

Science.gov (United States)

Hilburn, Jessica; Hammond, Brian S; Fendler, Eleanor J; Groziak, Patricia A

2003-04-01

Nosocomial infections are a major problem in health care facilities, resulting in extended durations of care, substantial morbidity and mortality, and excess costs. Since alcohol gel hand sanitizers combine high immediate antimicrobial efficacy with ease of use, this study was carried out to determine the effect of the use of an alcohol gel hand sanitizer by caregivers on infection types and rates in an acute care facility. Patients were educated about the study through a poster on the unit, and teachable patients were given portable bottles of the alcohol hand gel for bedside use, along with an educational brochure explaining how and why to practice good hand hygiene. Infection rate and type data were collected in 1 unit of a 498-bed acute care facility for 16 months (February 2000 to May 2001). An alcohol gel hand sanitizer was provided and used by caregivers in the orthopedic surgical unit of the facility during this period. The primary infection types (more than 80%) found were urinary tract (UTI) and surgical site (SSI) infections. Infection types and rates for the unit during the period the alcohol hand sanitizer (intervention) was used were compared with the infection types and rates for the same unit when the alcohol hand sanitizer was not used (baseline); the results demonstrated a 36.1% decrease in infection rates for the 10-month period that the hand sanitizer was used. This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program in acute care facilities.

The Ninapro database: A resource for sEMG naturally controlled robotic hand prosthetics.

Science.gov (United States)

Atzori, Manfredo; Muller, Henning

2015-01-01

The dexterous natural control of robotic prosthetic hands with non-invasive techniques is still a challenge: surface electromyography gives some control capabilities but these are limited, often not natural and require long training times; the application of pattern recognition techniques recently started to be applied in practice. While results in the scientific literature are promising they have to be improved to reach the real needs. The Ninapro database aims to improve the field of naturally controlled robotic hand prosthetics by permitting to worldwide research groups to develop and test movement recognition and force control algorithms on a benchmark database. Currently, the Ninapro database includes data from 67 intact subjects and 11 amputated subject performing approximately 50 different movements. The data are aimed at permitting the study of the relationships between surface electromyography, kinematics and dynamics. The Ninapro acquisition protocol was created in order to be easy to be reproduced. Currently, the number of datasets included in the database is increasing thanks to the collaboration of several research groups.

Hands4U: the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial.

Science.gov (United States)

van der Meer, Esther W C; Boot, Cécile R L; van der Gulden, Joost W J; Knol, Dirk L; Jungbauer, Frank H W; Coenraads, Pieter Jan; Anema, Johannes R

2015-05-01

Healthcare workers have an increased risk of developing hand eczema. A multifaceted implementation strategy was developed to implement a guideline to prevent hand eczema among healthcare workers. To investigate the effects of the implementation strategy on self-reported hand eczema and preventive behaviour. A randomized controlled trial was performed. A total of 48 departments (n = 1649) were randomly allocated to the multifaceted implementation strategy or the control group. The strategy consisted of education, participatory working groups, and role models. Outcome measures were self-reported hand eczema and preventive behaviour. Data were collected at baseline, and 3, 6, 9 and 12 months of follow-up. Participants in the intervention group were significantly more likely to report hand eczema [odds ratio (OR) 1.45; 95% confidence interval (CI) 1.03-2.04], and they reported significantly less hand washing (B, - 0.38; 95%CI: - 0.48 to - 0.27), reported significantly more frequent use of a moisturizer (B, 0.30; 95%CI: 0.22-0.39) and were more likely to report wearing cotton undergloves (OR 6.33; 95%CI: 3.23-12.41) than participants in the control group 12 months after baseline. The strategy implemented can be used in practice, as it showed positive effects on preventive behaviour. More research is needed to investigate the unexpected effects on hand eczema. © 2014 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.

Changes to online control and eye-hand coordination with healthy ageing.

Science.gov (United States)

O'Rielly, Jessica L; Ma-Wyatt, Anna

2018-06-01

Goal directed movements are typically accompanied by a saccade to the target location. Online control plays an important part in correction of a reach, especially if the target or goal of the reach moves during the reach. While there are notable changes to visual processing and motor control with healthy ageing, there is limited evidence about how eye-hand coordination during online updating changes with healthy ageing. We sought to quantify differences between older and younger people for eye-hand coordination during online updating. Participants completed a double step reaching task implemented under time pressure. The target perturbation could occur 200, 400 and 600 ms into a reach. We measured eye position and hand position throughout the trials to investigate changes to saccade latency, movement latency, movement time, reach characteristics and eye-hand latency and accuracy. Both groups were able to update their reach in response to a target perturbation that occurred at 200 or 400 ms into the reach. All participants demonstrated incomplete online updating for the 600 ms perturbation time. Saccade latencies, measured from the first target presentation, were generally longer for older participants. Older participants had significantly increased movement times but there was no significant difference between groups for touch accuracy. We speculate that the longer movement times enable the use of new visual information about the target location for online updating towards the end of the movement. Interestingly, older participants also produced a greater proportion of secondary saccades within the target perturbation condition and had generally shorter eye-hand latencies. This is perhaps a compensatory mechanism as there was no significant group effect on final saccade accuracy. Overall, the pattern of results suggests that online control of movements may be qualitatively different in older participants. Crown Copyright © 2018. Published by Elsevier B.V. All

Implantable electronics of a closed-loop system for controlling prosthetic hands

Directory of Open Access Journals (Sweden)

Nikas Antonios

2017-09-01

Full Text Available This paper presents the design of implantable electronics as a part of a system for prosthetic hand control. Purpose of the implant is the sensing of electrical signals originating from biological tissue and the actuation of the same, therefore closing the loop and allowing for an improved control of the prosthetic hand. The implant contains two integrated circuits for eight channel EMG monitoring and four channel stimulation, respectively. An on-board microcontroller allows for local pre-processing. All intracorporeal to extracorporeal communications are running through and are directed by the main processing platform. The external components of the control system include, in addition to the main processing and control platform, the inductive power transfer circuits and the pressure sensors for the sensory feedback. Different assembly and encapsulation options are taken into account for the implantable electronics and are unified in a single PCB design.

Calculator-Controlled Robots: Hands-On Mathematics and Science Discovery

Science.gov (United States)

Tuchscherer, Tyson

2010-01-01

The Calculator Controlled Robots activities are designed to engage students in hands-on inquiry-based missions. These activities address National science and technology standards, as well as specifically focusing on mathematics content and process standards. There are ten missions and three exploration extensions that provide activities for up to…

Depth camera-based 3D hand gesture controls with immersive tactile feedback for natural mid-air gesture interactions.

Science.gov (United States)

Kim, Kwangtaek; Kim, Joongrock; Choi, Jaesung; Kim, Junghyun; Lee, Sangyoun

2015-01-08

Vision-based hand gesture interactions are natural and intuitive when interacting with computers, since we naturally exploit gestures to communicate with other people. However, it is agreed that users suffer from discomfort and fatigue when using gesture-controlled interfaces, due to the lack of physical feedback. To solve the problem, we propose a novel complete solution of a hand gesture control system employing immersive tactile feedback to the user's hand. For this goal, we first developed a fast and accurate hand-tracking algorithm with a Kinect sensor using the proposed MLBP (modified local binary pattern) that can efficiently analyze 3D shapes in depth images. The superiority of our tracking method was verified in terms of tracking accuracy and speed by comparing with existing methods, Natural Interaction Technology for End-user (NITE), 3D Hand Tracker and CamShift. As the second step, a new tactile feedback technology with a piezoelectric actuator has been developed and integrated into the developed hand tracking algorithm, including the DTW (dynamic time warping) gesture recognition algorithm for a complete solution of an immersive gesture control system. The quantitative and qualitative evaluations of the integrated system were conducted with human subjects, and the results demonstrate that our gesture control with tactile feedback is a promising technology compared to a vision-based gesture control system that has typically no feedback for the user's gesture inputs. Our study provides researchers and designers with informative guidelines to develop more natural gesture control systems or immersive user interfaces with haptic feedback.

Depth Camera-Based 3D Hand Gesture Controls with Immersive Tactile Feedback for Natural Mid-Air Gesture Interactions

Directory of Open Access Journals (Sweden)

Kwangtaek Kim

2015-01-01

Full Text Available Vision-based hand gesture interactions are natural and intuitive when interacting with computers, since we naturally exploit gestures to communicate with other people. However, it is agreed that users suffer from discomfort and fatigue when using gesture-controlled interfaces, due to the lack of physical feedback. To solve the problem, we propose a novel complete solution of a hand gesture control system employing immersive tactile feedback to the user’s hand. For this goal, we first developed a fast and accurate hand-tracking algorithm with a Kinect sensor using the proposed MLBP (modified local binary pattern that can efficiently analyze 3D shapes in depth images. The superiority of our tracking method was verified in terms of tracking accuracy and speed by comparing with existing methods, Natural Interaction Technology for End-user (NITE, 3D Hand Tracker and CamShift. As the second step, a new tactile feedback technology with a piezoelectric actuator has been developed and integrated into the developed hand tracking algorithm, including the DTW (dynamic time warping gesture recognition algorithm for a complete solution of an immersive gesture control system. The quantitative and qualitative evaluations of the integrated system were conducted with human subjects, and the results demonstrate that our gesture control with tactile feedback is a promising technology compared to a vision-based gesture control system that has typically no feedback for the user’s gesture inputs. Our study provides researchers and designers with informative guidelines to develop more natural gesture control systems or immersive user interfaces with haptic feedback.

Hand function evaluation: a factor analysis study.

Science.gov (United States)

Jarus, T; Poremba, R

1993-05-01

The purpose of this study was to investigate hand function evaluations. Factor analysis with varimax rotation was used to assess the fundamental characteristics of the items included in the Jebsen Hand Function Test and the Smith Hand Function Evaluation. The study sample consisted of 144 subjects without disabilities and 22 subjects with Colles fracture. Results suggest a four factor solution: Factor I--pinch movement; Factor II--grasp; Factor III--target accuracy; and Factor IV--activities of daily living. These categories differentiated the subjects without Colles fracture from the subjects with Colles fracture. A hand function evaluation consisting of these four factors would be useful. Such an evaluation that can be used for current clinical purposes is provided.

Accessibility Is the Mother of Invention: When It Comes to an Innovative Hand Control System

Science.gov (United States)

Exceptional Parent, 2007

2007-01-01

This article features Sure Grip hand control, an innovative hand control system created by Keith Howell, the President and founder of Howell Ventures LTD. Howell was in his early teens when he experienced an accident that resulted in his quadriplegia. From that point on, Howell set about to manufacture a set of controls that would emulate the…

Hand sanitisers for reducing illness absences in primary school children in New Zealand: a cluster randomised controlled trial study protocol

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Poore Marion R

2010-01-01

Full Text Available Abstract Background New Zealand has relatively high rates of morbidity and mortality from infectious disease compared with other OECD countries, with infectious disease being more prevalent in children compared with others in the population. Consequences of infectious disease in children may have significant economic and social impact beyond the direct effects of the disease on the health of the child; including absence from school, transmission of infectious disease to other pupils, staff, and family members, and time off work for parents/guardians. Reduction of the transmission of infectious disease between children at schools could be an effective way of reducing the community incidence of infectious disease. Alcohol based no-rinse hand sanitisers provide an alternative hand cleaning technology, for which there is some evidence that they may be effective in achieving this. However, very few studies have investigated the effectiveness of hand sanitisers, and importantly, the potential wider economic implications of this intervention have not been established. Aims The primary objective of this trial is to establish if the provision of hand sanitisers in primary schools in the South Island of New Zealand, in addition to an education session on hand hygiene, reduces the incidence rate of absence episodes due to illness in children. In addition, the trial will establish the cost-effectiveness and conduct a cost-benefit analysis of the intervention in this setting. Methods/Design A cluster randomised controlled trial will be undertaken to establish the effectiveness and cost-effectiveness of hand sanitisers. Sixty-eight primary schools will be recruited from three regions in the South Island of New Zealand. The schools will be randomised, within region, to receive hand sanitisers and an education session on hand hygiene, or an education session on hand hygiene alone. Fifty pupils from each school in years 1 to 6 (generally aged from 5 to 11 years

Influencing factors on hand hygiene behavior of nursing students based on theory of planned behavior: A descriptive survey study.

Science.gov (United States)

Jeong, Sun Young; Kim, Kyung Mi

2016-01-01

Hand hygiene is the single most important measure to prevent transmission of infection, but the compliance rate of healthcare workers is relatively low. This study was conducted to identify the knowledge, beliefs, behavior, and affecting factors about hand hygiene among nursing students. A descriptive survey study. The study was carried out in two South Korean nursing schools. A total 208 nursing students participated in this study. Questionnaires were used to collect data. The percentage of correct answers in the survey section concerning hand hygiene knowledge was 68.1%. No significant difference in the knowledge, behavioral beliefs, normative beliefs, or control beliefs data was found related to general characteristics. Behavioral beliefs correlated with normative beliefs (r=.25, phand hygiene behavior (r=.17, p=.017), and control beliefs correlated with hand hygiene behavior (r=.18, p=.010). The results suggest that knowledge is not enough to change the beliefs related to hand hygiene; positive behavioral beliefs and strong control beliefs are also needed to increase hand hygiene compliance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hand hygiene compliance in transplant and other special patient groups: an observational study.

Science.gov (United States)

Graf, Karolin; Ott, Ella; Wolny, Michael; Tramp, Nadine; Vonberg, Ralf-Peter; Haverich, Axel; Chaberny, Iris Freya

2013-06-01

This study evaluates hand hygiene behavior of health care workers in a German university hospital stratified for treatment of special patient groups (eg, transplant patients). From 2008 to 2010, comprehensive education and training of all health care workers was implemented to improve hand hygiene compliance. Consumption rates of alcohol-based hand rub and gloves were collected and evaluated. Of the 5,647 opportunities of hand disinfection evaluated, 1,607 occurred during care for transplant patients. To our knowledge, this is the largest survey of hand hygiene compliance in special patient groups on intensive care units in a university hospital in Germany. Health care workers on surgical intensive care units showed lower hand hygiene compliance compared with health care workers on other types of intensive care units. Compliance toward hand hygiene was significantly higher on hemato-oncologic and pediatric wards. In general, hand disinfection was performed significantly more frequently after an intervention than before (P hand hygiene compliance when caring for transplant patients or other patients (odds ratio, 1.16; 95% confidence interval: 0.95-1.42). Nurse's and physician's hand hygiene compliance improved because of education. Hand hygiene compliance is not increased in the care for transplant patients (despite their predisposition for nosocomial infections) compared with other patients. Additional studies will be necessary to further investigate these findings. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

New frontiers in the rubber hand experiment: when a robotic hand becomes one's own.

Science.gov (United States)

Caspar, Emilie A; De Beir, Albert; Magalhaes De Saldanha Da Gama, Pedro A; Yernaux, Florence; Cleeremans, Axel; Vanderborght, Bram

2015-09-01

The rubber hand illusion is an experimental paradigm in which participants consider a fake hand to be part of their body. This paradigm has been used in many domains of psychology (i.e., research on pain, body ownership, agency) and is of clinical importance. The classic rubber hand paradigm nevertheless suffers from limitations, such as the absence of active motion or the reliance on approximate measurements, which makes strict experimental conditions difficult to obtain. Here, we report on the development of a novel technology-a robotic, user- and computer-controllable hand-that addresses many of the limitations associated with the classic rubber hand paradigm. Because participants can actively control the robotic hand, the device affords higher realism and authenticity. Our robotic hand has a comparatively low cost and opens up novel and innovative methods. In order to validate the robotic hand, we have carried out three experiments. The first two studies were based on previous research using the rubber hand, while the third was specific to the robotic hand. We measured both sense of agency and ownership. Overall, results show that participants experienced a "robotic hand illusion" in the baseline conditions. Furthermore, we also replicated previous results about agency and ownership.

Humans can integrate force feedback to toes in their sensorimotor control of a robotic hand.

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Panarese, Alessandro; Edin, Benoni B; Vecchi, Fabrizio; Carrozza, Maria C; Johansson, Roland S

2009-12-01

Tactile sensory feedback is essential for dexterous object manipulation. Users of hand myoelectric prostheses without tactile feedback must depend essentially on vision to control their device. Indeed, improved tactile feedback is one of their main priorities. Previous research has provided evidence that conveying tactile feedback can improve prostheses control, although additional effort is required to solve problems related to pattern recognition learning, unpleasant sensations, sensory adaptation, and low spatiotemporal resolution. Still, these studies have mainly focused on providing stimulation to hairy skin regions close to the amputation site, i.e., usually to the upper arm. Here, we explored the possibility to provide tactile feedback to the glabrous skin of toes, which have mechanical and neurophysiological properties similar to the fingertips. We explored this paradigm in a grasp-and-lift task, in which healthy participants controlled two opposing digits of a robotic hand by changing the spacing of their index finger and thumb. The normal forces applied by the robotic fingertips to a test object were fed back to the right big and second toe. We show that within a few lifting trials, all the participants incorporated the force feedback received by the foot in their sensorimotor control of the robotic hand.

Efficacy of paraffin bath therapy in hand osteoarthritis: a single-blinded randomized controlled trial.

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Dilek, Banu; Gözüm, Mehtap; Şahin, Ebru; Baydar, Meltem; Ergör, Gül; El, Ozlem; Bircan, Çigdem; Gülbahar, Selmin

2013-04-01

To evaluate the efficacy of paraffin bath therapy on pain, function, and muscle strength in patients with hand osteoarthritis. Prospective single-blinded randomized controlled trial. Department of physical medicine and rehabilitation in a university hospital. Patients with bilateral hand osteoarthritis (N=56). Patients were randomized into 2 groups with a random number table by using block randomization with 4 patients in a block. Group 1 (n=29) had paraffin bath therapy (5 times per week, for 3-week duration) for both hands. Group 2 (n=27) was the control group. All patients were informed about joint-protection techniques, and paracetamol intake was recorded. The primary outcome measures were pain (at last 48h) at rest and during activities of daily living (ADL), assessed with a visual analog scale (0-10cm) at 12 weeks. The secondary outcome measures were the Australian Canadian Osteoarthritis Hand Index (AUSCAN) and the Dreiser Functional Index (DFI), used for subjective functional evaluation, loss of range of motion (ROM), grip and pinch strength, painful and tender joint counts, and paracetamol intake. A researcher blind to group allocation recorded the measures for both hands at baseline, 3 weeks, and 12 weeks at the hospital setting. At baseline, there were no significant differences between groups in any of the parameters (P>.05). After treatment, the paraffin group exhibited significant improvement in pain at rest and during ADL, ROM of the right hand, and pain and stiffness dimensions of the AUSCAN (P.05). The control group showed a significant deterioration in right hand grip and bilateral lateral pinch and right chuck pinch strength (Pparaffin group (Pparaffin group were significantly higher than the control group at 12 weeks (PParaffin bath therapy seemed to be effective both in reducing pain and tenderness and maintaining muscle strength in hand osteoarthritis. It may be regarded as a beneficial short-term therapy option, which is effective for a 12

‎ Late Recovery from Stuttering: The Role of Hand ‎Dominancy, Fine Motor and ‎Inhibition Control

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Hiwa Mohammadi

2016-02-01

Full Text Available Objective: There are controversial reports about factors that affect recovery from stuttering. In the ‎present study, the effect of hand dominancy, fine motor and inhibition control on late ‎recovery from stuttering was investigated among a group of Kurdish-Persian children who ‎stuttered in Iran.‎Method: Twenty-two Kurdish-Persian children aged 7-14 years who stuttered were followed for 6 ‎years. Based on the evaluation of three experienced speech therapists and parental judgments, ‎these children were classified into recovered or persistent groups. Data about fine motor ‎control of hand and inhibition control were obtained, using Purdue Pegboard and Victoria ‎Strop Color Word Tests, respectively. Risk factors including sex, age, and family history of ‎stuttering, handedness, inhibitory control and fine motor control of hand were compared ‎between the groups and modeled to predict recovery from stuttering using logistic regression.‎Results: From the 22 participants, 5 (22.7% recovered from stuttering. The recovered and persistent ‎groups did not show significant differences in the interference effect. By dividing the scores ‎of the Purdue Pegboard tests to the right and left hand, we created a new Handedness Index ‎‎(HI. HI was significantly higher in the recovered group. The score of right hand was higher ‎than the left in the recovered group, but no difference was found between the two hands in ‎the persistent group. Among the investigated risk factors, only HI could predict the recovery ‎from or persistency of stuttering with 94% sensitivity and 84% specificity.‎Conclusion: Handedness Index can predict the recovery from stuttering significantly among children who ‎stutter.‎

Ability of Hand Hygiene Interventions Using Alcohol-Based Hand Sanitizers and Soap To Reduce Microbial Load on Farmworker Hands Soiled during Harvest.

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de Aceituno, Anna Fabiszewski; Bartz, Faith E; Hodge, Domonique Watson; Shumaker, David J; Grubb, James E; Arbogast, James W; Dávila-Aviña, Jorgé; Venegas, Fabiola; Heredia, Norma; García, Santos; Leon, Juan S

2015-11-01

Effective hand hygiene is essential to prevent the spread of pathogens on produce farms and reduce foodborne illness. The U.S. Food and Drug Administration Food Safety Modernization Act Proposed Rule for Produce Safety recommends the use of soap and running water for hand hygiene of produce handlers. The use of alcohol-based hand sanitizer (ABHS) may be an effective alternative hygiene intervention where access to water is limited. There are no published data on the efficacy of either soap or ABHS-based interventions to reduce microbial contamination in agricultural settings. The goal of this study was to assess the ability of two soap-based (traditional or pumice) and two ABHS-based (label-use or two-step) hygiene interventions to reduce microbes (coliforms, Escherichia coli, and Enterococcus spp.) and soil (absorbance of hand rinsate at 600 nm [A600]) on farmworker hands after harvesting produce, compared with the results for a no-hand-hygiene control. With no hand hygiene, farmworker hands were soiled (median A600, 0.48) and had high concentrations of coliforms (geometric mean, 3.4 log CFU per hand) and Enterococcus spp. (geometric mean, 5.3 log CFU per hand) after 1 to 2 h of harvesting tomatoes. Differences in microbial loads in comparison to the loads in the control group varied by indicator organism and hygiene intervention (0 to 2.3 log CFU per hand). All interventions yielded lower concentrations of Enterococcus spp. and E. coli (P hands (P hand washing with soap at reducing indicator organisms on farmworker hands. Based on these results, ABHS is an efficacious hand hygiene solution for produce handlers, even on soiled hands.

Method of Grasping Control by Computing Internal and External Impedances for Two Robot Fingers, and Its Application to Admittance Control of a Robot Hand-Arm System

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Jian Huang

2015-08-01

Full Text Available Impedance control is an important technology used in the grasping control of a robot hand. Numerous studies related to grasping algorithms have been reported in recent years, with the contact force between robot fingers and the object to be grasped being primarily discussed in most cases. Generally, a coupling effect occurs between the internal loop of the grasping operation and the external loop of the interaction with the environment when a multi-fingered robot hand is used to complete a contact task. Therefore, a robot hand cannot hold an object using a large external force to complete a wide range of tasks by applying the conventional method. In this paper, the coupling of the internal/external forces occurring in grasping operations using multiple fingers is analysed. Then, improved impedance control based on the previous method is proposed as an effective tool to solve the problem of grasping failure caused by single-finger contact. Furthermore, a method for applying the improved grasping algorithm to the admittance control of a robot hand-arm system is also proposed. The proposed method divides the impedance effect into the grasping control of the hand and the cooperative control of the arm, so that expanding the task space and increasing the flexibility of impedance adjustment can be achieved. Experiments were conducted to demonstrate the effectiveness of the proposed method.

Effect of hand sanitizer location on hand hygiene compliance.

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Cure, Laila; Van Enk, Richard

2015-09-01

Hand hygiene is the most important intervention to prevent infection in hospitals. Health care workers should clean their hands at least before and after contact with patients. Hand sanitizer dispensers are important to support hand hygiene because they can be made available throughout hospital units. The aim of this study was to determine whether the usability of sanitizer dispensers correlates with compliance of staff in using the sanitizer in a hospital. This study took place in a Midwest, 404-bed, private, nonprofit community hospital with 15 inpatient care units in addition to several ambulatory units. The usability and standardization of sanitizers in 12 participating inpatient units were evaluated. The hospital measured compliance of staff with hand hygiene as part of their quality improvement program. Data from 2010-2012 were analyzed to measure the relationship between compliance and usability using mixed-effects logistic regression models. The total usability score (P = .0046), visibility (P = .003), and accessibility of the sanitizer on entrance to the patient room (P = .00055) were statistically associated with higher observed compliance rates. Standardization alone showed no significant impact on observed compliance (P = .37). Hand hygiene compliance can be influenced by visibility and accessibility of dispensers. The sanitizer location should be part of multifaceted interventions to improve hand hygiene. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

HUMAN HAND STUDY FOR ROBOTIC EXOSKELETON DELVELOPMENT

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BIROUAS Flaviu Ionut; NILGESZ Arnold

2016-01-01

This paper will be presenting research with application in the rehabilitation of hand motor functions by the aid of robotics. The focus will be on the dimensional parameters of the biological human hand from which the robotic system will be developed. The term used for such measurements is known as anthropometrics. The anthropometric parameters studied and presented in this paper are mainly related to the angular limitations of the finger joints of the human hand.

Humanlike robot hands controlled by brain activity arouse illusion of ownership in operators

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Alimardani, Maryam; Nishio, Shuichi; Ishiguro, Hiroshi

2013-08-01

Operators of a pair of robotic hands report ownership for those hands when they hold image of a grasp motion and watch the robot perform it. We present a novel body ownership illusion that is induced by merely watching and controlling robot's motions through a brain machine interface. In past studies, body ownership illusions were induced by correlation of such sensory inputs as vision, touch and proprioception. However, in the presented illusion none of the mentioned sensations are integrated except vision. Our results show that during BMI-operation of robotic hands, the interaction between motor commands and visual feedback of the intended motions is adequate to incorporate the non-body limbs into one's own body. Our discussion focuses on the role of proprioceptive information in the mechanism of agency-driven illusions. We believe that our findings will contribute to improvement of tele-presence systems in which operators incorporate BMI-operated robots into their body representations.

Evaluation of feedforward and feedback contributions to hand stiffness and variability in multijoint arm control.

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He, Xin; Du, Yu-Fan; Lan, Ning

2013-07-01

The purpose of this study is to validate a neuromechanical model of the virtual arm (VA) by comparing emerging behaviors of the model to those of experimental observations. Hand stiffness of the VA model was obtained by either theoretical computation or simulated perturbations. Variability in hand position of the VA was generated by adding signal dependent noise (SDN) to the motoneuron pools of muscles. Reflex circuits of Ia, Ib and Renshaw cells were included to regulate the motoneuron pool outputs. Evaluation of hand stiffness and variability was conducted in simulations with and without afferent feedback under different patterns of muscle activations during postural maintenance. The simulated hand stiffness and variability ellipses captured the experimentally observed features in shape, magnitude and orientation. Steady state afferent feedback contributed significantly to the increase in hand stiffness by 35.75±16.99% in area, 18.37±7.80% and 16.15±7.15% in major and minor axes; and to the reduction of hand variability by 49.41±21.19% in area, 36.89±12.78% and 18.87±23.32% in major and minor axes. The VA model reproduced the neuromechanical behaviors that were consistent with experimental data, and it could be a useful tool for study of neural control of posture and movement, as well as for application to rehabilitation.

The human hand as an inspiration for robot hand development

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Santos, Veronica

2014-01-01

“The Human Hand as an Inspiration for Robot Hand Development” presents an edited collection of authoritative contributions in the area of robot hands. The results described in the volume are expected to lead to more robust, dependable, and inexpensive distributed systems such as those endowed with complex and advanced sensing, actuation, computation, and communication capabilities. The twenty-four chapters discuss the field of robotic grasping and manipulation viewed in light of the human hand’s capabilities and push the state-of-the-art in robot hand design and control. Topics discussed include human hand biomechanics, neural control, sensory feedback and perception, and robotic grasp and manipulation. This book will be useful for researchers from diverse areas such as robotics, biomechanics, neuroscience, and anthropologists.

Hand Gesture Based Wireless Robotic Arm Control for Agricultural Applications

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Kannan Megalingam, Rajesh; Bandhyopadhyay, Shiva; Vamsy Vivek, Gedela; Juned Rahi, Muhammad

2017-08-01

One of the major challenges in agriculture is harvesting. It is very hard and sometimes even unsafe for workers to go to each plant and pluck fruits. Robotic systems are increasingly combined with new technologies to automate or semi automate labour intensive work, such as e.g. grape harvesting. In this work we propose a semi-automatic method for aid in harvesting fruits and hence increase productivity per man hour. A robotic arm fixed to a rover roams in the in orchard and the user can control it remotely using the hand glove fixed with various sensors. These sensors can position the robotic arm remotely to harvest the fruits. In this paper we discuss the design of hand glove fixed with various sensors, design of 4 DoF robotic arm and the wireless control interface. In addition the setup of the system and the testing and evaluation under lab conditions are also presented in this paper.

An automated hand hygiene compliance system is associated with improved monitoring of hand hygiene.

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McCalla, Saungi; Reilly, Maggie; Thomas, Rowena; McSpedon-Rai, Dawn

2017-05-01

Consistent hand hygiene is key to reducing health care-associated infections (HAIs) and assessing compliance with hand hygiene protocols is vital for hospital infection control staff. A new automated hand hygiene compliance system (HHCS) was trialed as an alternative to human observers in an intensive care unit and an intensive care stepdown unit at a hospital facility in the northeastern United States. Using a retrospective cohort design, researchers investigated whether implementation of the HHCS resulted in improved hand hygiene compliance and a reduction in common HAI rates. Pearson χ 2 tests were used to assess changes in compliance, and incidence rate ratios were used to test for significant differences in infection rates. During the study period, the HHCS collected many more hand hygiene events compared with human observers (632,404 vs 480) and ensured that the hospital met its compliance goals (95%+). Although decreases in multidrug-resistant organisms, central line-associated bloodstream infections, and catheter-associated urinary tract infection rates were observed, they represented nonsignificant differences. Human hand hygiene observers may not report accurate measures of compliance. The HHCS is a promising new tool for fine-grained assessment of hand hygiene compliance. Further study is needed to examine the association between the HHCS and HAI rate reduction. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

HUMAN HAND STUDY FOR ROBOTIC EXOSKELETON DELVELOPMENT

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BIROUAS Flaviu Ionut

2016-11-01

Full Text Available This paper will be presenting research with application in the rehabilitation of hand motor functions by the aid of robotics. The focus will be on the dimensional parameters of the biological human hand from which the robotic system will be developed. The term used for such measurements is known as anthropometrics. The anthropometric parameters studied and presented in this paper are mainly related to the angular limitations of the finger joints of the human hand.

HAND2 Target Gene Regulatory Networks Control Atrioventricular Canal and Cardiac Valve Development.

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Laurent, Frédéric; Girdziusaite, Ausra; Gamart, Julie; Barozzi, Iros; Osterwalder, Marco; Akiyama, Jennifer A; Lincoln, Joy; Lopez-Rios, Javier; Visel, Axel; Zuniga, Aimée; Zeller, Rolf

2017-05-23

The HAND2 transcriptional regulator controls cardiac development, and we uncover additional essential functions in the endothelial to mesenchymal transition (EMT) underlying cardiac cushion development in the atrioventricular canal (AVC). In Hand2-deficient mouse embryos, the EMT underlying AVC cardiac cushion formation is disrupted, and we combined ChIP-seq of embryonic hearts with transcriptome analysis of wild-type and mutants AVCs to identify the functionally relevant HAND2 target genes. The HAND2 target gene regulatory network (GRN) includes most genes with known functions in EMT processes and AVC cardiac cushion formation. One of these is Snai1, an EMT master regulator whose expression is lost from Hand2-deficient AVCs. Re-expression of Snai1 in mutant AVC explants partially restores this EMT and mesenchymal cell migration. Furthermore, the HAND2-interacting enhancers in the Snai1 genomic landscape are active in embryonic hearts and other Snai1-expressing tissues. These results show that HAND2 directly regulates the molecular cascades initiating AVC cardiac valve development. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Assessment of Myoelectric Controller Performance and Kinematic Behavior of a Novel Soft Synergy-Inspired Robotic Hand for Prosthetic Applications.

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Fani, Simone; Bianchi, Matteo; Jain, Sonal; Pimenta Neto, José Simões; Boege, Scott; Grioli, Giorgio; Bicchi, Antonio; Santello, Marco

2016-01-01

Myoelectric artificial limbs can significantly advance the state of the art in prosthetics, since they can be used to control mechatronic devices through muscular activity in a way that mimics how the subjects used to activate their muscles before limb loss. However, surveys indicate that dissatisfaction with the functionality of terminal devices underlies the widespread abandonment of prostheses. We believe that one key factor to improve acceptability of prosthetic devices is to attain human likeness of prosthesis movements, a goal which is being pursued by research on social and human-robot interactions. Therefore, to reduce early abandonment of terminal devices, we propose that controllers should be designed so as to ensure effective task accomplishment in a natural fashion. In this work, we have analyzed and compared the performance of three types of myoelectric controller algorithms based on surface electromyography to control an underactuated and multi-degrees of freedom prosthetic hand, the SoftHand Pro. The goal of the present study was to identify the myoelectric algorithm that best mimics the native hand movements. As a preliminary step, we first quantified the repeatability of the SoftHand Pro finger movements and identified the electromyographic recording sites for able-bodied individuals with the highest signal-to-noise ratio from two pairs of muscles, i.e., flexor digitorum superficialis/extensor digitorum communis, and flexor carpi radialis/extensor carpi ulnaris. Able-bodied volunteers were then asked to execute reach-to-grasp movements, while electromyography signals were recorded from flexor digitorum superficialis/extensor digitorum communis as this was identified as the muscle pair characterized by high signal-to-noise ratio and intuitive control. Subsequently, we tested three myoelectric controllers that mapped electromyography signals to position of the SoftHand Pro. We found that a differential electromyography-to-position mapping ensured the

Assessment of Myoelectric Controller Performance and Kinematic Behavior of a Novel Soft Synergy-inspired Robotic Hand for Prosthetic Applications

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Simone Fani

2016-10-01

Full Text Available Myoelectric-artificial limbs can significantly advance the state of the art in prosthetics, since they can be used to control mechatronic devices through muscular activity in a way that mimics how the subjects used to activate their muscles before limb loss. However, surveys indicate that dissatisfaction with the functionality of terminal devices underlies the widespread abandonment of prostheses. We believe that one key factor to improve acceptability of prosthetic devices is to attain human-likeness of prosthesis movements, a goal which is being pursued by research on social and human-robot interactions. Therefore, to reduce early abandonment of terminal devices, we propose that controllers should be designed such as to ensure effective task accomplishment in a natural fashion. In this work, we have analyzed and compared the performance of three types of myoelectric controller algorithms based on surface electromyography to control an under-actuated and multi-degrees of freedom prosthetic hand, the SoftHand Pro. The goal of the present study was to identify the myoelectric algorithm that best mimics the native hand movements. As a preliminary step, we first quantified the repeatability of the SoftHand Pro finger movements and identified the electromyographic recording sites for able-bodied individuals with the highest signal-to-noise ratio from two pairs of muscles, i.e. flexor digitorum superficialis/extensor digitorum communis, and flexor carpi radialis/extensor carpi ulnaris. Able-bodied volunteers were then asked to execute reach-to-grasp movements, while electromyography signals were recorded from flexor digitorum superficialis/extensor digitorum communis as this was identified as the muscle pair characterized by high signal-to-noise ratio and intuitive control. Subsequently, we tested three myoelectric controllers that mapped electromyography signals to position of the SoftHand Pro. We found that a differential electromyography

Kinect technology for hand tracking control of surgical robots: technical and surgical skill comparison to current robotic masters.

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Kim, Yonjae; Leonard, Simon; Shademan, Azad; Krieger, Axel; Kim, Peter C W

2014-06-01

Current surgical robots are controlled by a mechanical master located away from the patient, tracking surgeon's hands by wire and pulleys or mechanical linkage. Contactless hand tracking for surgical robot control is an attractive alternative, because it can be executed with minimal footprint at the patient's bedside without impairing sterility, while eliminating current disassociation between surgeon and patient. We compared technical and technologic feasibility of contactless hand tracking to the current clinical standard master controllers. A hand-tracking system (Kinect™-based 3Gear), a wire-based mechanical master (Mantis Duo), and a clinical mechanical linkage master (da Vinci) were evaluated for technical parameters with strong clinical relevance: system latency, static noise, robot slave tremor, and controller range. Five experienced surgeons performed a skill comparison study, evaluating the three different master controllers for efficiency and accuracy in peg transfer and pointing tasks. da Vinci had the lowest latency of 89 ms, followed by Mantis with 374 ms and 3Gear with 576 ms. Mantis and da Vinci produced zero static error. 3Gear produced average static error of 0.49 mm. The tremor of the robot used by the 3Gear and Mantis system had a radius of 1.7 mm compared with 0.5 mm for da Vinci. The three master controllers all had similar range. The surgeons took 1.98 times longer to complete the peg transfer task with the 3Gear system compared with Mantis, and 2.72 times longer with Mantis compared with da Vinci (p value 2.1e-9). For the pointer task, surgeons were most accurate with da Vinci with average error of 0.72 mm compared with Mantis's 1.61 mm and 3Gear's 2.41 mm (p value 0.00078). Contactless hand-tracking technology as a surgical master can execute simple surgical tasks. Whereas traditional master controllers outperformed, given that contactless hand-tracking is a first-generation technology, clinical potential is promising and could

Bio-inspired grasp control in a robotic hand with massive sensorial input.

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Ascari, Luca; Bertocchi, Ulisse; Corradi, Paolo; Laschi, Cecilia; Dario, Paolo

2009-02-01

The capability of grasping and lifting an object in a suitable, stable and controlled way is an outstanding feature for a robot, and thus far, one of the major problems to be solved in robotics. No robotic tools able to perform an advanced control of the grasp as, for instance, the human hand does, have been demonstrated to date. Due to its capital importance in science and in many applications, namely from biomedics to manufacturing, the issue has been matter of deep scientific investigations in both the field of neurophysiology and robotics. While the former is contributing with a profound understanding of the dynamics of real-time control of the slippage and grasp force in the human hand, the latter tries more and more to reproduce, or take inspiration by, the nature's approach, by means of hardware and software technology. On this regard, one of the major constraints robotics has to overcome is the real-time processing of a large amounts of data generated by the tactile sensors while grasping, which poses serious problems to the available computational power. In this paper a bio-inspired approach to tactile data processing has been followed in order to design and test a hardware-software robotic architecture that works on the parallel processing of a large amount of tactile sensing signals. The working principle of the architecture bases on the cellular nonlinear/neural network (CNN) paradigm, while using both hand shape and spatial-temporal features obtained from an array of microfabricated force sensors, in order to control the sensory-motor coordination of the robotic system. Prototypical grasping tasks were selected to measure the system performances applied to a computer-interfaced robotic hand. Successful grasps of several objects, completely unknown to the robot, e.g. soft and deformable objects like plastic bottles, soft balls, and Japanese tofu, have been demonstrated.

Compensatory motor control after stroke: an alternative joint strategy for object-dependent shaping of hand posture.

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Raghavan, Preeti; Santello, Marco; Gordon, Andrew M; Krakauer, John W

2010-06-01

Efficient grasping requires planned and accurate coordination of finger movements to approximate the shape of an object before contact. In healthy subjects, hand shaping is known to occur early in reach under predominantly feedforward control. In patients with hemiparesis after stroke, execution of coordinated digit motion during grasping is impaired as a result of damage to the corticospinal tract. The question addressed here is whether patients with hemiparesis are able to compensate for their execution deficit with a qualitatively different grasp strategy that still allows them to differentiate hand posture to object shape. Subjects grasped a rectangular, concave, and convex object while wearing an instrumented glove. Reach-to-grasp was divided into three phases based on wrist kinematics: reach acceleration (reach onset to peak horizontal wrist velocity), reach deceleration (peak horizontal wrist velocity to reach offset), and grasp (reach offset to lift-off). Patients showed reduced finger abduction, proximal interphalangeal joint (PIP) flexion, and metacarpophalangeal joint (MCP) extension at object grasp across all three shapes compared with controls; however, they were able to partially differentiate hand posture for the convex and concave shapes using a compensatory strategy that involved increased MCP flexion rather than the PIP flexion seen in controls. Interestingly, shape-specific hand postures did not unfold initially during reach acceleration as seen in controls, but instead evolved later during reach deceleration, which suggests increased reliance on sensory feedback. These results indicate that kinematic analysis can identify and quantify within-limb compensatory motor control strategies after stroke. From a clinical perspective, quantitative study of compensation is important to better understand the process of recovery from brain injury. From a motor control perspective, compensation can be considered a model for how joint redundancy is exploited

Comparative assessment of antimicrobial efficacy of different hand sanitizers: An in vitro study.

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Jain, Vardhaman Mulchand; Karibasappa, Gundabaktha Nagappa; Dodamani, Arun Suresh; Prashanth, Vishwakarma K; Mali, Gaurao Vasant

2016-09-01

To evaluate the antimicrobial efficacy of four different hand sanitizers against Staphylococcus aureus , Staphylococcus epidermidis , Pseudomonas aeruginosa , Escherichia coli , and Enterococcus faecalis as well as to assess and compare the antimicrobial effectiveness among four different hand sanitizers. The present study is an in vitro study to evaluate antimicrobial efficacy of Dettol, Lifebuoy, PureHands, and Sterillium hand sanitizers against clinical isolates of the aforementioned test organisms. The well variant of agar disk diffusion test using Mueller-Hinton agar was used for evaluating the antimicrobial efficacy of hand sanitizers. McFarland 0.5 turbidity standard was taken as reference to adjust the turbidity of bacterial suspensions. Fifty microliters of the hand sanitizer was introduced into each of the 4 wells while the 5 th well incorporated with sterile water served as a control. This was done for all the test organisms and plates were incubated in an incubator for 24 h at 37΀C. After incubation, antimicrobial effectiveness was determined using digital caliper (mm) by measuring the zone of inhibition. The mean diameters of zones of inhibition (in mm) observed in Group A (Sterillium), Group B (PureHands), Group C (Lifebuoy), and Group D (Dettol) were 22 ± 6, 7.5 ± 0.5, 9.5 ± 1.5, and 8 ± 1, respectively. Maximum inhibition was found with Group A against all the tested organisms. Data were statistically analyzed using analysis of variance, followed by post hoc test for group-wise comparisons. The difference in the values of different sanitizers was statistically significant at P hand sanitizer to maintain the hand hygiene.

The SmartHand transradial prosthesis

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Carrozza Maria Chiara

2011-05-01

Full Text Available Abstract Background Prosthetic components and control interfaces for upper limb amputees have barely changed in the past 40 years. Many transradial prostheses have been developed in the past, nonetheless most of them would be inappropriate if/when a large bandwidth human-machine interface for control and perception would be available, due to either their limited (or inexistent sensorization or limited dexterity. SmartHand tackles this issue as is meant to be clinically experimented in amputees employing different neuro-interfaces, in order to investigate their effectiveness. This paper presents the design and on bench evaluation of the SmartHand. Methods SmartHand design was bio-inspired in terms of its physical appearance, kinematics, sensorization, and its multilevel control system. Underactuated fingers and differential mechanisms were designed and exploited in order to fit all mechatronic components in the size and weight of a natural human hand. Its sensory system was designed with the aim of delivering significant afferent information to the user through adequate interfaces. Results SmartHand is a five fingered self-contained robotic hand, with 16 degrees of freedom, actuated by 4 motors. It integrates a bio-inspired sensory system composed of 40 proprioceptive and exteroceptive sensors and a customized embedded controller both employed for implementing automatic grasp control and for potentially delivering sensory feedback to the amputee. It is able to perform everyday grasps, count and independently point the index. The weight (530 g and speed (closing time: 1.5 seconds are comparable to actual commercial prostheses. It is able to lift a 10 kg suitcase; slippage tests showed that within particular friction and geometric conditions the hand is able to stably grasp up to 3.6 kg cylindrical objects. Conclusions Due to its unique embedded features and human-size, the SmartHand holds the promise to be experimentally fitted on transradial

Double nerve intraneural interface implant on a human amputee for robotic hand control.

Science.gov (United States)

Rossini, Paolo M; Micera, Silvestro; Benvenuto, Antonella; Carpaneto, Jacopo; Cavallo, Giuseppe; Citi, Luca; Cipriani, Christian; Denaro, Luca; Denaro, Vincenzo; Di Pino, Giovanni; Ferreri, Florinda; Guglielmelli, Eugenio; Hoffmann, Klaus-Peter; Raspopovic, Stanisa; Rigosa, Jacopo; Rossini, Luca; Tombini, Mario; Dario, Paolo

2010-05-01

The principle underlying this project is that, despite nervous reorganization following upper limb amputation, original pathways and CNS relays partially maintain their function and can be exploited for interfacing prostheses. Aim of this study is to evaluate a novel peripheral intraneural multielectrode for multi-movement prosthesis control and for sensory feed-back, while assessing cortical reorganization following the re-acquired stream of data. Four intrafascicular longitudinal flexible multielectrodes (tf-LIFE4) were implanted in the median and ulnar nerves of an amputee; they reliably recorded output signals for 4 weeks. Artificial intelligence classifiers were used off-line to analyse LIFE signals recorded during three distinct hand movements under voluntary order. Real-time control of motor output was achieved for the three actions. When applied off-line artificial intelligence reached >85% real-time correct classification of trials. Moreover, different types of current stimulation were determined to allow reproducible and localized hand/fingers sensations. Cortical organization was observed via TMS in parallel with partial resolution of symptoms due to the phantom-limb syndrome (PLS). tf-LIFE4s recorded output signals in human nerves for 4 weeks, though the efficacy of sensory stimulation decayed after 10 days. Recording from a number of fibres permitted a high percentage of distinct actions to be classified correctly. Reversal of plastic changes and alleviation of PLS represent corollary findings of potential therapeutic benefit. This study represents a breakthrough in robotic hand use in amputees. Copyright 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Hand hygiene in emergency medical services.

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Teter, Jonathan; Millin, Michael G; Bissell, Rick

2015-01-01

Hospital-acquired infections (HAIs) affect millions of patients annually (World Health Organization. Guidelines on Hand Hygiene in Healthcare. Geneva: WHO Press; 2009). Hand hygiene compliance of clinical staff has been identified by numerous studies as a major contributing factor to HAIs around the world. Infection control and hand hygiene in the prehospital environment can also contribute to patient harm and spread of infections. Emergency medical services (EMS) practitioners are not monitored as closely as hospital personnel in terms of hand hygiene training and compliance. Their ever-changing work environment is less favorable to traditional hospital-based aseptic techniques and education. This study aimed to determine the current state of hand hygiene practices among EMS providers and to provide recommendations for improving practices in the emergency health services environment. This study was a prospective, observational prevalence study and survey, conducted over a 2-month period. We selected participants from visits to three selected hospital emergency departments in the mid-Atlantic region. There were two data components to the study: a participant survey and hand swabs for pathogenic cultures. This study recruited a total sample of 62 participants. Overall, the study revealed that a significant number of EMS providers (77%) have a heavy bacterial load on their hands after patient care. All levels of providers had a similar distribution of bacterial load. Survey results revealed that few providers perform hand hygiene before (34%) or in between patients (24%), as recommended by the Centers for Disease Control and Prevention guidelines. This study demonstrates that EMS providers are potential vectors of microorganisms if proper hand hygiene is not performed properly. Since EMS providers treat a variety of patients and operate in a variety of environments, providers may be exposed to potentially pathogenic organisms, serving as vectors for the exposure of

The effect of smartphone addiction on hand joints in psoriatic patients: an ultrasound-based study.

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Megna, M; Gisonni, P; Napolitano, M; Orabona, G Dell'Aversano; Patruno, C; Ayala, F; Balato, N

2018-01-01

Distal interphalangeal (DIP) arthritis is a frequent form of psoriatic arthritis being often linked to nail psoriasis. Modern society is characterized by overuse of smartphones. Indeed, literature has recently focalized on research into smartphone addiction and health-related problems. As smartphone addiction is able to determine overuse and repeated movements of DIP joints and nails, the aim of this study was to evaluate the impact of smartphone use on hand joints of young psoriatic patients. An observational study involving four different groups such as non-smartphone-addicted (SA) psoriatic patients, SA psoriatic patients, non-SA controls and SA controls was performed. Each subject underwent an ultrasound examination of both hands by three independent and blinded to group assignment radiologists. A specific score was used to evaluate the inflammatory state of the analysed joints. The total ultrasound score was statistically significantly higher in SA controls respect to non-SA controls (3.4 vs. 1.4; P Smartphone overuse was found to be linked with higher signs of inflammation of musculoskeletal structures of hands joints in both psoriasis and controls through ultrasound examination. Therefore, smartphone overuse may be a factor which facilitate or speed up the possible development of psoriatic arthritis. © 2017 European Academy of Dermatology and Venereology.

Muscle Synergies Control during Hand-Reaching Tasks in Multiple Directions Post-stroke

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Sharon Israely

2018-02-01

Full Text Available Purpose: A muscle synergies model was suggested to represent a simplifying motor control mechanism by the brainstem and spinal cord. The aim of the study was to investigate the feasibility of such control mechanisms in the rehabilitation of post-stroke individuals during the execution of hand-reaching movements in multiple directions, compared to non-stroke individuals.Methods: Twelve non-stroke and 13 post-stroke individuals participated in the study. Muscle synergies were extracted from EMG data that was recorded during hand reaching tasks, using the NMF algorithm. The optimal number of synergies was evaluated in both groups using the Variance Accounted For (VAF and the Mean Squared Error (MSE. A cross validation procedure was carried out to define a representative set of synergies. The similarity index and the K-means algorithm were applied to validate the existence of such a set of synergies, but also to compare the modulation properties of synergies for different movement directions between groups. The similarity index and hierarchical cluster analysis were also applied to compare between group synergies.Results: Four synergies were chosen to optimally capture the variances in the EMG data, with mean VAF of 0.917 ± 0.034 and 0.883 ± 0.046 of the data variances, with respective MSE of 0.007 and 0.016, in the control and study groups, respectively. The representative set of synergies was set to be extracted from movement to the center of the reaching space. Two synergies had different muscle activation balance between groups. Seven and 17 clusters partitioned the muscle synergies of the control and study groups. The control group exhibited a gradual change in the activation in the amplitude in the time domain (modulation of synergies, as reflected by the similarity index, whereas the study group exhibited consistently significant differences between all movement directions and the representative set of synergies. The study findings support

The effect of improved hand hygiene on nosocomial MRSA control

OpenAIRE

Marimuthu, Kalisvar; Pittet, Didier; Harbarth, Stephan

2014-01-01

The purpose of this review is to examine studies that have assessed the association between hand hygiene enhancement and methicillin-resistant Staphylococcus aureus (MRSA) rates and to explore controversies surrounding this association. Many studies have been published confirming the link between improved hand hygiene compliance and reduction in MRSA acquisition and infections, including bacteremia. These studies have also shown the cost-beneficial nature of these programmes. Despite consider...

How the impact of median neuropathy on sensorimotor control capability of hands for diabetes: an achievable assessment from functional perspectives.

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Haw-Yen Chiu

Full Text Available To comprehend the sensorimotor control ability in diabetic hands, this study investigated the sensation, motor function and precision pinch performances derived from a pinch-holding-up activity (PHUA test of the hands of diabetic patients and healthy subjects. The precision, sensitivity and specificity of the PHUA test in the measurements of diabetic patients were also analyzed. We hypothesized that the diabetic hands would have impacts on the sensorimotor functions of the hand performances under functionally quantitative measurements. One hundred and fifty-nine patients with clinically defined diabetes mellitus (DM and 95 age- and gender-matched healthy controls were included. Semmes-Weinstein monofilament (SWM, static and moving two-point discrimination (S2PD and M2PD, maximal pinch strength and precision pinch performance tests were conducted to evaluate the sensation, motor and sensorimotor status of the recruited hands. The results showed that there were significant differences (all p<0.05 in SWM, S2PD, M2PD and maximum pinch strength between the DM and control groups. A higher force ratio in the DM patients than in the controls (p<0.001 revealed a poor ability of pinch force adjustment in the DM patients. The percentage of maximal pinch strength was also significantly different (p<0.001 between the DM and control groups. The sensitivity, specificity and area under the receiver operating characteristic curve were 0.85, 0.51, and 0.724, respectively, for the PHUA test. Statistically significant degradations in sensory and motor functions and sensorimotor control ability were observed in the hands of the diabetic patients. The PHUA test could be feasibly used as a clinical tool to determine the sensorimotor function of the hands of diabetic patients from a functional perspective.

Prefrontal cortex activation upon a demanding virtual hand-controlled task: a new frontier for neuroergonomics

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Marika eCarrieri

2016-02-01

Full Text Available Functional near-infrared spectroscopy (fNIRS is a non-invasive vascular-based functional neuroimaging technology that can assess, simultaneously from multiple cortical areas, concentration changes in oxygenated-deoxygenated hemoglobin at the level of the cortical microcirculation blood vessels. fNIRS, with its high degree of ecological validity and its very limited requirement of physical constraints to subjects, could represent a valid tool for monitoring cortical responses in the research field of neuroergonomics. In virtual reality (VR real situations can be replicated with greater control than those obtainable in the real world. Therefore, VR is the ideal setting where studies about neuroergonomics applications can be performed. The aim of the present study was to investigate, by a 20-channel fNIRS system, the dorsolateral/ventrolateral prefrontal cortex (DLPFC/VLPFC in subjects while performing a demanding VR hand-controlled task (HCT. Considering the complexity of the HCT, its execution should require the attentional resources allocation and the integration of different executive functions. The HCT simulates the interaction with a real, remotely-driven, system operating in a critical environment. The hand movements were captured by a high spatial and temporal resolution 3D hand-sensing device, the LEAP motion controller, a gesture-based control interface that could be used in VR for tele-operated applications. Fifteen University students were asked to guide, with their right hand/forearm, a virtual ball (VB over a virtual route (VROU reproducing a 42-m narrow road including some critical points. The subjects tried to travel as long as possible without making VB fall. The distance traveled by the guided VB was 70.2±37.2 m. The less skilled subjects failed several times in guiding the VB over the VROU. Nevertheless, a bilateral VLPFC activation, in response to the HCT execution, was observed in all the subjects. No correlation was found

Prefrontal Cortex Activation Upon a Demanding Virtual Hand-Controlled Task: A New Frontier for Neuroergonomics.

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Carrieri, Marika; Petracca, Andrea; Lancia, Stefania; Basso Moro, Sara; Brigadoi, Sabrina; Spezialetti, Matteo; Ferrari, Marco; Placidi, Giuseppe; Quaresima, Valentina

2016-01-01

Functional near-infrared spectroscopy (fNIRS) is a non-invasive vascular-based functional neuroimaging technology that can assess, simultaneously from multiple cortical areas, concentration changes in oxygenated-deoxygenated hemoglobin at the level of the cortical microcirculation blood vessels. fNIRS, with its high degree of ecological validity and its very limited requirement of physical constraints to subjects, could represent a valid tool for monitoring cortical responses in the research field of neuroergonomics. In virtual reality (VR) real situations can be replicated with greater control than those obtainable in the real world. Therefore, VR is the ideal setting where studies about neuroergonomics applications can be performed. The aim of the present study was to investigate, by a 20-channel fNIRS system, the dorsolateral/ventrolateral prefrontal cortex (DLPFC/VLPFC) in subjects while performing a demanding VR hand-controlled task (HCT). Considering the complexity of the HCT, its execution should require the attentional resources allocation and the integration of different executive functions. The HCT simulates the interaction with a real, remotely-driven, system operating in a critical environment. The hand movements were captured by a high spatial and temporal resolution 3-dimensional (3D) hand-sensing device, the LEAP motion controller, a gesture-based control interface that could be used in VR for tele-operated applications. Fifteen University students were asked to guide, with their right hand/forearm, a virtual ball (VB) over a virtual route (VROU) reproducing a 42 m narrow road including some critical points. The subjects tried to travel as long as possible without making VB fall. The distance traveled by the guided VB was 70.2 ± 37.2 m. The less skilled subjects failed several times in guiding the VB over the VROU. Nevertheless, a bilateral VLPFC activation, in response to the HCT execution, was observed in all the subjects. No correlation was found

Illusory movement perception improves motor control for prosthetic hands

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Marasco, Paul D.; Hebert, Jacqueline S.; Sensinger, Jon W.; Shell, Courtney E.; Schofield, Jonathon S.; Thumser, Zachary C.; Nataraj, Raviraj; Beckler, Dylan T.; Dawson, Michael R.; Blustein, Dan H.; Gill, Satinder; Mensh, Brett D.; Granja-Vazquez, Rafael; Newcomb, Madeline D.; Carey, Jason P.; Orzell, Beth M.

2018-01-01

To effortlessly complete an intentional movement, the brain needs feedback from the body regarding the movement’s progress. This largely non-conscious kinesthetic sense helps the brain to learn relationships between motor commands and outcomes to correct movement errors. Prosthetic systems for restoring function have predominantly focused on controlling motorized joint movement. Without the kinesthetic sense, however, these devices do not become intuitively controllable. Here we report a method for endowing human amputees with a kinesthetic perception of dexterous robotic hands. Vibrating the muscles used for prosthetic control via a neural-machine interface produced the illusory perception of complex grip movements. Within minutes, three amputees integrated this kinesthetic feedback and improved movement control. Combining intent, kinesthesia, and vision instilled participants with a sense of agency over the robotic movements. This feedback approach for closed-loop control opens a pathway to seamless integration of minds and machines. PMID:29540617

Environmental factors and their association with emergency department hand hygiene compliance: an observational study.

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Carter, Eileen J; Wyer, Peter; Giglio, James; Jia, Haomiao; Nelson, Germaine; Kauari, Vepuka E; Larson, Elaine L

2016-05-01

Hand hygiene is effective in preventing healthcare-associated infections. Environmental conditions in the emergency department (ED), including crowding and the use of non-traditional patient care areas (ie, hallways), may pose barriers to hand hygiene compliance. We examined the relationship between these environmental conditions and proper hand hygiene. This was a single-site, observational study. From October 2013 to January 2014, trained observers recorded hand hygiene compliance among staff in the ED according to the World Health Organization 'My 5 Moments for Hand Hygiene'. Multivariable logistic regression was used to analyse the relationship between environmental conditions and hand hygiene compliance, while controlling for important covariates (eg, hand hygiene indication, glove use, shift, etc). A total of 1673 hand hygiene opportunities were observed. In multivariable analyses, hand hygiene compliance was significantly lower when the ED was at its highest level of crowding than when the ED was not crowded and lower among hallway care areas than semiprivate care areas (OR=0.39, 95% CI 0.28 to 0.55; OR=0.73, 95% CI 0.55 to 0.97). Unique environmental conditions pose barriers to hand hygiene compliance in the ED setting and should be considered by ED hand hygiene improvement efforts. Further study is needed to evaluate the impact of these environmental conditions on actual rates of infection transmission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Repeatability of grasp recognition for robotic hand prosthesis control based on sEMG data.

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Palermo, Francesca; Cognolato, Matteo; Gijsberts, Arjan; Muller, Henning; Caputo, Barbara; Atzori, Manfredo

2017-07-01

Control methods based on sEMG obtained promising results for hand prosthetics. Control system robustness is still often inadequate and does not allow the amputees to perform a large number of movements useful for everyday life. Only few studies analyzed the repeatability of sEMG classification of hand grasps. The main goals of this paper are to explore repeatability in sEMG data and to release a repeatability database with the recorded experiments. The data are recorded from 10 intact subjects repeating 7 grasps 12 times, twice a day for 5 days. The data are publicly available on the Ninapro web page. The analysis for the repeatability is based on the comparison of movement classification accuracy in several data acquisitions and for different subjects. The analysis is performed using mean absolute value and waveform length features and a Random Forest classifier. The accuracy obtained by training and testing on acquisitions at different times is on average 27.03% lower than training and testing on the same acquisition. The results obtained by training and testing on different acquisitions suggest that previous acquisitions can be used to train the classification algorithms. The inter-subject variability is remarkable, suggesting that specific characteristics of the subjects can affect repeatibility and sEMG classification accuracy. In conclusion, the results of this paper can contribute to develop more robust control systems for hand prostheses, while the presented data allows researchers to test repeatability in further analyses.

COMPARISON THE NUMBER OF BACTERIA BETWEEN WASHING HANDS USING SOAP AND HAND SANITIZER AS A BACTERIOLOGY LEARNING RESOURCE FOR STUDENTS

OpenAIRE

Satya Darmayani; Askrening Askrening; Apita Ariyani

2017-01-01

Hands are the principal carriers of bacterial diseases, therefore very important to know that washing hands with soap or hand sanitizer is highly effective healthy behaviors to reduce bacteria in the palm. This study aimed to determine the total number of bacteria between washing hands with soap and hand sanitizer, also applying the results of these studies as a learning resource in bacteriology. The research design was the true experiment with pretest-posttest control group research design a...

Control Capabilities of Myoelectric Robotic Prostheses by Hand Amputees: A Scientific Research and Market Overview.

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Atzori, Manfredo; Müller, Henning

2015-01-01

Hand amputation can dramatically affect the capabilities of a person. Cortical reorganization occurs in the brain, but the motor and somatosensorial cortex can interact with the remnant muscles of the missing hand even many years after the amputation, leading to the possibility to restore the capabilities of hand amputees through myoelectric prostheses. Myoelectric hand prostheses with many degrees of freedom are commercially available and recent advances in rehabilitation robotics suggest that their natural control can be performed in real life. The first commercial products exploiting pattern recognition to recognize the movements have recently been released, however the most common control systems are still usually unnatural and must be learned through long training. Dexterous and naturally controlled robotic prostheses can become reality in the everyday life of amputees but the path still requires many steps. This mini-review aims to improve the situation by giving an overview of the advancements in the commercial and scientific domains in order to outline the current and future chances in this field and to foster the integration between market and scientific research.

Control Capabilities of Myoelectric Robotic Prostheses by Hand Amputees: A Scientific Research and Market Overview

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Manfredo eAtzori

2015-11-01

Full Text Available Hand amputation can dramatically affect the capabilities of a person. Cortical reorganization occurs in the brain, but the motor and somatosensorial cortex can interact with the remnant muscles of the missing hand even many years after the amputation, leading to the possibility to restore the capabilities of hand amputees through myoelectric prostheses. Myoelectric hand prostheses with many degrees of freedom are commercially available and recent advances in rehabilitation robotics suggest that their natural control can be performed in real life. The first commercial products exploiting pattern recognition to recognize the movements have recently been released, however the most common control systems are still usually unnatural and must be learned through long training. Dexterous and naturally controlled robotic prostheses can become reality in the everyday life of amputees but the path still requires many steps. This mini-review aims to improve the situation by giving an overview of the advancements in the commercial and scientific domains in order to outline the current and future chances in this field and to foster the integration between market and scientific research.

sEMG Signal Acquisition Strategy towards Hand FES Control

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Cinthya Lourdes Toledo-Peral

2018-01-01

Full Text Available Due to damage of the nervous system, patients experience impediments in their daily life: severe fatigue, tremor or impaired hand dexterity, hemiparesis, or hemiplegia. Surface electromyography (sEMG signal analysis is used to identify motion; however, standardization of electrode placement and classification of sEMG patterns are major challenges. This paper describes a technique used to acquire sEMG signals for five hand motion patterns from six able-bodied subjects using an array of recording and stimulation electrodes placed on the forearm and its effects over functional electrical stimulation (FES and volitional sEMG combinations, in order to eventually control a sEMG-driven FES neuroprosthesis for upper limb rehabilitation. A two-part protocol was performed. First, personalized templates to place eight sEMG bipolar channels were designed; with these data, a universal template, called forearm electrode set (FELT, was built. Second, volitional and evoked movements were recorded during FES application. 95% classification accuracy was achieved using two sessions per movement. With the FELT, it was possible to perform FES and sEMG recordings simultaneously. Also, it was possible to extract the volitional and evoked sEMG from the raw signal, which is highly important for closed-loop FES control.

Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients.

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Hsu, Hsiu-Yun; Lin, Cheng-Feng; Su, Fong-Chin; Kuo, Huan-Ting; Chiu, Haw-Yen; Kuo, Li-Chieh

2012-05-09

Hemianaesthesia patients usually exhibit awkward and inefficient finger movements of the affected hands. Conventionally, most interventions emphasize the improvement of motor deficits, but rarely address sensory capability and sensorimotor control following stroke. Thus it is critical for stroke patients with sensory problems to incorporate appropriate strategies for dealing with sensory impairment, into traditional hand function rehabilitation programs. In this study, we used a custom-designed computerized evaluation and re-education biofeedback (CERB) prototype to analyze hand grasp performances, and monitor the training effects on hand coordination for stroke patients with sensory disturbance and without motor deficiency. The CERB prototype was constructed to detect momentary pinch force modulation for 14 sub-acute and chronic stroke patients with sensory deficiency and 14 healthy controls. The other ten chronic stroke patients (ranges of stroke period: 6-60 months) were recruited to investigate the effects of 4-weeks computerized biofeedback treatments on the hand control ability. The biofeedback procedures provide visual and auditory cues to the participants when the interactive force of hand-to-object exceeded the target latitude in a pinch-up-holding task to trigger optimal motor strategy. Follow-up measurements were conducted one month after training. The hand sensibility, grip forces and results of hand functional tests were recorded and analyzed. The affected hands of the 14 predominant sensory stroke patients exhibited statistically significant elevation in the magnitude of peak pinch force (p = 0.033) in pinching and lifting-up tasks, and poor results for hand function tests (p = 0.005) than sound hands did. In addition, the sound hands of patients were less efficient in force modulation (p = 0.009) than the hands of healthy subjects were. Training with the biofeedback system produced significant improvements in grip force modulation (p = 0.020) and

Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients

Directory of Open Access Journals (Sweden)

Hsu Hsiu-Yun

2012-05-01

Full Text Available Abstract Background Hemianaesthesia patients usually exhibit awkward and inefficient finger movements of the affected hands. Conventionally, most interventions emphasize the improvement of motor deficits, but rarely address sensory capability and sensorimotor control following stroke. Thus it is critical for stroke patients with sensory problems to incorporate appropriate strategies for dealing with sensory impairment, into traditional hand function rehabilitation programs. In this study, we used a custom-designed computerized evaluation and re-education biofeedback (CERB prototype to analyze hand grasp performances, and monitor the training effects on hand coordination for stroke patients with sensory disturbance and without motor deficiency. Methods The CERB prototype was constructed to detect momentary pinch force modulation for 14 sub-acute and chronic stroke patients with sensory deficiency and 14 healthy controls. The other ten chronic stroke patients (ranges of stroke period: 6–60 months were recruited to investigate the effects of 4-weeks computerized biofeedback treatments on the hand control ability. The biofeedback procedures provide visual and auditory cues to the participants when the interactive force of hand-to-object exceeded the target latitude in a pinch-up-holding task to trigger optimal motor strategy. Follow-up measurements were conducted one month after training. The hand sensibility, grip forces and results of hand functional tests were recorded and analyzed. Results The affected hands of the 14 predominant sensory stroke patients exhibited statistically significant elevation in the magnitude of peak pinch force (p = 0.033 in pinching and lifting-up tasks, and poor results for hand function tests (p = 0.005 than sound hands did. In addition, the sound hands of patients were less efficient in force modulation (p = 0.009 than the hands of healthy subjects were. Training with the biofeedback system produced

Robotic Hand Controlling Based on Flexible Sensor

OpenAIRE

Bilgin, Süleyman; Üser, Yavuz; Mercan, Muhammet

2016-01-01

Today's technology has increased the interest in robotic systems andincrease the number of studies realized in this area.  There are many studies on robotic systems inseveral fields to facilitate human life in the literature. In this study, arobot hand is designed to repeat finger movements depending upon flexiblesensors mounted on any wearable glove. In the literature, various sensors thatdetect the finger movement are used. The sensor that detects the angle of thefingers has b...

Hand sanitizer-dispensing door handles increase hand hygiene compliance: a pilot study.

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Babiarz, Lukasz S; Savoie, Brent; McGuire, Mark; McConnell, Lauren; Nagy, Paul

2014-04-01

Improving rates of hand hygiene compliance (HHC) has been shown to reduce nosocomial disease. We compared the HHC for a traditional wall-mounted unit and a novel sanitizer-dispensing door handle device in a hospital inpatient ultrasound area. HHC increased 24.5%-77.1% (P sanitizer-dispensing door handle, whereas it remained unchanged for the other rooms. Technical improvements like a sanitizer-dispensing door handle can improve hospital HHC. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Hand Hygiene Adherence Among Health Care Workers at Japanese Hospitals: A Multicenter Observational Study in Japan.

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Sakihama, Tomoko; Honda, Hitoshi; Saint, Sanjay; Fowler, Karen E; Shimizu, Taro; Kamiya, Toru; Sato, Yumiko; Arakawa, Soichi; Lee, Jong Ja; Iwata, Kentaro; Mihashi, Mutsuko; Tokuda, Yasuharu

2016-03-01

Although proper hand hygiene among health care workers is an important component of efforts to prevent health care-associated infection, there are few data available on adherence to hand hygiene practices in Japan. The aim of this study was to examine hand hygiene adherence at teaching hospitals in Japan. An observational study was conducted from July to November 2011 in 4 units (internal medicine, surgery, intensive care, and/or emergency department) in 4 geographically diverse hospitals (1 university hospital and 3 community teaching hospitals) in Japan. Hand hygiene practice before patient contact was assessed by an external observer. In a total of 3545 health care worker-patient observations, appropriate hand hygiene practice was performed in 677 (overall adherence, 19%; 95% confidence interval, 18%-20%). Subgroup rates of hand hygiene adherence were 15% among physicians and 23% among nurses. The ranges of adherence were 11% to 25% between hospitals and 11% to 31% between units. Adherence of the nurses and the physicians to hand hygiene was correlated within each hospital. There was a trend toward higher hand hygiene adherence in hospitals with infection control nurses, compared with hospitals without them (29% versus 16%). The hand hygiene adherence in Japanese teaching hospitals in our sample was low, even lower than reported mean values from other international studies. Greater adherence to hand hygiene should be encouraged in Japan.

Humans can integrate feedback of discrete events in their sensorimotor control of a robotic hand.

Science.gov (United States)

Cipriani, Christian; Segil, Jacob L; Clemente, Francesco; ff Weir, Richard F; Edin, Benoni

2014-11-01

Providing functionally effective sensory feedback to users of prosthetics is a largely unsolved challenge. Traditional solutions require high band-widths for providing feedback for the control of manipulation and yet have been largely unsuccessful. In this study, we have explored a strategy that relies on temporally discrete sensory feedback that is technically simple to provide. According to the Discrete Event-driven Sensory feedback Control (DESC) policy, motor tasks in humans are organized in phases delimited by means of sensory encoded discrete mechanical events. To explore the applicability of DESC for control, we designed a paradigm in which healthy humans operated an artificial robot hand to lift and replace an instrumented object, a task that can readily be learned and mastered under visual control. Assuming that the central nervous system of humans naturally organizes motor tasks based on a strategy akin to DESC, we delivered short-lasting vibrotactile feedback related to events that are known to forcefully affect progression of the grasp-lift-and-hold task. After training, we determined whether the artificial feedback had been integrated with the sensorimotor control by introducing short delays and we indeed observed that the participants significantly delayed subsequent phases of the task. This study thus gives support to the DESC policy hypothesis. Moreover, it demonstrates that humans can integrate temporally discrete sensory feedback while controlling an artificial hand and invites further studies in which inexpensive, noninvasive technology could be used in clever ways to provide physiologically appropriate sensory feedback in upper limb prosthetics with much lower band-width requirements than with traditional solutions.

Predictors of hand hygiene practice among Saudi nursing students: A cross-sectional self-reported study.

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Cruz, Jonas P; Bashtawi, Meshrif A

2016-01-01

Hand hygiene is an important component of infection control, which is critical to ensuring patients' safety in hospitals. Nursing students are regarded as healthcare workers in training and can also be vehicles of cross-contamination within the hospital. Thus, this study aimed to identify the predictors of hand hygiene practice among Saudi nursing students. A descriptive, cross-sectional, self-reported study was conducted among 198 Saudi nursing students. Knowledge, attitude, and practice of hand hygiene were assessed using the WHO Hand Hygiene Knowledge Questionnaire for Health-Care Workers and its adopted scales. A regression analysis was performed to identify the predictors of hand hygiene practice. The respondents demonstrated moderate knowledge of hand hygiene (mean 13.20±2.80). The majority displayed a moderate attitude toward hand hygiene (52.1%), while only a few reported a poor attitude (13.1%). Approximately 68.7%, 29.8%, and 1.5% of the respondents reported moderate, good, and poor practice of hand hygiene, respectively. Having a good attitude toward hand hygiene, being male, being aware that hand hygiene is an effective intervention in preventing healthcare-associated infections (HAIs), attendance at hand hygiene trainings and seminars, and being in the lower academic level of nursing education were identified as predictors of better hand hygiene practice. The importance of ensuring a positive attitude toward hand hygiene and improving awareness of hand hygiene is emphasized, as are educational interventions. Educational interventions should be implemented to reinforce knowledge and instill a positive attitude toward hand hygiene. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Dynamics, control and sensor issues pertinent to robotic hands for the EVA retriever system

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Mclauchlan, Robert A.

1987-01-01

Basic dynamics, sensor, control, and related artificial intelligence issues pertinent to smart robotic hands for the Extra Vehicular Activity (EVA) Retriever system are summarized and discussed. These smart hands are to be used as end effectors on arms attached to manned maneuvering units (MMU). The Retriever robotic systems comprised of MMU, arm and smart hands, are being developed to aid crewmen in the performance of routine EVA tasks including tool and object retrieval. The ultimate goal is to enhance the effectiveness of EVA crewmen.

Knowledge, Attitudes, and Practices Study on Hand Hygiene Among Imam Hossein Hospital’s Residents in 2013

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Nabavi, Mahmoud; Alavi-Moghaddam, Mostafa; Gachkar, Latif; Moeinian, Mohammad

2015-01-01

Background: Hand hygiene is considered one of the most important infection control measures for preventing health care-associated infections. Although the techniques involved in hand hygiene are simple, compliance with hand hygiene recommendations is poor worldwide. Objectives: We sought to perform a knowledge, attitudes, and practices (KAP) study on hand hygiene among medical residents at Imam Hossein hospital, Tehran, Iran. Patients and Methods: This cross-sectional KAP study was conducted among medical residents in Imam Hossein hospital, Iran, 2013. All medical residents from different wards were invited to participate in this study (270 in total). The world health organization questionnaires and an observational checklist were used to collect data. The χ2 test and the Fisher exact test were utilized to analyze the qualitative variables. Since the quantitative variables had no normal distribution, the Mann-Whitney test and the Kruskal-Wallis method were employed. A P value hand hygiene, and only 20.16% (n = 25) managed to identify the correct answer. Moreover, 3.1% (n = 8) of the residents adhered to the 8 standard steps, 12.1% (n = 31) washed their hands for 20 - 30 seconds, and only 2 residents observed the sequences of hand hygiene. Additionally, none of the residents performed hand washing with available means (water and hand-washing liquid) in the morning visit hours. Conclusions: Concerning hand hygiene, the residents had moderate knowledge but overall poor attitudes and practices. The present study underscores the need for further improvement in the existing training programs to address the gaps in KAP regarding hand hygiene. PMID:26568858

The alien hand sign. Localization, lateralization and recovery.

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Goldberg, G; Bloom, K K

1990-10-01

The alien hand sign was first described by Brion and Jedynak as a "feeling of estrangement between the patient and one of his hands." The affected hand frequently shows a grasp reflex and an instinctive grasp reaction as well as elements of what Denny-Brown referred to as a "magnetic apraxia" associated with frontal lobe damage. Most notably, however, the affected hand is observed to perform apparently purposive behaviors that are perceived as being outside the volitional control of the patient. The patients interpret the behavior of their own affected limb as being controlled by an external agent. They do not feel that they are initiating or controlling the behavior of the hand and often express dismay at the hand's "extravolitional" activity. The patients attempt to control behavior of the alien hand with the unimpaired hand by forcibly restraining the affected limb, an act that may be termed "self-restriction." In this paper, we report an additional four cases of alien hand sign in right-handed subjects: two involving the right hand and two involving the left hand. In each case, the clinical findings were associated with extensive unilateral damage of the medial frontal cortex of the hemisphere contralateral to the affected hand. Furthermore, the alien movement gradually disappears over the course of 6-12 months after the stroke. These clinical case studies are presented and discussed in the context of the "dual premotoer systems hypothesis," an anatomicophysiological model that proposes that action is organized by two separate but interactive premotor brain systems corresponding to evolutionarily defined medial and lateral cortical moieties. It is hypothesized that the alien mode behavior results from unconstrained activity of the lateral premotor system in the damaged hemisphere. The residual volitional control in the limb occurs through the activity of the intact medial premotor system of the ipsilateral hemisphere. Recovery may occur through extension of

A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students.

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Kingston, Liz M; O'Connell, Nuala H; Dunne, Colum P

2018-04-01

In Ireland, the setting for this study, the national prevalence rate of health care-associated infection (HCAI) in acute-care facilities is 5.2%. Hand hygiene and in particular hand rubbing using alcohol-based hand rub (ABHR) is highly efficacious in preventing HCAI transmission. Yet, compliance among healthcare professionals is sub-optimal. Less is known about the practices of nursing and medical students and no study comparing practices among these groups in Ireland was found. Hence, the aim of this study was to provide insight into the current hand hygiene and hand rubbing practices of nursing and medical students in Ireland and, by doing so, contribute to the broader understanding of this topic. This observational study employed a cross-sectional, self-reported design. An electronically administered questionnaire was sent to all nursing and medical students from one university. Data were analysed using appropriate software. The response rate was 37% (323/872). Higher compliance with the World Health Organisation 'my five moments for hand hygiene' model was reported among nursing students (NS) than medical students (MS), with scope for improvement in both disciplines identified. Hand hygiene compliance was highest after body fluid exposure (99.5% NS, 91% MS) and lowest after touching a patient's surroundings (61.5% NS, 57.5% MS). Attitudes towards hand rubbing were largely positive in both disciplines. 16% of NS were not aware of the clinical contraindications to ABHR use, compared to 45% of MS. 9% of NS did not know when to use soap and water and when to use ABHR, compared to 36% of MS. In contrast, more medical students (46%) than nursing students (22%) were routinely using alcohol-based hand rub for decontamination of hands as recommended. Results suggest scope to review current hand hygiene curricula focusing on the knowledge gaps, the practice deficits and the barriers to ABHR usage identified. Copyright © 2018 Elsevier Ltd. All rights reserved.

Post-stroke Rehabilitation Training with a Motor-Imagery-Based Brain-Computer Interface (BCI-Controlled Hand Exoskeleton: A Randomized Controlled Multicenter Trial

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Alexander A. Frolov

2017-07-01

Full Text Available Repeated use of brain-computer interfaces (BCIs providing contingent sensory feedback of brain activity was recently proposed as a rehabilitation approach to restore motor function after stroke or spinal cord lesions. However, there are only a few clinical studies that investigate feasibility and effectiveness of such an approach. Here we report on a placebo-controlled, multicenter clinical trial that investigated whether stroke survivors with severe upper limb (UL paralysis benefit from 10 BCI training sessions each lasting up to 40 min. A total of 74 patients participated: median time since stroke is 8 months, 25 and 75% quartiles [3.0; 13.0]; median severity of UL paralysis is 4.5 points [0.0; 30.0] as measured by the Action Research Arm Test, ARAT, and 19.5 points [11.0; 40.0] as measured by the Fugl-Meyer Motor Assessment, FMMA. Patients in the BCI group (n = 55 performed motor imagery of opening their affected hand. Motor imagery-related brain electroencephalographic activity was translated into contingent hand exoskeleton-driven opening movements of the affected hand. In a control group (n = 19, hand exoskeleton-driven opening movements of the affected hand were independent of brain electroencephalographic activity. Evaluation of the UL clinical assessments indicated that both groups improved, but only the BCI group showed an improvement in the ARAT's grasp score from 0 [0.0; 14.0] to 3.0 [0.0; 15.0] points (p < 0.01 and pinch scores from 0.0 [0.0; 7.0] to 1.0 [0.0; 12.0] points (p < 0.01. Upon training completion, 21.8% and 36.4% of the patients in the BCI group improved their ARAT and FMMA scores respectively. The corresponding numbers for the control group were 5.1% (ARAT and 15.8% (FMMA. These results suggests that adding BCI control to exoskeleton-assisted physical therapy can improve post-stroke rehabilitation outcomes. Both maximum and mean values of the percentage of successfully decoded imagery-related EEG activity, were higher

Interventions to improve hand hygiene compliance in patient care.

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Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H

2010-09-08

Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. To update the review done in 2007, to assess the short and longer-term success of strategies to improve hand hygiene compliance and to determine whether a sustained increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of: the Cochrane Central Register of Controlled Trials; the Cochrane Effective Practice and Organisation of Care Group specialised register of trials; MEDLINE; PubMed; EMBASE; CINAHL; and the BNI. Originally searched to July 2006, for the update databases were searched from August 2006 until November 2009. Randomised controlled trials, controlled clinical trials, controlled before and after studies, and interrupted time series analyses meeting explicit entry and quality criteria used by the Cochrane Effective Practice and Organisation of Care Group were eligible for inclusion. Studies reporting indicators of hand hygiene compliance and proxy indicators such as product use were considered. Self-reported data were not considered a valid measure of compliance. Studies to promote hand hygiene compliance as part of a care bundle approach were included, providing data relating specifically to hand hygiene were presented separately. Studies were excluded if hand hygiene was assessed in simulations, non-clinical settings or the operating theatre setting. Two reviewers independently extracted data and assessed data quality. Four studies met the criteria for the review: two from the original review and two from the update. Two studies evaluated simple education initiatives, one using a randomized clinical trial design and the other a controlled before and after design. Both measured hand hygiene compliance by direct observation. The other two studies were both interrupted times series studies. One study presented three separate interventions within the

Increased efficiency in the second-hand tire trade provides opportunity for dengue control.

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Pliego Pliego, Emilene; Velázquez-Castro, Jorge; Eichhorn, Markus P; Fraguela Collar, Andrés

2018-01-21

Dengue fever is increasing in geographical range, spread by invasion of its vector mosquitoes. The trade in second-hand tires has been implicated as a factor in this process because they act as mobile reservoirs of mosquito eggs and larvae. Regional transportation of tires can create linkages between rural areas with dengue and disease-free urban areas, potentially giving rise to outbreaks even in areas with strong local control measures. In this work we sought to model the dynamics of mosquito transportation via the tire trade, in particular to predict its role in causing unexpected dengue outbreaks through vertical transmission of the virus across generations of mosquitoes. We also aimed to identify strategies for regulating the trade in second-hand tires, improving disease control. We created a mathematical model which captures the dynamics of dengue between rural and urban areas, taking into account the movement and storage time of tires, and mosquito diapause. We simulate a series of scenarios in which a mosquito population is introduced to a dengue-free area via movement of tires, either as single or multiple events, increasing the likelihood of a dengue outbreak. A persistent disease state can be induced regardless of whether urban conditions for an outbreak are met, and an existing endemic state can be enhanced by vector input. Finally we assess the potential for regulation of tire processing as a means of reducing the transmission of dengue fever using a specific case study from Puerto Rico. Our work demonstrates the importance of the second-hand tire trade in modulating the spread of dengue fever across regions, in particular its role in introducing dengue to disease-free areas. We propose that reduction of tire storage time and control of their movement can play a crucial role in containing dengue outbreaks. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neuro-prosthetic interplay. Comment on "Hand synergies: Integration of robotics and neuroscience for understanding the control of biological and artificial hands" by M. Santello et al.

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Schieber, Marc H.

2016-07-01

Control of the human hand has been both difficult to understand scientifically and difficult to emulate technologically. The article by Santello and colleagues in the current issue of Physics of Life Reviews[1] highlights the accelerating pace of interaction between the neuroscience of controlling body movement and the engineering of robotic hands that can be used either autonomously or as part of a motor neuroprosthesis, an artificial body part that moves under control from a human subject's own nervous system. Motor neuroprostheses typically involve a brain-computer interface (BCI) that takes signals from the subject's nervous system or muscles, interprets those signals through a decoding algorithm, and then applies the resulting output to control the artificial device.

Biomechanical Reconstruction Using the Tacit Learning System: Intuitive Control of Prosthetic Hand Rotation.

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Oyama, Shintaro; Shimoda, Shingo; Alnajjar, Fady S K; Iwatsuki, Katsuyuki; Hoshiyama, Minoru; Tanaka, Hirotaka; Hirata, Hitoshi

2016-01-01

Background: For mechanically reconstructing human biomechanical function, intuitive proportional control, and robustness to unexpected situations are required. Particularly, creating a functional hand prosthesis is a typical challenge in the reconstruction of lost biomechanical function. Nevertheless, currently available control algorithms are in the development phase. The most advanced algorithms for controlling multifunctional prosthesis are machine learning and pattern recognition of myoelectric signals. Despite the increase in computational speed, these methods cannot avoid the requirement of user consciousness and classified separation errors. "Tacit Learning System" is a simple but novel adaptive control strategy that can self-adapt its posture to environment changes. We introduced the strategy in the prosthesis rotation control to achieve compensatory reduction, as well as evaluated the system and its effects on the user. Methods: We conducted a non-randomized study involving eight prosthesis users to perform a bar relocation task with/without Tacit Learning System support. Hand piece and body motions were recorded continuously with goniometers, videos, and a motion-capture system. Findings: Reduction in the participants' upper extremity rotatory compensation motion was monitored during the relocation task in all participants. The estimated profile of total body energy consumption improved in five out of six participants. Interpretation: Our system rapidly accomplished nearly natural motion without unexpected errors. The Tacit Learning System not only adapts human motions but also enhances the human ability to adapt to the system quickly, while the system amplifies compensation generated by the residual limb. The concept can be extended to various situations for reconstructing lost functions that can be compensated.

Hands4U: the effectiveness of a multifaceted implementation strategy on behaviour related to the prevention of hand eczema-a randomised controlled trial among healthcare workers.

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van der Meer, Esther W C; Boot, Cécile R L; Twisk, Jos W R; Coenraads, Pieter Jan; Jungbauer, Frank H W; van der Gulden, Joost W J; Anema, Johannes R

2014-07-01

To investigate the effects of a multifaceted implementation strategy on behaviour, behavioural determinants, knowledge and awareness of healthcare workers regarding the use of recommendations to prevent hand eczema. The Hands4U study is a randomised controlled trial. A total of 48 departments (n=1649 workers) were randomly allocated to the multifaceted implementation strategy or the control group (minimal implementation strategy). Within the departments designated to the multifaceted implementation strategy, participatory working groups were set up to enhance the implementation of the recommendations for hand eczema. In addition, working group members were trained to become role models, and an education session was given within the department. Outcome measures were awareness, knowledge, receiving information, behaviour and behavioural determinants. Data were collected at baseline, with a 3- and 6-month follow-up. Statistically significant effects were found after 6 months for awareness (OR 6.30; 95% CI 3.41 to 11.63), knowledge (B 0.74; 95% CI 0.54 to 0.95), receiving information (OR 9.81; 95% CI 5.60 to 17.18), washing hands (B -0.40; 95% -0.51 to -0.29), use of moisturiser (B 0.29; 95% CI 0.20 to 0.38), cotton under gloves (OR 3.94; 95% CI 2.04 to 7.60) and the overall compliance measure (B 0.14; 95% CI 0.02 to 0.26), as a result of the multifaceted implementation strategy. No effects were found for behavioural determinants. The multifaceted implementation strategy can be used in healthcare settings to enhance the implementation of recommendations for the prevention of hand eczema. NTR2812. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The left hand doesn't know what the right hand is doing: the disruptive effects of attention to the hands in skilled typewriting.

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Logan, Gordon D; Crump, Matthew J C

2009-10-01

Everyone knows that attention to the details disrupts skilled performance, but little empirical evidence documents this fact. We show that attention to the hands disrupts skilled typewriting. We had skilled typists type words preceded by cues that told them to type only the letters assigned to one hand or to type all of the letters. Cuing the hands disrupted performance markedly, slowing typing and increasing the error rate (Experiment 1); these deleterious effects were observed even when no keystrokes were actually inhibited (Experiment 3). However, cuing the same letters with colors was not disruptive (Experiment 2). We account for the disruption with a hierarchical control model, in which an inner loop controls the hands and an outer loop controls what is typed. Typing letters using only one hand requires the outer loop to monitor the inner loop's output; the outer loop slows inner-loop cycle time to increase the likelihood of inhibiting responses with the unwanted hand. This produces the disruption.

A randomised controlled trial of the use of aromatherapy and hand massage to reduce disruptive behaviour in people with dementia.

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Fu, Chieh-Yu; Moyle, Wendy; Cooke, Marie

2013-07-10

Aromatherapy and hand massage therapies have been reported to have some benefit for people with dementia who display behavioural symptoms; however there are a number of limitations of reported studies. The aim is to investigate the effect of aromatherapy (3% lavender oil spray) with and without hand massage on disruptive behaviour in people with dementia living in long-term care. In a single blinded randomised controlled trial 67 people with a diagnosis of dementia and a history of disruptive behaviour, from three long-term care facilities were recruited and randomised using a random number table into three groups: (1) Combination (aromatherapy and hand massage) (n = 22), (2) Aromatherapy (n = 23), (3) Placebo control (water spray) (n = 22). The intervention was given twice daily for six weeks. Data on residents' behaviour (CMAI) and cognition (MMSE) were collected before, during and after the intervention. Despite a downward trend in behaviours displayed not one of the interventions significantly reduced disruptive behaviour. Further large-scale placebo controlled studies are required where antipsychotic medication is controlled and a comparison of the methods of application of aromatherapy are investigated. ACTRN12612000917831.

[Hand hygiene: first measure to control nosocomial infection].

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Christiaens, G; Barbier, C; Mutsers, J; Warnotte, J; De Mol, P; Bouffioux, C

2006-01-01

Hand hygiene prevents cross infection in hospi tals, however adherence to guidelines is commonly poor. The hand-hygiene promotion programme started on May 2004 at the University Hospital of Liège after a baseline survey of compliance. We attempted to promote hand hygiene and most par ticularly alcohol-based hand disinfection. We measured MRSA transmission rates and consumption of alcohol-based handrub solution and soap in parallel. During the campaign, consump tion of alcohol-based handrub solution and soap increased by 56% and 24% respectively and MRSA transmission rates decreased from 11,04 to 7,07 cases per 1000 admissions.

Illusory movement perception improves motor control for prosthetic hands.

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Marasco, Paul D; Hebert, Jacqueline S; Sensinger, Jon W; Shell, Courtney E; Schofield, Jonathon S; Thumser, Zachary C; Nataraj, Raviraj; Beckler, Dylan T; Dawson, Michael R; Blustein, Dan H; Gill, Satinder; Mensh, Brett D; Granja-Vazquez, Rafael; Newcomb, Madeline D; Carey, Jason P; Orzell, Beth M

2018-03-14

To effortlessly complete an intentional movement, the brain needs feedback from the body regarding the movement's progress. This largely nonconscious kinesthetic sense helps the brain to learn relationships between motor commands and outcomes to correct movement errors. Prosthetic systems for restoring function have predominantly focused on controlling motorized joint movement. Without the kinesthetic sense, however, these devices do not become intuitively controllable. We report a method for endowing human amputees with a kinesthetic perception of dexterous robotic hands. Vibrating the muscles used for prosthetic control via a neural-machine interface produced the illusory perception of complex grip movements. Within minutes, three amputees integrated this kinesthetic feedback and improved movement control. Combining intent, kinesthesia, and vision instilled participants with a sense of agency over the robotic movements. This feedback approach for closed-loop control opens a pathway to seamless integration of minds and machines. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Hand functions in type 1 and type 2 diabetes mellitus

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Akpinar Pinar

2017-01-01

Full Text Available Introduction/Objective. Hand functions have an enormous impact on activities of daily living in patients with diabetes mellitus (DM, such as self-care, administering insulin injections, and preparing and eating meals. The aim of the study was to evaluate hand functions and grip strength in patients with type 1 and type 2 DM. Methods. This was an observational case-control study investigating the hand functions and grip strength in patients with type 1 and type 2 DM. The study comprised 41 patients with type 1 DM aged 25–50 years sex- and age-matched, 40 non-diabetic controls, and 91 patients with type 2 DM aged 40–65 years sex- and age-matched 60 non-diabetic controls. Patients with documented history of diabetic sensorimotor neuropathy and adhesive capsulitis were excluded. The Duruoz Hand Index was used to assess the functional hand disability. Grip strength was tested with a calibrated Jamar dynamometer. Results. The Duruoz Hand Index scores in patients with type 2 DM were significantly higher than in persons in the control group (p 0.05. Grip strength values of patients with type 1 DM were significantly lower compared to those in the control group (p < 0.05, whereas there was no significant difference between patients with type 2 DM and their control group. There was a negatively significant correlation between grip strength and the Duruoz Hand Index scores in patients with both type 1 and type 2 DM (p < 0.05. Conclusion. Patients with type 1 DM and type 2 DM have different degrees of hand disability as compared to healthy control groups.

Contact pressure measurement in hand tool evaluation studies

NARCIS (Netherlands)

Kuijt-Evers, L.F.M.; Bosch, T.

2006-01-01

In hand tool evaluation studies, several objective measurements are used. Grip force distribution and grip force are important as they give feedback about the force which has to be performed with the hand on the handle. A measurement technique -which is related to grip force measurement- is contact

Universal Robot Hand Equipped with Tactile and Joint Torque Sensors: Development and Experiments on Stiffness Control and Object Recognition

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Hiroyuki NAKAMOTO

2007-04-01

Full Text Available Various humanoid robots have been developed and multifunction robot hands which are able to attach those robots like human hand is needed. But a useful robot hand has not been depeveloped, because there are a lot of problems such as control method of many degrees of freedom and processing method of enormous sensor outputs. Realizing such robot hand, we have developed five-finger robot hand. In this paper, the detailed structure of developed robot hand is described. The robot hand we developed has five fingers of multi-joint that is equipped with joint torque sensors and tactile sensors. We report experimental results of a stiffness control with the developed robot hand. Those results show that it is possible to change the stiffness of joints. Moreover we propose an object recognition method with the tactile sensor. The validity of that method is assured by experimental results.

Coordination of hand shape.

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Pesyna, Colin; Pundi, Krishna; Flanders, Martha

2011-03-09

The neural control of hand movement involves coordination of the sensory, motor, and memory systems. Recent studies have documented the motor coordinates for hand shape, but less is known about the corresponding patterns of somatosensory activity. To initiate this line of investigation, the present study characterized the sense of hand shape by evaluating the influence of differences in the amount of grasping or twisting force, and differences in forearm orientation. Human subjects were asked to use the left hand to report the perceived shape of the right hand. In the first experiment, six commonly grasped items were arranged on the table in front of the subject: bottle, doorknob, egg, notebook, carton, and pan. With eyes closed, subjects used the right hand to lightly touch, forcefully support, or imagine holding each object, while 15 joint angles were measured in each hand with a pair of wired gloves. The forces introduced by supporting or twisting did not influence the perceptual report of hand shape, but for most objects, the report was distorted in a consistent manner by differences in forearm orientation. Subjects appeared to adjust the intrinsic joint angles of the left hand, as well as the left wrist posture, so as to maintain the imagined object in its proper spatial orientation. In a second experiment, this result was largely replicated with unfamiliar objects. Thus, somatosensory and motor information appear to be coordinated in an object-based, spatial-coordinate system, sensitive to orientation relative to gravitational forces, but invariant to grasp forcefulness.

Post-stroke Rehabilitation Training with a Motor-Imagery-Based Brain-Computer Interface (BCI)-Controlled Hand Exoskeleton: A Randomized Controlled Multicenter Trial.

Science.gov (United States)

Frolov, Alexander A; Mokienko, Olesya; Lyukmanov, Roman; Biryukova, Elena; Kotov, Sergey; Turbina, Lydia; Nadareyshvily, Georgy; Bushkova, Yulia

2017-01-01

Repeated use of brain-computer interfaces (BCIs) providing contingent sensory feedback of brain activity was recently proposed as a rehabilitation approach to restore motor function after stroke or spinal cord lesions. However, there are only a few clinical studies that investigate feasibility and effectiveness of such an approach. Here we report on a placebo-controlled, multicenter clinical trial that investigated whether stroke survivors with severe upper limb (UL) paralysis benefit from 10 BCI training sessions each lasting up to 40 min. A total of 74 patients participated: median time since stroke is 8 months, 25 and 75% quartiles [3.0; 13.0]; median severity of UL paralysis is 4.5 points [0.0; 30.0] as measured by the Action Research Arm Test, ARAT, and 19.5 points [11.0; 40.0] as measured by the Fugl-Meyer Motor Assessment, FMMA. Patients in the BCI group ( n = 55) performed motor imagery of opening their affected hand. Motor imagery-related brain electroencephalographic activity was translated into contingent hand exoskeleton-driven opening movements of the affected hand. In a control group ( n = 19), hand exoskeleton-driven opening movements of the affected hand were independent of brain electroencephalographic activity. Evaluation of the UL clinical assessments indicated that both groups improved, but only the BCI group showed an improvement in the ARAT's grasp score from 0 [0.0; 14.0] to 3.0 [0.0; 15.0] points ( p exoskeleton-assisted physical therapy can improve post-stroke rehabilitation outcomes. Both maximum and mean values of the percentage of successfully decoded imagery-related EEG activity, were higher than chance level. A correlation between the classification accuracy and the improvement in the upper extremity function was found. An improvement of motor function was found for patients with different duration, severity and location of the stroke.

Studying hand grip strength development among students who have taken tennis and massage courses

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Erzeybek Mustafa Said

2017-01-01

Full Text Available In this study, the finger and hand force developments of the students who have taken selective/applied Tennis and Massage courses at the University have been examined. From the students of the Department of Physical Education and Sport, 19 healthy females and 73 healthy males (age = 21.25 ± 1.55 years (average ± SD who have taken selective Tennis courses;51 healthy males (age = 22.00 ± 1.04 years (average ± SD who have taken Massage courses; and as the control group,16 healthy womenand50 healthy males(age = 21.72 ± 1.47 years (average ± SD have been participated to the study. The age, length, body weight, grip strength of both hands as well as the finger grip strength of the subjects have been recorded. The course schedule has been set as once a week four hours practice for both tennis and massage. Two weeks of the education and training program that takes twelve weeks in total were assigned for theoretical classes. The remaining period of ten weeks was for practice classes and the measurements were performed before and after this ten weeks period. The hand grip strength measurement has been carried out with a Takkei branded hand dynamometer whereas for the measurement of the finger grip strength, a Baseline branded pinch meter has been used. For both the pre-test and final test of the finger grip and hand grip strength measurements, the paired sample t test has been used in terms of in-group comparisons, whereas for the inter-group comparisons, one-way ANOVA has been used. For the significant F values, post hoc Tukey test has been used. The right hand and the left hand grip values of both test groups as well as the values of the control group have been significantly increased between the pre-test and final test. Particularly, preferring the exercises that improve the hand and finger grip strengths would enable a better racket handle grip as well as an improved shot efficiency for tennis. This would also enable masseurs/masseuses to apply

Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study

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Lau Claudia H

2012-05-01

Full Text Available Abstract Background Illness-related absences have been shown to lead to negative educational and economic outcomes. Both hand washing and hand sanitizer interventions have been shown to be effective in reducing illness-related absences. However, while the importance of hand hygiene in schools is clear, the role of instruction in use is less obvious. The purpose of this study was to compare absenteeism rates among elementary students given access to hand hygiene facilities versus students given both access and short repetitive instruction in use, particularly during influenza season when illness-related absences are at a peak. Methods A hand hygiene intervention was implemented from October to May during the 2009/2010 academic year, including peak flu season, in two Chicago Public Elementary Schools among students grades pre-kindergarten to eighth grade (ages 4–14. Classrooms were systematically assigned to an intervention or control group by grade (cluster design. Hand hygiene facilities (sanitizer and soap were made available to all students. Students in the intervention group also received short repetitive instruction in hand hygiene every 2 months. Only absences as a result of respiratory or gastrointestinal illness were used to establish illness-related absenteeism rates. Percent absent days were calculated and bivariate analyses were performed to compare percent absent days among students given access to hand hygiene facilities versus students given both access and instruction. Prior to the intervention, teachers’ perceptions of students’ hand hygiene were also evaluated. Teacher perceptions were analysed to describe attitudes and beliefs. Results Data were collected and analysed for 773 students reporting 1,886 absences during the study period (1.73% of total school days. Both the percent total absent days and percent illness-related absent days were significantly lower in the group receiving short instruction during flu season (P�

Comparison of working length control consistency between hand K-files and Mtwo NiTi rotary system.

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Krajczár, Károly; Varga, Enikő; Marada, Gyula; Jeges, Sára; Tóth, Vilmos

2016-04-01

The purpose of this study was to investigate the consistency of working length control between hand instrumentation in comparison to engine driven Mtwo nickel-titanium rotary files. Forty extracted maxillary molars were selected and divided onto two parallel groups. The working lengths of the mesiobuccal root canals were estimated. The teeth were fixed in a phantom head. The root canal preparation was carried out group 1 (n=20) with hand K-files, (VDW, Munich, Germany) and group 2 (n=20) with Mtwo instruments (VDW, Munich, Germany). Vestibulo-oral and mesio-distal directional x-ray images were taken before the preparation with #10 K-file, inserted into the mesiobuccal root canal to the working length, and after preparation with #25, #30 and #40 files. Working lenght changes were detected with measurements between the radiological apex and the instrument tips. In the Mtwo group a difference in the working competency (protary files. Mtwo NiTi rotary file did therefore proved to be more accurate in comparison to the conventional hand instrumentation. Working length, Mtwo, nickel-titanium, hand preparation, engine driven preparation.

Stable Myoelectric Control of a Hand Prosthesis using Non-Linear Incremental Learning

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Arjan eGijsberts

2014-02-01

Full Text Available Stable myoelectric control of hand prostheses remains an open problem. The only successful human-machine interface is surface electromyography, typically allowing control of a few degrees of freedom. Machine learning techniques may have the potential to remove these limitations, but their performance is thus far inadequate: myoelectric signals change over time under the influence of various factors, deteriorating control performance. It is therefore necessary, in the standard approach, to regularly retrain a new model from scratch.We hereby propose a non-linear incremental learning method in which occasional updates with a modest amount of novel training data allow continual adaptation to the changes in the signals. In particular, Incremental Ridge Regression and an approximation of the Gaussian Kernel known as Random Fourier Features are combined to predict finger forces from myoelectric signals, both finger-by-finger and grouped in grasping patterns.We show that the approach is effective and practically applicable to this problem by first analyzing its performance while predicting single-finger forces. Surface electromyography and finger forces were collected from 10 intact subjects during four sessions spread over two different days; the results of the analysis show that small incremental updates are indeed effective to maintain a stable level of performance.Subsequently, we employed the same method on-line to teleoperate a humanoid robotic arm equipped with a state-of-the-art commercial prosthetic hand. The subject could reliably grasp, carry and release everyday-life objects, enforcing stable grasping irrespective of the signal changes, hand/arm movements and wrist pronation and supination.

Surface EMG in advanced hand prosthetics.

Science.gov (United States)

Castellini, Claudio; van der Smagt, Patrick

2009-01-01

One of the major problems when dealing with highly dexterous, active hand prostheses is their control by the patient wearing them. With the advances in mechatronics, building prosthetic hands with multiple active degrees of freedom is realisable, but actively controlling the position and especially the exerted force of each finger cannot yet be done naturally. This paper deals with advanced robotic hand control via surface electromyography. Building upon recent results, we show that machine learning, together with a simple downsampling algorithm, can be effectively used to control on-line, in real time, finger position as well as finger force of a highly dexterous robotic hand. The system determines the type of grasp a human subject is willing to use, and the required amount of force involved, with a high degree of accuracy. This represents a remarkable improvement with respect to the state-of-the-art of feed-forward control of dexterous mechanical hands, and opens up a scenario in which amputees will be able to control hand prostheses in a much finer way than it has so far been possible.

Effects of hyperthyroidism on hand grip strength and function.

Science.gov (United States)

Erkol İnal, Esra; Çarlı, Alparslan Bayram; Çanak, Sultan; Aksu, Oğuzhan; Köroğlu, Banu Kale; Savaş, Serpil

2015-01-01

Hyperthyroidism is a pathologic condition in which the body is exposed to excessive amounts of circulating thyroid hormones. Skeletal muscle is one of the major target organs of thyroid hormones. We evaluated hand grip strength and function in patients with overt hyperthyroidism. Fifty-one patients newly diagnosed with hyperthyroidism and 44 healthy controls participated in this study. Age, height, weight, and dominant hand of all participants were recorded. The diagnosis of hyperthyroidism was confirmed by clinical examination and laboratory tests. Hand grip strength was tested at the dominant hand with a Jamar hand dynamometer. The grooved pegboard test (PGT) was used to evaluate hand dexterity. The Duruöz Hand Index (DHI) was used to assess hand function. No significant differences were found in terms of clinical and demographic findings between the patients with hyperthyroidism and healthy controls (p > 0.05). Significant differences were found between the patients with hyperthyroidism and healthy controls regarding PGT and DHI scores (p Hyperthyroidism seemed to affect hand dexterity and function more than hand grip strength and seemed to be associated with reduced physical function more than muscle strength. This may also indicate that patients with hyperthyroidism should be evaluated by multidisplinary modalities.

Randomized Controlled Trial of Antiseptic Hand Hygiene Methods in an Outpatient Surgery Clinic.

Science.gov (United States)

Therattil, Paul J; Yueh, Janet H; Kordahi, Anthony M; Cherla, Deepa V; Lee, Edward S; Granick, Mark S

2015-12-01

Outpatient wound care plays an integral part in any plastic surgery practice. However, compliance with hand hygiene measures has shown to be low, due to skin irritation and lack of time. The objective of this trial was to determine whether single-use, long-acting antiseptics can be as effective as standard multiple-use hand hygiene methods in an outpatient surgical setting. A prospective, randomized controlled trial was performed in the authors' outpatient plastic surgery clinic at Rutgers New Jersey Medical School, Newark, NJ to compare the efficacy of an ethyl alcohol-based sanitizer (Avagard D Instant Hand Aniseptic, 3M Health Care, St. Paul, MN), a benzalkonium chloride-based sanitizer (Soft & Shield, Bioderm Technologies, Inc, Trenton, NJ, distributed by NAPP Technologies, Hackensack, NJ ), and soap and- water handwashing. Subjects included clinic personnel, who were followed throughout the course of a 3-hour clinic session with hourly hand bacterial counts taken. During the course of the trial, 95 subjects completed the clinic session utilizing 1 of the hand hygiene methods (36 ethyl alcohol-based sanitizer, 38 benzalkonium chloride-based sanitizer, and 21 soap-and-water handwashing). There was no difference between hand bacterial counts using the different methods at 4 hourly time points (P greater than 0.05). Hand bacterial counts increased significantly over the 3-hour clinic session with the ethyl alcohol-based sanitizer (9.24 to 21.90 CFU, P less than 0.05), benzalkonium chloride-based sanitizer (6.69 to 21.59 CFU, P less than 0.05), and soap-and-water handwashing (8.43 to 22.75 CFU, P less than 0.05). There does not appear to be any difference in efficacy between single-use, long-acting sanitizer, and standard multiple-use hand hygiene methods. Hand bacterial counts increased significantly over the course of the 3-hour clinic session regardless of the hand hygiene measure used. Hand condition of subjects was improved with the ethyl alcohol

An EMG-Controlled Robotic Hand Exoskeleton for Bilateral Rehabilitation.

Science.gov (United States)

Leonardis, Daniele; Barsotti, Michele; Loconsole, Claudio; Solazzi, Massimiliano; Troncossi, Marco; Mazzotti, Claudio; Castelli, Vincenzo Parenti; Procopio, Caterina; Lamola, Giuseppe; Chisari, Carmelo; Bergamasco, Massimo; Frisoli, Antonio

2015-01-01

This paper presents a novel electromyography (EMG)-driven hand exoskeleton for bilateral rehabilitation of grasping in stroke. The developed hand exoskeleton was designed with two distinctive features: (a) kinematics with intrinsic adaptability to patient's hand size, and (b) free-palm and free-fingertip design, preserving the residual sensory perceptual capability of touch during assistance in grasping of real objects. In the envisaged bilateral training strategy, the patient's non paretic hand acted as guidance for the paretic hand in grasping tasks. Grasping force exerted by the non paretic hand was estimated in real-time from EMG signals, and then replicated as robotic assistance for the paretic hand by means of the hand-exoskeleton. Estimation of the grasping force through EMG allowed to perform rehabilitation exercises with any, non sensorized, graspable objects. This paper presents the system design, development, and experimental evaluation. Experiments were performed within a group of six healthy subjects and two chronic stroke patients, executing robotic-assisted grasping tasks. Results related to performance in estimation and modulation of the robotic assistance, and to the outcomes of the pilot rehabilitation sessions with stroke patients, positively support validity of the proposed approach for application in stroke rehabilitation.

Intelligent, self-contained robotic hand

Science.gov (United States)

Krutik, Vitaliy; Doo, Burt; Townsend, William T.; Hauptman, Traveler; Crowell, Adam; Zenowich, Brian; Lawson, John

2007-01-30

A robotic device has a base and at least one finger having at least two links that are connected in series on rotary joints with at least two degrees of freedom. A brushless motor and an associated controller are located at each joint to produce a rotational movement of a link. Wires for electrical power and communication serially connect the controllers in a distributed control network. A network operating controller coordinates the operation of the network, including power distribution. At least one, but more typically two to five, wires interconnect all the controllers through one or more joints. Motor sensors and external world sensors monitor operating parameters of the robotic hand. The electrical signal output of the sensors can be input anywhere on the distributed control network. V-grooves on the robotic hand locate objects precisely and assist in gripping. The hand is sealed, immersible and has electrical connections through the rotary joints for anodizing in a single dunk without masking. In various forms, this intelligent, self-contained, dexterous hand, or combinations of such hands, can perform a wide variety of object gripping and manipulating tasks, as well as locomotion and combinations of locomotion and gripping.

Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study

Science.gov (United States)

2012-01-01

Background Illness-related absences have been shown to lead to negative educational and economic outcomes. Both hand washing and hand sanitizer interventions have been shown to be effective in reducing illness-related absences. However, while the importance of hand hygiene in schools is clear, the role of instruction in use is less obvious. The purpose of this study was to compare absenteeism rates among elementary students given access to hand hygiene facilities versus students given both access and short repetitive instruction in use, particularly during influenza season when illness-related absences are at a peak. Methods A hand hygiene intervention was implemented from October to May during the 2009/2010 academic year, including peak flu season, in two Chicago Public Elementary Schools among students grades pre-kindergarten to eighth grade (ages 4–14). Classrooms were systematically assigned to an intervention or control group by grade (cluster design). Hand hygiene facilities (sanitizer and soap) were made available to all students. Students in the intervention group also received short repetitive instruction in hand hygiene every 2 months. Only absences as a result of respiratory or gastrointestinal illness were used to establish illness-related absenteeism rates. Percent absent days were calculated and bivariate analyses were performed to compare percent absent days among students given access to hand hygiene facilities versus students given both access and instruction. Prior to the intervention, teachers’ perceptions of students’ hand hygiene were also evaluated. Teacher perceptions were analysed to describe attitudes and beliefs. Results Data were collected and analysed for 773 students reporting 1,886 absences during the study period (1.73% of total school days). Both the percent total absent days and percent illness-related absent days were significantly lower in the group receiving short instruction during flu season (P = 0.002, P�

Cultural adaptation of the Michigan Hand Outcomes Questionnaire in patients with Carpal Tunnel Syndrome: A Turkish version study

Directory of Open Access Journals (Sweden)

Ilker Ilhanli

2015-03-01

Full Text Available Objective: Cultural adaptations of the questionnaires are important for easy use. We aimed to assess the reliability and validity of the Turkish Version of the Michigan Hand Outcomes Questionnaire in patients with Carpal Tunnel Syndrome. Methods: To assess test-retest reliability, the Turkish “Michigan Hand Outcomes Questionnaire” and “Disabilities of Arm, Shoulder and Hand” questionnaires were answered by patients and controls and were repeated a week later. For testing internal consistency, the Cronbach's alpha test was used. For testing validity, correlations between the subscales of the “Michigan Hand Outcomes Questionnaire” and “Disabilities of Arm, Shoulder and Hand” questionnaire were measured in patient groups. One hundred patients with idiopathic Carpal Tunnel Syndrome and 50 healthy participants were included in the study. Results: In test-retest reliability, intraclass correlations of the subscales of the “Michigan Hand Outcomes Questionnaire” were high. Cronbach's alphas were found to be high in all subscales. There was no significant correlation between asthetics and pain scales. We found significant differences between patients and controls regarding all subscales of the “Michigan Hand Outcomes Questionnaire”. Correlations between subscales of the “Michigan Hand Outcomes Questionnaire” and “Disabilities of Arm, Shoulder and Hand” questionnaire were significant. We found no difference between one-hand effected and two-hand effected patients, in terms of the “Michigan Hand Outcomes Questionnaire”, “Disabilities of Arm, Shoulder and Hand” questionnaire Function/Symptom and Work average scores. Conclusion: This study showed that the Turkish version of the “Michigan Hand Outcomes Questionnaire” is reliable and valid and can be used in Turkish patients with Carpal Tunnel Syndrome because it is comprehensible and practicable

Modeling and control of an anthropomorphic robotic hand

OpenAIRE

Bensalah, Choukri

2016-01-01

Mención Europea en el título de doctor This thesis presents methods and tools for enabling the successful use of robotic hands. For highly dexterous and/or anthropomorphic robotic hands, these methods have to share some common goals, such as overcoming the potential complexity of the mechanical design and the ability of performing accurate tasks with low and efficient computational cost. A prerequisite for dexterity is to increase the workspace of the robotic hand. For th...

Hand hygiene in reducing transient flora on the hands of healthcare workers: an educational intervention.

Science.gov (United States)

Kapil, R; Bhavsar, H K; Madan, M

2015-01-01

Hand hygiene has now been recognised as one of the most effective intervention to control the transmission of infections in a hospital and education is an important tool to ensure its implementation. In order to convince the users and as a part of education, it is important to generate evidence on the role of hand hygiene in reducing the bacterial flora on their hands. The present study was undertaken in a tertiary care hospital to demonstrate the presence of bacterial flora on the hands of healthcare workers (HCW) in different categories, to teach them proper hand hygiene technique using alcohol-based hand rub and determine the outcome for reduction of bacteria. A total sample size of 60 subjects including resident doctors, medical students, nurses and hospital attendants were included in the study after obtaining informed consent. Each person was educated on the technique of hand hygiene with alcohol-based hand rub and hand impressions were cultured before and after hand hygiene. All the subjects were also given a questionnaire to assess their perception on hand hygiene. The WHO posters on proper hand hygiene were displayed in the appropriate areas of the hospital in addition, as an educational tool. Majority (42 out of 60) of the HCWs had bacterial count up to 100 colonies or more on both hands before the application of hand rub while working in the hospital. After use of alcohol hand rub with a proper hand hygiene technique, it was found that the percentage reduction was 95-99% among doctors and nurses, 70% among hospital attendants and 50% among sanitary attendants. Staphylococcus aureus was present on the hands of eight persons of which three were methicillin-resistant Staphylococcus aureus. The study demonstrates that transient bacteria are present on the hands of HCWs but majority could be removed by proper hand hygiene, which needs continuous education to be effective. It also shows that active education by demonstrating the proper hand hygiene technique

Comparative study of presurgical hand hygiene with hydroalcoholic solution versus traditional presurgical hand hygiene.

Science.gov (United States)

López Martín, M Beatriz; Erice Calvo-Sotelo, Alejo

To compare presurgical hand hygiene with hydroalcoholic solution following the WHO protocol with traditional presurgical hand hygiene. Cultures of the hands of surgeons and surgical nurses were performed before and after presurgical hand hygiene and after removing gloves at the end of surgery. Cultures were done in 2different days: the first day after traditional presurgical hand hygiene, and the second day after presurgical hand hygiene with hydroalcoholic solution following the WHO protocol. The duration of the traditional hand hygiene was measured and compared with the duration (3min) of the WHO protocol. The cost of the products used in the traditional technique was compared with the cost of the hydroalcoholic solution used. The variability of the traditional technique was determined by observation. Following presurgical hand hygiene with hydroalcoholic solution, colony-forming units (CFU) were detected in 5 (7.3%) subjects, whereas after traditional presurgical hand hygiene CFU were detected in 14 subjects (20.5%) (p < 0.05). After glove removal, the numbers of CFU were similar. The time employed in hand hygiene with hydroalcoholic solution (3min) was inferior to the time employed in the traditional technique (p < 0.05), its cost was less than half, and there was no variability. Compared with other techniques, presurgical hand hygiene with hydroalcoholic solution significantly decreases CFU, has similar latency time, a lower cost, and saves time. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Effectiveness of a nonrinse, alcohol-free antiseptic hand wash.

Science.gov (United States)

Moadab, A; Rupley, K F; Wadhams, P

2001-06-01

This study evaluated the efficacy of a novel surfactant, allantoin, and benzalkonium chloride hand sanitizer using the US Food and Drug Administration's method for testing antiseptic hand washes that podiatric physicians and other health-care personnel use. The alcohol-free product, HandClens, was compared with an alcohol-based product, Purell. Independent researchers from the California College of Podiatric Medicine conducted the study using 40 volunteer students from the class of 2001. The results show that HandClens outperformed Purell and met the regulatory requirements for a hand sanitizer. Purell failed as an antimicrobial hand wash and was less effective than a control soap used in the study.

[Arm Motor Function Recovery during Rehabilitation with the Use of Hand Exoskeleton Controlled by Brain-Computer Interface: a Patient with Severe Brain Damage].

Science.gov (United States)

Biryukova, E V; Pavlova, O G; Kurganskaya, M E; Bobrov, P D; Turbina, L G; Frolov, A A; Davydov, V I; Sil'tchenko, A V; Mokienko, O A

2016-01-01

We studied the dynamics of motor function recovery in a patient with severe brain damage in the course of neurorehabilitation using hand exoskeleton controlled by brain-computer interface. For estimating the motor function of paretic arm, we used the biomechanical analysis of movements registered during the course of rehabilitation. After 15 weekly sessions of hand exoskeleton control, the following results were obtained: a) the velocity profile of goal-directed movements of paretic hand became bell-shaped, b) the patient began to extend and abduct the hand which was flexed and adducted in the beginning of rehabilitation, and c) the patient began to supinate the forearm which was pronated in the beginning of rehabilitation. The first result is an evidence of the general improvement of the quality of motor control, while the second and third results prove that the spasticity of paretic arm has decreased.

Hand eczema classification

DEFF Research Database (Denmark)

Diepgen, T L; Andersen, Klaus Ejner; Brandao, F M

2008-01-01

of the disease is rarely evidence based, and a classification system for different subdiagnoses of hand eczema is not agreed upon. Randomized controlled trials investigating the treatment of hand eczema are called for. For this, as well as for clinical purposes, a generally accepted classification system...... A classification system for hand eczema is proposed. Conclusions It is suggested that this classification be used in clinical work and in clinical trials....

Multi-fingered robotic hand

Science.gov (United States)

Ruoff, Carl F. (Inventor); Salisbury, Kenneth, Jr. (Inventor)

1990-01-01

A robotic hand is presented having a plurality of fingers, each having a plurality of joints pivotally connected one to the other. Actuators are connected at one end to an actuating and control mechanism mounted remotely from the hand and at the other end to the joints of the fingers for manipulating the fingers and passing externally of the robot manipulating arm in between the hand and the actuating and control mechanism. The fingers include pulleys to route the actuators within the fingers. Cable tension sensing structure mounted on a portion of the hand are disclosed, as is covering of the tip of each finger with a resilient and pliable friction enhancing surface.

Alcohol-based instant hand sanitizer use in military settings: a prospective cohort study of Army basic trainees.

Science.gov (United States)

Mott, Peter J; Sisk, Brian W; Arbogast, James W; Ferrazzano-Yaussy, Cristina; Bondi, Cara A M; Sheehan, James J

2007-11-01

We investigated the impact of a customized alcohol-based instant hand sanitizer hand-hygiene regimen in an Army basic training setting. The entire population at the U.S. Army Field Artillery Training Center, Fort Sill, Oklahoma, participated in the 13-week prospective cohort study between January 18, 2005 and April 18, 2005. Two training battalions were randomly assigned to the control group, one to the primary intervention group (customized Purell Instant Hand Sanitizer regimen, education, reinforcement) and one to the secondary intervention group (customized Purell Instant Hand Sanitizer regimen). When compared to the control group, intervention groups experienced 40% less respiratory illness (p < 0.001), 48% less gastrointestinal illness (p < 0.02), 44% less lost training time (p < 0.001), and 31% fewer health care encounters (p < 0.001). These findings suggest that this intervention is capable of significantly reducing illness in this setting and has the potential to help reduce absenteeism in the military workforce as a whole.

Identification of motion from multi-channel EMG signals for control of prosthetic hand

International Nuclear Information System (INIS)

Geethanjali, P.; Ray, K.K.

2011-01-01

Full text: The authors in this paper propose an effective and efficient pattern recognition technique from four channel electromyogram (EMG) signals for control of multifunction prosthetic hand. Time domain features such as mean absolute value, number of zero crossings, number of slope sign changes and waveform length are considered for pattern recognition. The patterns are classified using simple logistic regression (SLR) technique and decision tree (DT) using J48 algorithm. In this study six specific hand and wrist motions are identified from the EMG signals obtained from ten different able-bodied. By considering relevant dominant features for pattern recognition, the processing time as well as memory space of the SLR and DT classifiers is found to be less in comparison with neural network (NN), k-nearest neighbour model 1 (kNN Model-1), k-nearest neighbour model 2 (kNN-Model-2) and linear discriminant analysis. The classification accuracy of SLR classifier is found to be 91 ± 1.9%. (author)

Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach, over 8 years, in 11 cities of Turkey.

Science.gov (United States)

Leblebicioglu, Hakan; Koksal, Iftihar; Rosenthal, Victor D; Akan, Özay Arıkan; Özgültekin, Asu; Kendirli, Tanil; Erben, Nurettin; Yalcin, Ata Nevzat; Ulusoy, Sercan; Sirmatel, Fatma; Ozdemir, Davut; Alp, Emine; Yıldızdaş, Dinçer; Esen, Saban; Ulger, Fatma; Dilek, Ahmet; Yilmaz, Hava; Yýlmaz, Gürdal; Kaya, Selçuk; Ulusoy, Hülya; Tulunay, Melek; Oral, Mehmet; Ünal, Necmettin; Turan, Güldem; Akgün, Nur; İnan, Asuman; Ince, Erdal; Karbuz, Adem; Çiftçi, Ergin; Taşyapar, Nevin; Güneş, Melek; Ozgunes, Ilhan; Usluer, Gaye; Turhan, Ozge; Gunay, Nurgul; Gumus, Eylul; Dursun, Oguz; Arda, Bilgin; Bacakoglu, Feza; Cengiz, Mustafa; Yilmaz, Leyla; Geyik, Mehmet Faruk; Şahin, Ahmet; Erdogan, Selvi; Kılıc, Aysegul Ulu; Horoz, Ozden Ozgur

2015-07-01

To evaluate the effectiveness of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach in Turkey and analyse predictors of poor hand hygiene compliance. An observational, prospective, interventional, before-and-after study was conducted from August 2003 to August 2011 in 12 intensive care units (ICU) of 12 hospitals in 11 cities. The study was divided into a baseline and a follow-up period and included random 30-minute observations for hand hygiene compliance in ICU. The hand hygiene approach included administrative support, supplies availability, education and training, reminders in the workplace, process surveillance, and performance feedback. We observed 21,145 opportunities for hand hygiene. Overall hand hygiene compliance increased from 28.8% to 91% (95% CI 87.6-93.0, p 0.0001). Multivariate and univariate analyses showed that several variables were significantly associated with poor hand hygiene compliance: males vs. females (39% vs. 48%; 95% CI 0.79-0.84, p 0.0001), ancillary staff vs. physicians (35% vs. 46%, 95% CI 0.73-0.78, p 0.0001), and adult vs. pediatric ICUs (42% vs. 74%, 95% CI 0.54-0.60, p 0.0001). Adherence to hand hygiene was significantly increased with the INICC Hand Hygiene Approach. Specific programmes should be directed to improve hand hygiene in variables found to be predictors of poor hand hygiene compliance.

Disentangling quality and safety indicator data: a longitudinal, comparative study of hand hygiene compliance and accreditation outcomes in 96 Australian hospitals

Science.gov (United States)

Mumford, Virginia; Greenfield, David; Hogden, Anne; Debono, Deborah; Gospodarevskaya, Elena; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

2014-01-01

Objectives The study aims are twofold. First, to investigate the suitability of hand hygiene as an indicator of accreditation outcomes and, second, to test the hypothesis that hospitals with better accreditation outcomes achieve higher hand hygiene compliance rates. Design A retrospective, longitudinal, multisite comparative survey. Setting Acute public hospitals in New South Wales, Australia. Participants 96 acute hospitals with accreditation survey results from two surveys during 2009–2012 and submitted data for more than four hand hygiene audits between 2010 and 2013. Outcomes Our primary outcome comprised observational hand hygiene compliance data from eight audits during 2010–2013. The explanatory variables in our multilevel regression model included: accreditation outcomes and scores for the infection control standard; timing of the surveys; and hospital size and activity. Results Average hand hygiene compliance rates increased from 67.7% to 80.3% during the study period (2010–2013), with 46.7% of hospitals achieving target compliance rates of 70% in audit 1, versus 92.3% in audit 8. Average hand hygiene rates at small hospitals were 7.8 percentage points (pp) higher than those at the largest hospitals (phand hygiene rates, accreditation outcomes and infection control scores is less clear. Conclusions Our results indicate that accreditation outcomes and hand hygiene audit data are measuring different parts of the quality and safety spectrum. Understanding what is being measured when selecting indicators to assess the impact of accreditation is critical as focusing on accreditation results would discount successful hand hygiene implementation by smaller hospitals. Conversely, relying on hand hygiene results would discount the infection control related research and leadership investment by larger hospitals. Our hypothesis appears to be confounded by an accreditation programme that makes it more difficult for smaller hospitals to achieve high infection

Fully embedded myoelectric control for a wearable robotic hand orthosis.

Science.gov (United States)

Ryser, Franziska; Butzer, Tobias; Held, Jeremia P; Lambercy, Olivier; Gassert, Roger

2017-07-01

To prevent learned non-use of the affected hand in chronic stroke survivors, rehabilitative training should be continued after discharge from the hospital. Robotic hand orthoses are a promising approach for home rehabilitation. When combined with intuitive control based on electromyography, the therapy outcome can be improved. However, such systems often require extensive cabling, experience in electrode placement and connection to external computers. This paper presents the framework for a stand-alone, fully wearable and real-time myoelectric intention detection system based on the Myo armband. The hard and software for real-time gesture classification were developed and combined with a routine to train and customize the classifier, leading to a unique ease of use. The system including training of the classifier can be set up within less than one minute. Results demonstrated that: (1) the proposed algorithm can classify five gestures with an accuracy of 98%, (2) the final system can online classify three gestures with an accuracy of 94.3% and, in a preliminary test, (3) classify three gestures from data acquired from mildly to severely impaired stroke survivors with an accuracy of over 78.8%. These results highlight the potential of the presented system for electromyography-based intention detection for stroke survivors and, with the integration of the system into a robotic hand orthosis, the potential for a wearable platform for all day robot-assisted home rehabilitation.

Effects of electromyography-driven robot-aided hand training with neuromuscular electrical stimulation on hand control performance after chronic stroke.

Science.gov (United States)

Rong, Wei; Tong, Kai Yu; Hu, Xiao Ling; Ho, Sze Kit

2015-03-01

An electromyography-driven robot system integrated with neuromuscular electrical stimulation (NMES) was developed to investigate its effectiveness on post-stroke rehabilitation. The performance of this system in assisting finger flexion/extension with different assistance combinations was evaluated in five stroke subjects. Then, a pilot study with 20-sessions training was conducted to evaluate the training's effectiveness. The results showed that combined assistance from the NMES-robot could improve finger movement accuracy, encourage muscle activation of the finger muscles and suppress excessive muscular activities in the elbow joint. When assistances from both NMES and the robot were 50% of their maximum assistances, finger-tracking performance had the best results, with the lowest root mean square error, greater range of motion, higher voluntary muscle activations of the finger joints and lower muscle co-contraction in the finger and elbow joints. Upper limb function improved after the 20-session training, indicated by the increased clinical scores of Fugl-Meyer Assessment, Action Research Arm Test and Wolf Motor Function Test. Muscle co-contraction was reduced in the finger and elbow joints reflected by the Modified Ashworth Scale. The findings demonstrated that an electromyography-driven NMES-robot used for chronic stroke improved hand function and tracking performance. Further research is warranted to validate the method on a larger scale. Implications for Rehabilitation The hand robotics and neuromuscular electrical stimulation (NMES) techniques are still separate systems in current post-stroke hand rehabilitation. This is the first study to investigate the combined effects of the NMES and robot on hand rehabilitation. The finger tracking performance was improved with the combined assistance from the EMG-driven NMES-robot hand system. The assistance from the robot could improve the finger movement accuracy and the assistance from the NMES could reduce the

The Combined Effects of Adaptive Control and Virtual Reality on Robot-Assisted Fine Hand Motion Rehabilitation in Chronic Stroke Patients: A Case Study.

Science.gov (United States)

Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping; Todd, Catherine

2018-01-01

Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive training that is needed to trigger neuroplasticity following a stroke. However, the lack of fully adaptive assist-as-needed control of the robotic devices and an inadequate immersive virtual environment that can promote active participation during training are obstacles hindering the achievement of better training results with fewer training sessions required. This study thus focuses on these research gaps by combining these 2 key components into a rehabilitation system, with special attention on the rehabilitation of fine hand motion skills. The effectiveness of the proposed system is tested by conducting clinical trials on a chronic stroke patient and verified through clinical evaluation methods by measuring the key kinematic features such as active range of motion (ROM), finger strength, and velocity. By comparing the pretraining and post-training results, the study demonstrates that the proposed method can further enhance the effectiveness of fine hand motion rehabilitation training by improving finger ROM, strength, and coordination. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Mind the hand

DEFF Research Database (Denmark)

Davidsen, Jacob; Christiansen, Ellen Tove

2014-01-01

Apart from touching the screen, what is the role of the hands for children collaborating around touchscreens? Based on embodied and multimodal interaction analysis of 8- and 9-year old pairs collaborating around touchscreens, we conclude that children use their hands to constrain and control acce...

The rubber hand illusion increases heat pain threshold.

Science.gov (United States)

Hegedüs, G; Darnai, G; Szolcsányi, T; Feldmann, Á; Janszky, J; Kállai, J

2014-09-01

Accumulating evidence shows that manipulations of cortical body representation, for example, by simply viewing one's own body, can relieve pain in healthy subjects. Despite the widespread use of the rubber hand illusion (RHI) as an effective experimental tool for the manipulation of bodily awareness, previous studies examining the analgesic effect of the RHI have produced conflicting results. We used noxious heat stimuli to induce finger pain in 29 healthy subjects, and we recorded the participants' pain thresholds and subjective pain ratings during the RHI and during the control conditions. Two control conditions were included in our experiment - a standard one with reduced illusion strength (asynchronous stroking control) and an additional one in which the participants viewed their own hand. Raw data showed that both the RHI and the vision of the own hand resulted in slightly higher pain thresholds than the asynchronous stroking control (illusion: 47.79 °C; own-hand: 47.99 °C; asynchronous: 47.52 °C). After logarithmic transformation to achieve normality, paired t-tests revealed that both increases in pain threshold were significant (illusion/asynchronous: p = 0.036; own-hand/asynchronous: p = 0.007). In contrast, there was no significant difference in pain threshold between the illusion and the own-hand conditions (p = 0.656). Pain rating scores were not log-normal, and Wilcoxon singed-rank tests found no significant differences in pain ratings between the study conditions. The RHI increases heat pain threshold and the analgesic effect of the RHI is comparable with that of seeing one's own hand. The latter finding may have clinical implications. © 2014 European Pain Federation - EFIC®

Home-based hand rehabilitation with a robotic glove in hemiplegic patients after stroke: a pilot feasibility study.

Science.gov (United States)

Bernocchi, Palmira; Mulè, Chiara; Vanoglio, Fabio; Taveggia, Giovanni; Luisa, Alberto; Scalvini, Simonetta

2018-03-01

To evaluate the feasibility and safety of home rehabilitation of the hand using a robotic glove, and, in addition, its effectiveness, in hemiplegic patients after stroke. In this non-randomized pilot study, 21 hemiplegic stroke patients (Ashworth spasticity index ≤ 3) were prescribed, after in-hospital rehabilitation, a 2-month home-program of intensive hand training using the Gloreha Lite glove that provides computer-controlled passive mobilization of the fingers. Feasibility was measured by: number of patients who completed the home-program, minutes of exercise and number of sessions/patient performed. Safety was assessed by: hand pain with a visual analog scale (VAS), Ashworth spasticity index for finger flexors, opponents of the thumb and wrist flexors, and hand edema (circumference of forearm, wrist and fingers), measured at start (T0) and end (T1) of rehabilitation. Hand motor function (Motricity Index, MI), fine manual dexterity (Nine Hole Peg Test, NHPT) and strength (Grip test) were also measured at T0 and T1. Patients performed, over a mean period 56 (49-63) days, a total of 1699 (1353-2045) min/patient of exercise with Gloreha Lite, 5.1 (4.3-5.8) days/week. Seventeen patients (81%) completed the full program. The mean VAS score of hand pain, Ashworth spasticity index and hand edema did not change significantly at T1 compared to T0. The MI, NHPT and Grip test improved significantly (p = 0.0020, 0.0156 and 0.0024, respectively) compared to baseline. Gloreha Lite is feasible and safe for use in home rehabilitation. The efficacy data show a therapeutic effect which need to be confirmed by a randomized controlled study.

Effectiveness Of Different House-Hold Hand Washing Agents On ...

African Journals Online (AJOL)

Hand hygiene is a very important procedure in infection control. Washing agents commonly in use were investigated for their effectiveness in reducing hand floral and cotton towel was used as drying agent. Agents studied include; water alone, carex soap, dettol, and imperial leather. The hands were inoculated (deliberate ...

Impaired hand size estimation in CRPS.

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Peltz, Elena; Seifert, Frank; Lanz, Stefan; Müller, Rüdiger; Maihöfner, Christian

2011-10-01

A triad of clinical symptoms, ie, autonomic, motor and sensory dysfunctions, characterizes complex regional pain syndromes (CRPS). Sensory dysfunction comprises sensory loss or spontaneous and stimulus-evoked pain. Furthermore, a disturbance in the body schema may occur. In the present study, patients with CRPS of the upper extremity and healthy controls estimated their hand sizes on the basis of expanded or compressed schematic drawings of hands. In patients with CRPS we found an impairment in accurate hand size estimation; patients estimated their own CRPS-affected hand to be larger than it actually was when measured objectively. Moreover, overestimation correlated significantly with disease duration, neglect score, and increase of two-point-discrimination-thresholds (TPDT) compared to the unaffected hand and to control subjects' estimations. In line with previous functional imaging studies in CRPS patients demonstrating changes in central somatotopic maps, we suggest an involvement of the central nervous system in this disruption of the body schema. Potential cortical areas may be the primary somatosensory and posterior parietal cortices, which have been proposed to play a critical role in integrating visuospatial information. CRPS patients perceive their affected hand to be bigger than it is. The magnitude of this overestimation correlates with disease duration, decreased tactile thresholds, and neglect-score. Suggesting a disrupted body schema as the source of this impairment, our findings corroborate the current assumption of a CNS involvement in CRPS. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

Fabrication, sensation and control of fluidic elastomer actuators and their application towards hand orthotics and prosthetics

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Zhao, Huichan

Due to their continuous and natural motion, fluidic elastomer actuators (FEAs) have shown potential in a range of robotic applications including prosthetics and orthotics. Despite their advantages and rapid developments, robots using these actuators still have several challenging issues to be addressed. First, the reliable production of low cost and complex actuators that can apply high forces is necessary, yet none of existing fabrication methods are both easy to implement and of high force output. Next, compliant or stretchable sensors that can be embedded into their bodies for sophisticated functions are required, however, many of these sensors suffer from hysteresis, fabrication complexity, chemical safety and environmental instability, and material incompatibility with soft actuators. Finally, feedback control for FEAs is necessary to achieve better performance, but most soft robots are still "open-loop". In this dissertation, I intend to help solve the above issues and drive the applications of soft robotics towards hand orthotics and prosthetics. First, I adapt rotational casting as a new manufacturing method for soft actuators. I present a cuboid soft actuator that can generate a force of >25 N at its tip, a near ten-fold increase over similar actuators previously reported. Next, I propose a soft orthotic finger with position control enabled via embedded optical fiber. I monitor both the static and dynamic states via the optical sensor and achieve the prescribed curvatures accurately and with stability by a gain-scheduled proportional-integral-derivative controller. Then I develop the soft orthotic fingers into a low-cost, closed-loop controlled, soft orthotic glove that can be worn by a typical human hand and helpful for grasping light objects, while also providing finger position control. I achieve motion control with inexpensive, binary pneumatic switches controlled by a simple finite-state-machine. Finally, I report the first use of stretchable optical

Development of the bedridden person support system using hand gesture.

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Ichimura, Kouhei; Magatani, Kazushige

2015-08-01

The purpose of this study is to support the bedridden and physically handicapped person who live independently. In this study, we developed Electric appliances control system that can be used on the bed. The subject can control Electric appliances using hand motion. Infrared sensors of a Kinect are used for the hand motion detection. Our developed system was tested with some normal subjects and results of the experiment were evaluated. In this experiment, all subjects laid on the bed and tried to control our system. As results, most of subjects were able to control our developed system perfectly. However, motion tracking of some subject's hand was reset forcibly. It was difficult for these subjects to make the system recognize his opened hand. From these results, we think if this problem will be improved our support system will be useful for the bedridden and physically handicapped persons.

Access to waterless hand sanitizer improves student hand hygiene behavior in primary schools in Nairobi, Kenya.

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Pickering, Amy J; Davis, Jennifer; Blum, Annalise G; Scalmanini, Jenna; Oyier, Beryl; Okoth, George; Breiman, Robert F; Ram, Pavani K

2013-09-01

Handwashing is difficult in settings with limited resources and water access. In primary schools within urban Kibera, Kenya, we investigated the impact of providing waterless hand sanitizer on student hand hygiene behavior. Two schools received a waterless hand sanitizer intervention, two schools received a handwashing with soap intervention, and two schools received no intervention. Hand cleaning behavior after toilet use was monitored for 2 months using structured observation. Hand cleaning after toileting was 82% at sanitizer schools (N = 2,507 toileting events), 38% at soap schools (N = 3,429), and 37% at control schools (N = 2,797). Students at sanitizer schools were 23% less likely to have observed rhinorrhea than control students (P = 0.02); reductions in student-reported gastrointestinal and respiratory illness symptoms were not statistically significant. Providing waterless hand sanitizer markedly increased student hand cleaning after toilet use, whereas the soap intervention did not. Waterless hand sanitizer may be a promising option to improve student hand cleansing behavior, particularly in schools with limited water access.

Hand held control unit for controlling a display screen-oriented computer game, and a display screen-oriented computer game having one or more such control units

NARCIS (Netherlands)

2001-01-01

A hand-held control unit is used to control a display screen-oriented computer game. The unit comprises a housing with a front side, a set of control members lying generally flush with the front side for through actuating thereof controlling actions of in-game display items, and an output for

Implementation of directly observed patient hand hygiene for hospitalized patients by hand hygiene ambassadors in Hong Kong.

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Cheng, Vincent C C; Tai, Josepha W M; Li, W S; Chau, P H; So, Simon Y C; Wong, Lisa M W; Ching, Radley H C; Ng, Modissa M L; Ho, Sara K Y; Lee, Doris W Y; Lee, W M; Wong, Sally C Y; Yuen, K Y

2016-06-01

The importance of compliance with hand hygiene by patients is increasingly recognized to prevent health care-associated infections. This descriptive study observed the effects of an education campaign, targeted to increase patients' self-initiated hand hygiene, and a hand hygiene ambassador-initiated directly observed hand hygiene program on patients' hand hygiene compliance in a university-affiliated hospital. The overall audited compliance of patients' self-initiated hand hygiene was only 37.5%, with a rate of 26.9% (112/416 episodes) before meals and medications, 27.5% (19/69 episodes) after using a urinal or bedpan, and 89.7% (87/97 episodes) after attending toilet facilities. Patients referred from a residential care home for older adults had significantly lower hand hygiene compliance (P = .007). Comparatively, the overall audited compliance of ambassador-initiated directly observed hand hygiene was 97.3% (428/440 episodes), which was significantly higher than patients' self-initiated hand hygiene via a patient education program (37.5%, 218/582 episodes, P hand hygiene can play an important role in improving compliance with hand hygiene by hospitalized patients. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Air Muscle Actuated Low Cost Humanoid Hand

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Peter Scarfe

2008-11-01

Full Text Available The control of humanoid robot hands has historically been expensive due to the cost of precision actuators. This paper presents the design and implementation of a low-cost air muscle actuated humanoid hand developed at Curtin University of Technology. This hand offers 10 individually controllable degrees of freedom ranging from the elbow to the fingers, with overall control handled through a computer GUI. The hand is actuated through 20 McKibben-style air muscles, each supplied by a pneumatic pressure-balancing valve that allows for proportional control to be achieved with simple and inexpensive components. The hand was successfully able to perform a number of human-equivalent tasks, such as grasping and relocating objects.

Air Muscle Actuated Low Cost Humanoid Hand

Directory of Open Access Journals (Sweden)

Peter Scarfe

2006-06-01

Full Text Available The control of humanoid robot hands has historically been expensive due to the cost of precision actuators. This paper presents the design and implementation of a low-cost air muscle actuated humanoid hand developed at Curtin University of Technology. This hand offers 10 individually controllable degrees of freedom ranging from the elbow to the fingers, with overall control handled through a computer GUI. The hand is actuated through 20 McKibben-style air muscles, each supplied by a pneumatic pressure-balancing valve that allows for proportional control to be achieved with simple and inexpensive components. The hand was successfully able to perform a number of human-equivalent tasks, such as grasping and relocating objects.

Integrated, multidisciplinary care for hand eczema: design of a randomized controlled trial and cost-effectiveness study.

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Gils, R.F. van; Valk, P.G.M. van der; Bruynzeel, D.; Coenraads, P.J.; Boot, C.R.L.; Mechelen, W. van; Anema, J.R.

2009-01-01

BACKGROUND: The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity

Hydroxychloroquine effectiveness in reducing symptoms of hand osteoarthritis (HERO): study protocol for a randomized controlled trial

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2013-01-01

Background Osteoarthritis (OA) is the most common type of arthritis, causing significant joint pain and disability. It is already a major cause of healthcare expenditure and its incidence will further increase with the ageing population. Current treatments for OA have major limitations and new analgesic treatments are needed. Synovitis is prevalent in OA and is associated with pain. Hydroxychloroquine is used in routine practice for treating synovitis in inflammatory arthritides, such as rheumatoid arthritis. We propose that treating patients with symptomatic hand OA with hydroxychloroquine will be a practical and safe treatment to reduce synovitis and pain. Methods/design HERO is an investigator-initiated, multicentre, randomized, double-blind, placebo-controlled trial. A total of 252 subjects with symptomatic hand OA will be recruited across primary and secondary care sites in the UK and randomized on a 1:1 basis to active treatment or placebo for 12 months. Daily medication dose will range from 200 to 400 mg according to ideal body weight. The primary endpoint is change in average hand pain during the previous two weeks (measured on a numerical rating scale (NRS)) between baseline and six months. Secondary endpoints include other self-reported pain, function and quality-of-life measures and radiographic structural change at 12 months. A health economics analysis will also be performed. An ultrasound substudy will be conducted to examine baseline levels of synovitis. Linear and logistic regression will be used to compare changes between groups using univariable and multivariable modelling analyses. All analyses will be conducted on an intention-to-treat basis. Discussion The HERO trial is designed to examine whether hydroxychloroquine is an effective analgesic treatment for OA and whether it provides any long-term structural benefit. The ultrasound substudy will address whether baseline synovitis is a predictor of therapeutic response. This will potentially

Clean Hands Count

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Alcohol-free instant hand sanitizer reduces elementary school illness absenteeism.

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Dyer, D L; Shinder, A; Shinder, F

2000-10-01

BACKGROUND AND HYPOTHESES: A substantial percentage of school absenteeism among children is related to transmissible infection. Rates of transmission can be reduced by hand washing with soap and water, but such washing occurs infrequently. This study tested whether an alcohol-free instant hand sanitizer (CleanHands) could reduce illness absenteeism in school-age children. A 10-week, open-label, crossover study was performed on 420 elementary school-age children (ages 5-12). Students were given a brief orientation immediately prior to the start of the study on the relationship of germs, illness, and hand washing. Each student in the treatment group then received the test product in individual bottles, with instructions to apply one to two sprays to the hands after coming into the classroom, before eating, and after using the restroom, in addition to their normal hand washing with soap and water. The control group was instructed to continue hand washing as normal with non-medicated soap. After 4 weeks of treatment and a 2-week wash-out period, the control and experimental groups were reversed. Data gathered on absenteeism were classified as gastrointestinal or respiratory related and normalized for nonillness-related absenteeism and school holidays. Compared to the hand washing-only control group, students using CleanHands were found to have 41.9% fewer illness-related absence days, representing a 28.9% and a 49.7% drop in gastrointestinal- and respiratory-related illnesses, respectively. Likewise, absence incidence decreased by 31.7%, consisting of a 44.2% and 50.2% decrease in incidence of gastrointestinal- and respiratory-related illnesses, respectively. No adverse events were reported during the study. Daily use of the instant hand sanitizer was associated with significantly lower rates of illness-related absenteeism.

Getting Their Hands Dirty: Qualitative Study on Hands-on Learning for Architectural Students in Design-build Course

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Zunaibi B. Abdullah

2011-06-01

Full Text Available This qualitative study provides an in-depth perspective of hands-on learning through the observation and analysis of architectural students' views in a design-build program at the University of Nebraska-Lincoln during the fall semester of 2008. Qualitative data was gathered from 14 participants involved in the construction of a low energy double-storey house in the city of Lincoln, Nebraska. The study inventoried the requisite characteristics of a design-build course. Participants' views and activities were studied to ascribe the qualitative benefits of hands-on learning. In addition, students' motivation towards hands-on activities were evaluated in reference to student confidence and independence levels towards their future career as architects, designers or other design-build professionals. The findings showed the design-build course could offer a specific knowledge that link between theoretical subjects and the practical expect of building contractions.

Clean Hands Count

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Clean Hands Count

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Cortical Asymmetries during Hand Laterality Task Vary with Hand Laterality: A fMRI Study in 295 Participants

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Mellet, Emmanuel; Mazoyer, Bernard; Leroux, Gaelle; Joliot, Marc; Tzourio-Mazoyer, Nathalie

2016-01-01

The aim of this study was to characterize, using fMRI, the functional asymmetries of hand laterality task (HLT) in a sample of 295 participants balanced for handedness. During HLT, participants have to decide whether the displayed picture of a hand represent a right or a left hand. Pictures of hands’ back view were presented for 150 ms in the right or left hemifield. At the whole hemisphere level, we evidenced that the laterality of the hand and of the hemifield in which the picture was displayed combined their effects on the hemispheric asymmetry in an additive way. We then identified a set of 17 functional homotopic regions of interest (hROIs) including premotor, motor, somatosensory and parietal regions, whose activity and asymmetry varied with the laterality of the presented hands. When the laterality of a right hand had to be evaluated, these areas showed stronger leftward asymmetry, the hROI located in the primary motor area showing a significant larger effect than all other hROIs. In addition a subset of six parietal regions involved in visuo-motor integration together with two postcentral areas showed a variation in asymmetry with hemifield of presentation. Finally, while handedness had no effect at the hemispheric level, two regions located in the parietal operculum and intraparietal sulcus exhibited larger leftward asymmetry with right handedness independently of the hand of presentation. The present results extend those of previous works in showing a shift of asymmetries during HLT according to the hand presented in sensorimotor areas including primary motor cortex. This shift was not affected by manual preference. They also demonstrate that the coordination of visual information and handedness identification of hands relied on the coexistence of contralateral motor and visual representations in the superior parietal lobe and the postcentral gyrus. PMID:27999536

fMRI-compatible rehabilitation hand device

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Tzika Aria

2006-10-01

Full Text Available Abstract Background Functional magnetic resonance imaging (fMRI has been widely used in studying human brain functions and neurorehabilitation. In order to develop complex and well-controlled fMRI paradigms, interfaces that can precisely control and measure output force and kinematics of the movements in human subjects are needed. Optimized state-of-the-art fMRI methods, combined with magnetic resonance (MR compatible robotic devices for rehabilitation, can assist therapists to quantify, monitor, and improve physical rehabilitation. To achieve this goal, robotic or mechatronic devices with actuators and sensors need to be introduced into an MR environment. The common standard mechanical parts can not be used in MR environment and MR compatibility has been a tough hurdle for device developers. Methods This paper presents the design, fabrication and preliminary testing of a novel, one degree of freedom, MR compatible, computer controlled, variable resistance hand device that may be used in brain MR imaging during hand grip rehabilitation. We named the device MR_CHIROD (Magnetic Resonance Compatible Smart Hand Interfaced Rehabilitation Device. A novel feature of the device is the use of Electro-Rheological Fluids (ERFs to achieve tunable and controllable resistive force generation. ERFs are fluids that experience dramatic changes in rheological properties, such as viscosity or yield stress, in the presence of an electric field. The device consists of four major subsystems: a an ERF based resistive element; b a gearbox; c two handles and d two sensors, one optical encoder and one force sensor, to measure the patient induced motion and force. The smart hand device is designed to resist up to 50% of the maximum level of gripping force of a human hand and be controlled in real time. Results Laboratory tests of the device indicate that it was able to meet its design objective to resist up to approximately 50% of the maximum handgrip force. The detailed

Access to Waterless Hand Sanitizer Improves Student Hand Hygiene Behavior in Primary Schools in Nairobi, Kenya

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Pickering, Amy J.; Davis, Jennifer; Blum, Annalise G.; Scalmanini, Jenna; Oyier, Beryl; Okoth, George; Breiman, Robert F.; Ram, Pavani K.

2013-01-01

Handwashing is difficult in settings with limited resources and water access. In primary schools within urban Kibera, Kenya, we investigated the impact of providing waterless hand sanitizer on student hand hygiene behavior. Two schools received a waterless hand sanitizer intervention, two schools received a handwashing with soap intervention, and two schools received no intervention. Hand cleaning behavior after toilet use was monitored for 2 months using structured observation. Hand cleaning after toileting was 82% at sanitizer schools (N = 2,507 toileting events), 38% at soap schools (N = 3,429), and 37% at control schools (N = 2,797). Students at sanitizer schools were 23% less likely to have observed rhinorrhea than control students (P = 0.02); reductions in student-reported gastrointestinal and respiratory illness symptoms were not statistically significant. Providing waterless hand sanitizer markedly increased student hand cleaning after toilet use, whereas the soap intervention did not. Waterless hand sanitizer may be a promising option to improve student hand cleansing behavior, particularly in schools with limited water access. PMID:23836575

The Effects of Age, Gender, and Hand on Force Control Capabilities of Healthy Adults.

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Lee, Baekhee; Lee, Mina; Yoh, Myeung Sook; You, Heecheon; Park, Hyunji; Jung, Kihyo; Lee, Byung Hwa; Na, Duk L; Kim, Geon Ha

2015-12-01

The present study examined the effects of age (20s to 70s), gender (male and female), and hand (dominant and nondominant) on force control capabilities (FCCs) in four force control phases (initiation, development, maintenance, and termination). Normative data of FCCs by force control phase are needed for various populations in age and gender to identify a type of motor performance reduction and its severity. FCCs of 360 participants (30 for each combination of age group and gender) were measured using a finger dynamometer and quantified in terms of initiation time (IT), development time (DT), maintenance error (ME), and termination time (TT). Although gradual increases (1%~28%) by age were shown in IT, DT, and TT, a dramatic increase in ME was observed among participants in their 50s (26%), 60s (68%), and 70s (160%) compared to those in their 20s~40s. The most distinctive interaction effect of age and gender was found in ME out of the four FCC measures. Lastly, hand and its related interactions were not found significant. Normative FCC data were established for four age groups (20s~40s, 50s, 60s, and 70s) and gender. The normative FCC data can be used for evaluating an individual's motor performance, screening patients with brain disorders, and designing input devices triggered and/or operated by the finger. © 2015, Human Factors and Ergonomics Society.

Toward the restoration of hand use to a paralyzed monkey: brain-controlled functional electrical stimulation of forearm muscles.

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Eric A Pohlmeyer

2009-06-01

Full Text Available Loss of hand use is considered by many spinal cord injury survivors to be the most devastating consequence of their injury. Functional electrical stimulation (FES of forearm and hand muscles has been used to provide basic, voluntary hand grasp to hundreds of human patients. Current approaches typically grade pre-programmed patterns of muscle activation using simple control signals, such as those derived from residual movement or muscle activity. However, the use of such fixed stimulation patterns limits hand function to the few tasks programmed into the controller. In contrast, we are developing a system that uses neural signals recorded from a multi-electrode array implanted in the motor cortex; this system has the potential to provide independent control of multiple muscles over a broad range of functional tasks. Two monkeys were able to use this cortically controlled FES system to control the contraction of four forearm muscles despite temporary limb paralysis. The amount of wrist force the monkeys were able to produce in a one-dimensional force tracking task was significantly increased. Furthermore, the monkeys were able to control the magnitude and time course of the force with sufficient accuracy to track visually displayed force targets at speeds reduced by only one-third to one-half of normal. Although these results were achieved by controlling only four muscles, there is no fundamental reason why the same methods could not be scaled up to control a larger number of muscles. We believe these results provide an important proof of concept that brain-controlled FES prostheses could ultimately be of great benefit to paralyzed patients with injuries in the mid-cervical spinal cord.

An EEG/EOG-based hybrid brain-neural computer interaction (BNCI) system to control an exoskeleton for the paralyzed hand.

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Soekadar, Surjo R; Witkowski, Matthias; Vitiello, Nicola; Birbaumer, Niels

2015-06-01

The loss of hand function can result in severe physical and psychosocial impairment. Thus, compensation of a lost hand function using assistive robotics that can be operated in daily life is very desirable. However, versatile, intuitive, and reliable control of assistive robotics is still an unsolved challenge. Here, we introduce a novel brain/neural-computer interaction (BNCI) system that integrates electroencephalography (EEG) and electrooculography (EOG) to improve control of assistive robotics in daily life environments. To evaluate the applicability and performance of this hybrid approach, five healthy volunteers (HV) (four men, average age 26.5 ± 3.8 years) and a 34-year-old patient with complete finger paralysis due to a brachial plexus injury (BPI) used EEG (condition 1) and EEG/EOG (condition 2) to control grasping motions of a hand exoskeleton. All participants were able to control the BNCI system (BNCI control performance HV: 70.24 ± 16.71%, BPI: 65.93 ± 24.27%), but inclusion of EOG significantly improved performance across all participants (HV: 80.65 ± 11.28, BPI: 76.03 ± 18.32%). This suggests that hybrid BNCI systems can achieve substantially better control over assistive devices, e.g., a hand exoskeleton, than systems using brain signals alone and thus may increase applicability of brain-controlled assistive devices in daily life environments.

COMPARISON THE NUMBER OF BACTERIA BETWEEN WASHING HANDS USING SOAP AND HAND SANITIZER AS A BACTERIOLOGY LEARNING RESOURCE FOR STUDENTS

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Satya Darmayani

2017-11-01

Full Text Available Hands are the principal carriers of bacterial diseases, therefore very important to know that washing hands with soap or hand sanitizer is highly effective healthy behaviors to reduce bacteria in the palm. This study aimed to determine the total number of bacteria between washing hands with soap and hand sanitizer, also applying the results of these studies as a learning resource in bacteriology. The research design was the true experiment with pretest-posttest control group research design and laboratory examination. Analysis of data using paired t-test and independent sample t-test with α = 0.05. The result using paired t-test obtained t count= 2.48921> t 0.05 (14 = 2.14479 (with liquid soap, obtained t count= 2.32937> t 0.05 (14 = 2.14479 (with hand sanitizer. As for the comparison of the total number of bacteria include washing hands with soap and hand sanitizer using independent samples t-test obtained results there were differences in the total number of bacteria include washing hands with liquid soap and hand sanitizer with t count= 2.23755> t 0.05 ( 13 = 2.16037. That results showed hand sanitizer more effective to reduce the number of bacteria than the liquid soap, that was hand sanitizer 96% and liquid soap by 95%.

Hand abnormalities in diabetics: Prevalence and predictors in Erbil city

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Wallada Khalid Mohammed

2017-12-01

Full Text Available Background and objective: The characteristics of diabetic foot disease are well documented in Erbil city; henceforth it would be appropriate to evaluate the problem of diabetic hand syndrome in this environment and to assess the frequency and the most important clinical and biochemical risk factors for the development of these complications. Methods: This is an observational case-control study done over a period of one year. A total of 100 consecutive patients with type 2 diabetes mellitus were enrolled and described as cases. One hundred age- and sex-matched nondiabetic individuals were taken in the control group; all were examined and then underwent the appropriate investigations. Results: Of the total 100 diabetic patients, 63% had macrovascular complications and 60% had one or more hand disorders. Limited joint mobility (47% vs. 18%, respectively; P = 0.0001 and Dupuytren’s contracture (16% vs. 2%, respectively; P = 0.001 were significantly higher in type 2 diabetes mellitus patients than in the controls, but not trigger finger. These hand soft-tissue changes correlated significantly with poor glycemic control. Conclusion: This study shows a high prevalence of hand disorders in diabetic patients with the limited joint mobility being the most common hand disorder. The hand soft tissue changes are under recognized in diabetic patients, occurring in 60% of the cases. We recommend that physicians should consider examining the periarticular region of the joints in the hands in each diabetic patient.

Are we ready to move beyond the reductionist approach of classical synergy control?. Comment on "Hand synergies: Integration of robotics and neuroscience for understanding the control of biological and artificial hands" by Marco Santello et al.

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Lacquaniti, Francesco; Ivanenko, Yuri P.; Zago, Myrka

2016-07-01

Starting from the classical concepts introduced by Sherrington [1] and considerably elaborated by Bernstein [2], much has been learned about motor synergies in the last several years. The contributions of the group funded by the European project ;The Hand Embodied; are remarkable in the field of biological and robotic control of the hand based on synergies, and they are reflected in this enjoyable review [3]. There, Santello et al. adopt Bernstein's definition of motor synergies as multiple elements working together towards a common goal, with the result that multiple degrees of freedom are controlled within a lower-dimensional space than the available number of dimensions.

Effect of hand sanitizer use on elementary school absenteeism.

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Hammond, B; Ali, Y; Fendler, E; Dolan, M; Donovan, S

2000-10-01

Several studies have indicated a connection between handwashing and illness-related absenteeism in school settings. The difficulty of ensuring consistent and effective handwashing among student populations has also been noted. The purpose of this study was to assess the effectiveness of the use of an alcohol gel hand sanitizer in the classroom to help decrease the illness-related absentee rate for elementary school students. This study involved 5 individual school districts, 16 individual schools, and more than 6000 students in Delaware, Ohio, Tennessee, and California. Individual schools in each district were paired into product and control groups. In the product group schools, an alcohol gel hand sanitizer was used by the students and staff when entering and leaving the classroom. Absenteeism due to infection was recorded, and the data were statistically analyzed. The overall reduction in absenteeism due to infection in the schools included in this study was 19.8% for schools that used an alcohol gel hand sanitizer compared with the control schools (P sanitizer was used. Elementary school absenteeism due to infection is significantly reduced when an alcohol gel hand sanitizer is used in the classroom as part of a hand hygiene program.

Intervening with healthcare workers' hand hygiene compliance, knowledge, and perception in a limited-resource hospital in Indonesia: A randomized controlled trial study

NARCIS (Netherlands)

D. Santosaningsih (Dewi); Erikawati, D. (Dewi); T. Santoso; Noorhamdani, N. (Noorhamdani); Ratridewi, I. (Irene); Candradikusuma, D. (Didi); Chozin, I.N. (Iin N.); Huwae, T.E.C.J. (Thomas E.C.J.); van der Donk, G. (Gwen); van Boven, E. (Eva); A.F. Voor in 't Holt (Anne); H.A. Verbrugh (Henri); J.A. Severin (Juliëtte)

2017-01-01

textabstractBackground: Hand hygiene is recognized as an important measure to prevent healthcare-associated infections. Hand hygiene adherence among healthcare workers is associated with their knowledge and perception. This study aimed to evaluate the effect of three different educational programs

Combined analysis of cortical (EEG) and nerve stump signals improves robotic hand control.

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Tombini, Mario; Rigosa, Jacopo; Zappasodi, Filippo; Porcaro, Camillo; Citi, Luca; Carpaneto, Jacopo; Rossini, Paolo Maria; Micera, Silvestro

2012-01-01

Interfacing an amputee's upper-extremity stump nerves to control a robotic hand requires training of the individual and algorithms to process interactions between cortical and peripheral signals. To evaluate for the first time whether EEG-driven analysis of peripheral neural signals as an amputee practices could improve the classification of motor commands. Four thin-film longitudinal intrafascicular electrodes (tf-LIFEs-4) were implanted in the median and ulnar nerves of the stump in the distal upper arm for 4 weeks. Artificial intelligence classifiers were implemented to analyze LIFE signals recorded while the participant tried to perform 3 different hand and finger movements as pictures representing these tasks were randomly presented on a screen. In the final week, the participant was trained to perform the same movements with a robotic hand prosthesis through modulation of tf-LIFE-4 signals. To improve the classification performance, an event-related desynchronization/synchronization (ERD/ERS) procedure was applied to EEG data to identify the exact timing of each motor command. Real-time control of neural (motor) output was achieved by the participant. By focusing electroneurographic (ENG) signal analysis in an EEG-driven time window, movement classification performance improved. After training, the participant regained normal modulation of background rhythms for movement preparation (α/β band desynchronization) in the sensorimotor area contralateral to the missing limb. Moreover, coherence analysis found a restored α band synchronization of Rolandic area with frontal and parietal ipsilateral regions, similar to that observed in the opposite hemisphere for movement of the intact hand. Of note, phantom limb pain (PLP) resolved for several months. Combining information from both cortical (EEG) and stump nerve (ENG) signals improved the classification performance compared with tf-LIFE signals processing alone; training led to cortical reorganization and

Hand dysfunction in type 2 diabetes mellitus: Systematic review with meta-analysis.

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Gundmi, Shubha; Maiya, Arun G; Bhat, Anil K; Ravishankar, N; Hande, Manjunatha H; Rajagopal, K V

2018-03-01

People with type 2 diabetes mellitus frequently show complications in feet and hands. However, the literature has mostly focused on foot complications. The disease can affect the strength and dexterity of the hands, thereby reducing function. This systematic review and meta-analysis focused on identifying the existing evidence on how type 2 diabetes mellitus affects hand strength, dexterity and function. We searched MEDLINE via PubMed, CINHAL, Scopus and Web of Science, and the Cochrane central register of controlled trials for reports of studies of grip and pinch strength as well as hand dexterity and function evaluated by questionnaires comparing patients with type 2 diabetes mellitus and healthy controls that were published between 1990 and 2017. Data are reported as standardized mean difference (SMD) or mean difference (MD) and 95% confidence intervals (CIs). Among 2077 records retrieved, only 7 full-text articles were available for meta-analysis. For both the dominant and non-dominant hand, type 2 diabetes mellitus negatively affected grip strength (SMD: -1.03; 95% CI: -2.24 to 0.18 and -1.37, -3.07 to 0.33) and pinch strength (-1.09, -2.56 to 0.38 and -1.12, -2.73 to 0.49), although not significantly. Dexterity of the dominant hand did not differ between diabetes and control groups but was poorer for the non-dominant hand, although not significantly. Hand function was worse for diabetes than control groups in 2 studies (MD: -8.7; 95% CI: -16.88 to -1.52 and 4.69, 2.03 to 7.35). This systematic review with meta-analysis suggested reduced hand function, specifically grip and pinch strength, for people with type 2 diabetes mellitus versus healthy controls. However, the sample size for all studies was low. Hence, we need studies with adequate sample size and randomized controlled trials to provide statistically significant results. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

A behavioural change package to prevent hand dermatitis in nurses working in the national health service (the SCIN trial): study protocol for a cluster randomised controlled trial.

Science.gov (United States)

Madan, Ira; Parsons, Vaughan; Cookson, Barry; English, John; Lavender, Tina; McCrone, Paul; Murphy, Caroline; Ntani, Georgia; Rushton, Lesley; Smedley, Julia; Williams, Hywel; Wright, Alison; Coggon, David

2016-03-17

Hand dermatitis can be a serious health problem in healthcare workers. While a range of skin care strategies and policy directives have been developed in recent years to minimise the risk, their effectiveness and cost-effectiveness remain unclear. Evidence now suggests that psychological theory can facilitate behaviour change with respect to improved hand care practices. Therefore, we will test the hypothesis that a behavioural change intervention to improve hand care, based on the Theory of Planned Behaviour and implementation intentions, coupled with provision of hand moisturisers, can produce a clinically useful reduction in the occurrence of hand dermatitis, when compared to standard care, among nurses working in the UK National Health Service (NHS) who are particularly at risk. Secondary aims will be to assess impacts on participants' beliefs and behaviour regarding hand care. In addition, we will assess the cost-effectiveness of the intervention in comparison with normal care. We will conduct a cluster randomised controlled trial at 35 NHS hospital trusts/health boards/universities, focussing on student nurses with a previous history of atopic disease or hand eczema and on nurses in intensive care units. Nurses at 'intervention-light' sites will be managed according to what would currently be regarded as best practice, with provision of an advice leaflet about optimal hand care to prevent hand dermatitis and encouragement to contact their occupational health (OH) department early if hand dermatitis occurs. Nurses at 'intervention-plus' sites will additionally receive a behavioural change programme (BCP) with on-going active reinforcement of its messages, and enhanced provision of moisturising cream. The impact of the interventions will be compared using information collected by questionnaires and through standardised photographs of the hands and wrists, collected at baseline and after 12 months follow-up. In addition, we will assemble relevant economic data

Hand trauma: A prospective observational study reporting diagnostic concordance in emergency hand trauma which supports centralised service improvements.

Science.gov (United States)

Miranda, B H; Spilsbury, Z P; Rosala-Hallas, A; Cerovac, S

2016-10-01

Hand injuries are common, contributing up to 30% of accident and emergency (A&E) attendances. The aim of this study was to prospectively analyse the pathological demographics of hand injuries in a level 1 trauma centre with a Hand Trauma Unit and direct A&E links, and compare clinical and intra-operative findings. The null hypothesis was that there would be no differences between clinical and intra-operative findings (100% diagnostic concordance). Data were prospectively collected for referrals during 2012. Referral diagnosis, additional pathologies found on clinical assessment and intra-operative findings were documented on a live database accessible from both the Hand Unit and associated operating theatres. Odds ratios were calculated using SAS. Injuries (1526) were identified in 1308 patients included in the study. Diagnostic concordance between Hand Unit clinical examination and intra-operative findings was 92.5% ± 2.85% (mean ± SEM); this was lower for flexor tendon injuries (56.3%) because a greater number of additional pathologies were found intra-operatively (2.25 ± 0.10). This 'trend' was noted across multiple referral pathologies including phalangeal fractures (1.28 ± 0.02; 82.9%), lacerations (1.33 ± 0.04; 79.1%), extensor tendon injuries (1.30 ± 0.05; 87.8%) and dislocations (1.18 ± 0.05; 87.8%). Odds ratio analysis indicated a relationship between primary referral diagnoses that were more or less likely to be associated with additional injuries (p management of hand trauma. Our findings, coupled with the presented relevant literature reports, lead us to advocate that A&E departments should move towards a system wherein links to specialist hand trauma services are in place; we hereby present useful data for hospitals implementing such services. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Dual-task performance involving hand dexterity and cognitive tasks and daily functioning in people with schizophrenia: a pilot study.

Science.gov (United States)

Lin, Keh-chung; Wu, Yi-fang; Chen, I-chen; Tsai, Pei-luen; Wu, Ching-yi; Chen, Chia-ling

2015-01-01

This study investigated separate and concurrent performance on cognitive and hand dexterity tasks and the relationship to daily functioning in 16 people with schizophrenia and 16 healthy control participants. Participants performed the Purdue Pegboard Test and the Serial Seven Subtraction Test under single- and dual-task conditions and completed two daily functioning evaluations. The hand dexterity of all participants declined in the dual-task condition, but the discrepancy between single-task and dual-task hand dexterity was greater in the schizophrenia group than in the control group (p.70, for all). The extent of discrepancy in hand dexterity was negatively correlated with daily functioning in the schizophrenia group (rs=-.3 to -.5, ps=.04-.26). Ability to perform dual tasks may be an indicator of daily functioning in people with schizophrenia. Use of dual-task training may be considered as a therapeutic activity with these clients. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Closed-loop control of spinal cord stimulation to restore hand function after paralysis

Directory of Open Access Journals (Sweden)

Jonas B Zimmermann

2014-05-01

Full Text Available As yet, no cure exists for upper-limb paralysis resulting from the damage to motor pathways after spinal cord injury or stroke. Recently, neural activity from the motor cortex of paralyzed individuals has been used to control the movements of a robot arm but restoring function to patients’ actual limbs remains a considerable challenge. Previously we have shown that electrical stimulation of the cervical spinal cord in anesthetized monkeys can elicit functional upper-limb movements like reaching and grasping. Here we show that stimulation can be controlled using cortical activity in awake animals to bypass disruption of the corticospinal system, restoring their ability to perform a simple upper-limb task. Monkeys were trained to grasp and pull a spring-loaded handle. After temporary paralysis of the hand was induced by reversible inactivation of primary motor cortex using muscimol, grasp-related single-unit activity from the ventral premotor cortex was converted into stimulation patterns delivered in real-time to the cervical spinal grey matter. During periods of closed-loop stimulation, task-modulated electromyogram, movement amplitude and task success rate were improved relative to interleaved control periods without stimulation. In some sessions, single motor unit activity from weakly active muscles was also used successfully to control stimulation. These results are the first use of a neural prosthesis to improve the hand function of primates after motor cortex disruption, and demonstrate the potential for closed-loop cortical control of spinal cord stimulation to reanimate paralyzed limbs.

Custom-made silicone hand prosthesis: A case study.

Science.gov (United States)

Nayak, S; Lenka, P K; Equebal, A; Biswas, A

2016-09-01

Up to now, a cosmetic glove was the most common method for managing transmetacarpal (TMC) and carpometacarpal (CMC) amputations, but it is devoid of markings and body color. At this amputation level, it is very difficult to fit a functional prosthesis because of the short available length, unsightly shape, grafted skin, contracture and lack of functional prosthetic options. A 30-year-old male came to our clinic with amputation at the 1st to 4th carpometacarpal level and a 5th metacarpal that was projected laterally and fused with the carpal bone. The stump had grafted skin, redness, and an unhealed suture line. He complained of pain projected over the metacarpal and suture area. The clinical team members decided to fabricate a custom-made silicone hand prosthesis to accommodate the stump, protect the grafted skin, improve the hand's appearance and provide some passive function. The custom silicone hand prosthesis was fabricated with modified flexible wires to provide passive interphalangeal movement. Basic training, care and maintenance instructions for the prosthesis were given to the patient. The silicone hand prosthesis was able to restore the appearance of the lost digits and provide some passive function. His pain (VAS score) was reduced. Improvement in activities of daily living was found in the DASH questionnaire and Jebsen-Taylor Hand Function test. A silicone glove is a good option for more distal amputations, as it can accommodate any deformity, protect the skin, enhance the appearance and provide functional assistance. This case study provides a simple method to get passively movable fingers after proximal hand amputation. Copyright © 2016. Published by Elsevier Masson SAS.

Disturbances in body ownership in schizophrenia: evidence from the rubber hand illusion and case study of a spontaneous out-of-body experience.

Directory of Open Access Journals (Sweden)

Katharine N Thakkar

Full Text Available A weakened sense of self may contribute to psychotic experiences. Body ownership, one component of self-awareness, can be studied with the rubber hand illusion (RHI. Watching a rubber hand being stroked while one's unseen hand is stroked synchronously can lead to a sense of ownership over the rubber hand, a shift in perceived position of the real hand, and a limb-specific drop in stimulated hand temperature. We aimed to assess the RHI in schizophrenia using quantifiable measures: proprioceptive drift and stimulation-dependent changes in hand temperature.The RHI was elicited in 24 schizophrenia patients and 21 matched controls by placing their unseen hand adjacent to a visible rubber hand and brushing real and rubber hands synchronously or asynchronously. Perceived finger location was measured before and after stimulation. Hand temperature was taken before and during stimulation. Subjective strength of the illusion was assessed by a questionnaire.Across groups, the RHI was stronger during synchronous stimulation, indicated by self-report and proprioceptive drift. Patients reported a stronger RHI than controls. Self-reported strength of RHI was associated with schizotypy in controls Proprioceptive drift was larger in patients, but only following synchronous stimulation. Further, we observed stimulation-dependent changes in skin temperature. During right hand stimulation, temperature dropped in the stimulated hand and rose in the unstimulated hand. Interestingly, induction of RHI led to an out-of-body experience in one patient, linking body disownership and psychotic experiences.The RHI is quantitatively and qualitatively stronger in schizophrenia. These findings suggest that patients have a more flexible body representation and weakened sense of self, and potentially indicate abnormalities in temporo-parietal networks implicated in body ownership. Further, results suggest that these body ownership disturbances might be at the heart of a subset of

Disturbances in Body Ownership in Schizophrenia: Evidence from the Rubber Hand Illusion and Case Study of a Spontaneous Out-of-Body Experience

Science.gov (United States)

Thakkar, Katharine N.; Nichols, Heathman S.; McIntosh, Lindsey G.; Park, Sohee

2011-01-01

Background A weakened sense of self may contribute to psychotic experiences. Body ownership, one component of self-awareness, can be studied with the rubber hand illusion (RHI). Watching a rubber hand being stroked while one's unseen hand is stroked synchronously can lead to a sense of ownership over the rubber hand, a shift in perceived position of the real hand, and a limb-specific drop in stimulated hand temperature. We aimed to assess the RHI in schizophrenia using quantifiable measures: proprioceptive drift and stimulation-dependent changes in hand temperature. Methods The RHI was elicited in 24 schizophrenia patients and 21 matched controls by placing their unseen hand adjacent to a visible rubber hand and brushing real and rubber hands synchronously or asynchronously. Perceived finger location was measured before and after stimulation. Hand temperature was taken before and during stimulation. Subjective strength of the illusion was assessed by a questionnaire. Results Across groups, the RHI was stronger during synchronous stimulation, indicated by self-report and proprioceptive drift. Patients reported a stronger RHI than controls. Self-reported strength of RHI was associated with schizotypy in controls Proprioceptive drift was larger in patients, but only following synchronous stimulation. Further, we observed stimulation-dependent changes in skin temperature. During right hand stimulation, temperature dropped in the stimulated hand and rose in the unstimulated hand. Interestingly, induction of RHI led to an out-of-body experience in one patient, linking body disownership and psychotic experiences. Conclusions The RHI is quantitatively and qualitatively stronger in schizophrenia. These findings suggest that patients have a more flexible body representation and weakened sense of self, and potentially indicate abnormalities in temporo-parietal networks implicated in body ownership. Further, results suggest that these body ownership disturbances might be at

A synergy-driven approach to a myoelectric hand.

Science.gov (United States)

Godfrey, S B; Ajoudani, A; Catalano, M; Grioli, G; Bicchi, A

2013-06-01

In this paper, we present the Pisa/IIT SoftHand with myoelectric control as a synergy-driven approach for a prosthetic hand. Commercially available myoelectric hands are more expensive, heavier, and less robust than their body-powered counterparts; however, they can offer greater freedom of motion and a more aesthetically pleasing appearance. The Pisa/IIT SoftHand is built on the motor control principle of synergies through which the immense complexity of the hand is simplified into distinct motor patterns. As the SoftHand grasps, it follows a synergistic path with built-in flexibility to allow grasping of a wide variety of objects with a single motor. Here we test, as a proof-of-concept, 4 myoelectric controllers: a standard controller in which the EMG signal is used only as a position reference, an impedance controller that determines both position and stiffness references from the EMG input, a standard controller with vibrotactile force feedback, and finally a combined vibrotactile-impedance (VI) controller. Four healthy subjects tested the control algorithms by grasping various objects. All controllers were sufficient for basic grasping, however the impedance and vibrotactile controllers reduced the physical and cognitive load on the user, while the combined VI mode was the easiest to use of the four. While these results need to be validated with amputees, they suggest a low-cost, robust hand employing hardware-based synergies is a viable alternative to traditional myoelectric prostheses.

The validity and reliability study of Hand Hygiene Belief Scale and Hand Hygiene Practices Inventory

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Mevlude Karadag

2016-06-01

Conclusion: The adaptation of translated and ldquo;Hand Hygiene Belief Scale and Hand Hygiene Practices Inventory and rdquo; in Turkey is found to be reliable and valid to evaluate hand hygiene belief and practices. [Cukurova Med J 2016; 41(2.000: 271-284

Kinetic study of human hand sodium using local in vivo neutron activation analysis

International Nuclear Information System (INIS)

Cohen Boulakia, Francine.

1978-01-01

Using local 'in vivo' activation analysis, turnover of human hand sodium is studied in 14 subjects, 7 controls and 7 decalcified osteoporotics patients. The hand of each subject is irradiated with neutrons emitted by 52 Cf sources; the equivalent dose delivered is 8 cGy. The 24 Na activity variation is plotted as function of time and the experimental curve so obtained is fitted to two exponentials. Two compartements are identified: a rapidly exchangeable one, with a half life of 1 h; an other, with a very slow turnover, the half lifes varying from 79 h to 35 h as the calcium concentration becomes sub-normal. The ratios calcium to slowly exchangeable sodium and rapidly to slowly exchangeable sodium appear to be promising for the evaluation of bone disease [fr

Nurses’ Knowledge Regarding Hand Hygiene and Its Individual and Organizational Predictors

Directory of Open Access Journals (Sweden)

Malihe Asadollahi

2015-03-01

Full Text Available Introduction: Based on recommendations from World Health Organization, hand hygiene is the most important way to control the hospital infections. Due to the critical role of nurses in patient care, they should have essential and updated information regarding hand hygiene. So this study aims at determining the knowledge of hand hygiene and its individual and organizational predictors among nurses in neonatal units. Methods: This descriptive and cross-sectional study was conducted in neonatal units in the hospitals affiliated to Tabriz University of Medical Sciences. The participants surveyed in this study were 150 nurses who were invited by census sampling method. A researcher prepared questionnaire that investigated the knowledge of participants about hand hygiene and was used after approving its validity and reliability. The quantitative analysis of this study used Statistical Package for Social Sciences SPSS version 13 by descriptive statistics and pearson correlation test, independent samples t-test, One-way ANOVA. For multivariable explanation of nurses’ knowledge based on independent variables multiple linear regressions was used. Results: Most of participants have an acceptable level of knowledge regarding hand hygiene. The highest score was for infection control domain and the lowest score was for definition of hand hygiene domain. Multivariable analysis showed that work experience and history of previous training were the most important predictors of participants’ knowledge about hand hygiene. Conclusion: It is recommended that infection control committees should revise their educational methods and give more emphasis on update guidelines regarding hand hygiene. Also, more experienced nurses should be employed in neonatal units.

Hand eczema in hairdressers: a Danish register-based study of the prevalence of hand eczema and its career consequences.

Science.gov (United States)

Lysdal, Susan Hovmand; Søsted, Heidi; Andersen, Klaus Ejner; Johansen, Jeanne Duus

2011-09-01

Occupational hand eczema is common in hairdressers, owing to wet work and hairdressing chemicals. To estimate the prevalence of hand eczema and its career consequences among hairdressers in Denmark. A register-based study was conducted, comprising all graduates from hairdressing vocational schools from 1985 to 2007 (n = 7840). The participants received a self-administered postal questionnaire including questions on hand eczema, atopic dermatitis, and career change. A response rate of 67.9% (n = 5324) was obtained. Of the respondents, 44.3% no longer worked as hairdressers and had worked for an average of 8.4 years in the profession before leaving it. Hand eczema was more common among ex-hairdressers (48.4%) than among current hairdressers (37.6%) (p reason for career change. In this group, logistic regression analysis showed that chronic hand eczema contributed the most to the decision to change career (odds ratio 50.12; 95% confidence interval 18.3-137). Hairdressers work an average of 8.4 years in the profession before leaving it, and hand eczema contributes significantly to this career change. © 2011 John Wiley & Sons A/S.

Influence of rub-in technique on required application time and hand coverage in hygienic hand disinfection

Directory of Open Access Journals (Sweden)

Feil Yvonne

2008-10-01

Full Text Available Abstract Background Recent data indicate that full efficacy of a hand rub preparation for hygienic hand disinfection can be achieved within 15 seconds (s. However, the efficacy test used for the European Norm (EN 1500 samples only the fingertips. Therefore, we investigated hand coverage using sixteen different application variations. The hand rub was supplemented with a fluorescent dye, and hands were assessed under UV light by a blind test, before and after application. Fifteen non-healthcare workers were used as subjects for each application variation apart from one test which was done with a group of twenty healthcare workers. All tests apart from the reference procedure were performed using 3 mL of hand rub. The EN 1500 reference procedure, which consists of 6 specific rub-in steps performed twice with an aliquot of 3 ml each time, served as a control. In one part of this study, each of the six steps was performed from one to five times before proceeding to the next step. In another part of the study, the entire sequence of six steps was performed from one to five times. Finally, all subjects were instructed to cover both hands completely, irrespective of any specific steps ("responsible application". Each rub-in technique was evaluated for untreated skin areas. Results The reference procedure lasted on average 75 s and resulted in 53% of subjects with at least one untreated area on the hands. Five repetitions of the rub-in steps lasted on average 37 s with 67% of subjects having incompletely treated hands. One repetition lasted on average 17 s, and all subjects had at least one untreated area. Repeating the sequence of steps lasted longer, but did not yield a better result. "Responsible application" was quite fast, lasting 25 s among non-healthcare worker subjects and 28 s among healthcare workers. It was also effective, with 53% and 55% of hands being incompletely treated. New techniques were as fast and effective as "responsible

Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study.

Science.gov (United States)

Erichsen Andersson, Annette; Frödin, Maria; Dellenborg, Lisen; Wallin, Lars; Hök, Jesper; Gillespie, Brigid M; Wikström, Ewa

2018-01-04

Hand hygiene and aseptic techniques are essential preventives in combating hospital-acquired infections. However, implementation of these strategies in the operating room remains suboptimal. There is a paucity of intervention studies providing detailed information on effective methods for change. This study aimed to evaluate the process of implementing a theory-driven knowledge translation program for improved use of hand hygiene and aseptic techniques in the operating room. The study was set in an operating department of a university hospital. The intervention was underpinned by theories on organizational learning, culture and person centeredness. Qualitative process data were collected via participant observations and analyzed using a thematic approach. Doubts that hand-hygiene practices are effective in preventing hospital acquired infections, strong boundaries and distrust between professional groups and a lack of psychological safety were identified as barriers towards change. Facilitated interprofessional dialogue and learning in "safe spaces" worked as mechanisms for motivation and engagement. Allowing for the free expression of different opinions, doubts and viewing resistance as a natural part of any change was effective in engaging all professional categories in co-creation of clinical relevant solutions to improve hand hygiene. Enabling nurses and physicians to think and talk differently about hospital acquired infections and hand hygiene requires a shift from the concept of one-way directed compliance towards change and learning as the result of a participatory and meaning-making process. The present study is a part of the Safe Hands project, and is registered with ClinicalTrials.gov (ID: NCT02983136 ). Date of registration 2016/11/28, retrospectively registered.

Video observation of hand hygiene practices during routine companion animal appointments and the effect of a poster intervention on hand hygiene compliance

Science.gov (United States)

2014-01-01

Background Hand hygiene is considered one of the most important infection control measures in human healthcare settings, but there is little information available regarding hand hygiene frequency and technique used in veterinary clinics. The objectives of this study were to describe hand hygiene practices associated with routine appointments in companion animal clinics in Ontario, and the effectiveness of a poster campaign to improve hand hygiene compliance. Results Observation of hand hygiene practices was performed in 51 clinics for approximately 3 weeks each using 2 small wireless surveillance cameras: one in an exam room, and one in the most likely location for hand hygiene to be performed outside the exam room following an appointment. Data from 38 clinics were included in the final analysis, including 449 individuals, 1139 appointments before and after the poster intervention, and 10894 hand hygiene opportunities. Overall hand hygiene compliance was 14% (1473/10894), while before and after patient contact compliance was 3% (123/4377) and 26% (1145/4377), respectively. Soap and water was used for 87% (1182/1353) of observed hand hygiene attempts with a mean contact time of 4 s (median 2 s, range 1-49 s), while alcohol-based hand rub (ABHR) was used for 7% (98/1353) of attempts with a mean contact time of 8 s (median 7 s, range 1-30 s). The presence of the posters had no significant effect on compliance, although some staff reported that they felt the posters did increase their personal awareness of the need to perform hand hygiene, and the posters had some effect on product contact times. Conclusions Overall hand hygiene compliance in veterinary clinics in this study was low, and contact time with hand hygiene products was frequently below current recommendations. Use of ABHR was low despite its advantages over hand washing and availability in the majority of clinics. The poster campaign had a limited effect on its own, but could still be used as a

Attitudes and practices of Irish hospital-based physicians towards hand hygiene and hand rubbing using alcohol-based hand rub: a comparison between 2007 and 2015.

Science.gov (United States)

Kingston, L M; Slevin, B L; O'Connell, N H; Dunne, C P

2017-09-01

Hand hygiene is the cornerstone of infection prevention and control practices, and reduces healthcare-associated infections significantly. However, international evidence suggests that medical doctors demonstrate poor compliance. To explore and compare practices and attitudes towards hand hygiene, particularly hand rubbing using alcohol-based hand rub (ABHR), among hospital-based physicians in Ireland between 2007 and 2015. In 2007, a random sample of doctors in a large teaching hospital was invited to complete a postal survey using a validated questionnaire. In 2015, the study was replicated among all doctors employed in a university hospital group, including the setting of the original study, using an online survey. Data were analysed using SPSS and Survey Monkey. Predominately positive and improving attitudes and practices were found, with 86% of doctors compliant with hand hygiene before patient contact in 2015, compared with 58% in 2007. Ninety-one percent of doctors were compliant after patient contact in 2015, compared with 76% in 2007. In 2015, only 39% of respondents reported that they 'almost always' used ABHR for hand hygiene. However, this represents 13.5% more than in 2007. Stated barriers to use of ABHR included dermatological issues, poor acceptance, tolerance and poor availability of ABHR products. Greater awareness of hand hygiene guidelines and greater governance appear to have had a positive impact on practice. However, despite this, practice remains suboptimal and there is scope for substantial improvement. Continued and sustained efforts are required in order to build on progress achieved since the World Health Organization hand hygiene guidelines were published in 2009. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Antiseptic Effect of Conventional Povidone-Iodine Scrub, Chlorhexidine Scrub, and Waterless Hand Rub in a Surgical Room: A Randomized Controlled Trial.

Science.gov (United States)

Tsai, Jui-Chen; Lin, Yen-Kuang; Huang, Yen-Jung; Loh, El-Wui; Wen, Hsiao-Yun; Wang, Chia-Hui; Tsai, Yin-Tai; Hsieh, Wen-Shyang; Tam, Ka-Wai

2017-04-01

OBJECTIVE Effective perioperative hand antisepsis is crucial for the safety of patients and medical staff in surgical rooms. The antimicrobial effectiveness of different antiseptic methods, including conventional hand scrubs and waterless hand rubs, has not been well evaluated. DESIGN, SETTING, AND PARTICIPANTS A randomized controlled trial was conducted to investigate the effectiveness of the 3 antiseptic methods among surgical staff of Taipei Medical University-Shuang Ho Hospital. For each method used, a group of 80 participants was enrolled. INTERVENTION Surgical hand cleansing with conventional 10% povidone-iodine scrub, conventional 4% chlorhexidine scrub, or waterless hand rub (1% chlorhexidine gluconate and 61% ethyl alcohol). RESULTS Colony-forming unit (CFU) counts were collected using the hand imprinting method before and after disinfection and after surgery. After surgical hand disinfection, the mean CFU counts of the conventional chlorhexidine (0.5±0.2, Pantiseptic method (P=.0036), but not other variables, predicted the mean CFU count. CONCLUSIONS Conventional chlorhexidine scrub and waterless hand rub were superior to a conventional povidone-iodine product in bacterial inhibition. We recommend using conventional chlorhexidine scrub as a standard method for perioperative hand antisepsis. Waterless hand rub may be used if the higher cost is affordable. Infect Control Hosp Epidemiol 2017;38:417-422.

Study of hand signs in Judeo-Christian art.

Science.gov (United States)

Ram, Ashwin N; Chung, Kevin C

2008-09-01

Hand gestures play a crucial role in religious art. An examination of Judeo-Christian art finds an ecclesiastical language that is concealed in metaphors and expressed by unique hand gestures. Many of these hand signs convey messages that are not familiar to most people admiring these paintings. Investigating the history and classifying some of the predominant hand signs found in Judeo-Christian art might serve to stimulate discussion concerning the many nuances of symbolic art. This presentation examines the meaning behind 8 common hand signs in Judeo-Christian art.

The fragrance hand immersion study - an experimental model simulating real-life exposure for allergic contact dermatitis on the hands.

Science.gov (United States)

Heydorn, S; Menné, T; Andersen, K E; Bruze, M; Svedman, C; Basketter, D; Johansen, J D

2003-06-01

Recently, we showed that 10 x 2% of consecutively patch-tested hand eczema patients had a positive patch test to a selection of fragrances containing fragrances relevant to hand exposure. In this study, we used repeated skin exposure to a patch test-positive fragrance allergen in patients previously diagnosed with hand eczema to explore whether immersion of fingers in a solution with or without the patch-test-positive fragrance allergen would cause or exacerbate hand eczema on the exposed finger. The study was double blinded and randomized. All participants had a positive patch test to either hydroxycitronellal or Lyral (hydroxyisohexyl 3-cyclohexene carboxaldehyde). Each participant immersed a finger from each hand, once a day, in a solution containing the fragrance allergen or placebo. During the first 2 weeks, the concentration of fragrance allergen in the solution was low (approximately 10 p.p.m.), whilst during the following 2 weeks, the concentration was relatively high (approximately 250 p.p.m.), imitating real-life exposure to a household product like dishwashing liquid diluted in water and the undiluted product, respectively. Evaluation was made using a clinical scale and laser Doppler flow meter. 3 of 15 hand eczema patients developed eczema on the finger immersed in the fragrance-containing solution, 3 of 15 on the placebo finger and 3 of 15 on both fingers. Using this experimental exposure model simulating real-life exposure, we found no association between immersion of a finger in a solution containing fragrance and development of clinically visible eczema on the finger in 15 participants previously diagnosed with hand eczema and with a positive patch test to the fragrance in question.

SeleCon: Scalable IoT Device Selection and Control Using Hand Gestures.

Science.gov (United States)

Alanwar, Amr; Alzantot, Moustafa; Ho, Bo-Jhang; Martin, Paul; Srivastava, Mani

2017-04-01

Although different interaction modalities have been proposed in the field of human-computer interface (HCI), only a few of these techniques could reach the end users because of scalability and usability issues. Given the popularity and the growing number of IoT devices, selecting one out of many devices becomes a hurdle in a typical smarthome environment. Therefore, an easy-to-learn, scalable, and non-intrusive interaction modality has to be explored. In this paper, we propose a pointing approach to interact with devices, as pointing is arguably a natural way for device selection. We introduce SeleCon for device selection and control which uses an ultra-wideband (UWB) equipped smartwatch. To interact with a device in our system, people can point to the device to select it then draw a hand gesture in the air to specify a control action. To this end, SeleCon employs inertial sensors for pointing gesture detection and a UWB transceiver for identifying the selected device from ranging measurements. Furthermore, SeleCon supports an alphabet of gestures that can be used for controlling the selected devices. We performed our experiment in a 9 m -by-10 m lab space with eight deployed devices. The results demonstrate that SeleCon can achieve 84.5% accuracy for device selection and 97% accuracy for hand gesture recognition. We also show that SeleCon is power efficient to sustain daily use by turning off the UWB transceiver, when a user's wrist is stationary.

Setup of a novel biofeedback prototype for sensorimotor control of the hand and preliminary application in patients with peripheral nerve injuries.

Science.gov (United States)

Chiu, Haw-Yen; Hsu, Hsiu-Yun; Su, Fong-Chin; Jou, I-Ming; Lin, Cheng-Feng; Kuo, Li-Chieh

2013-02-01

Biofeedback training is widely used for rehabilitative intervention in patients with central or peripheral nervous impairment to train correct movement patterns; however, no biofeedback apparatus is currently available to correct pinch force ratios for patients with sensory deficiencies. A cross-sectional and longitudinal design was used in an observational measurement study for establishing a prototype and to determine the effects of biofeedback intervention, respectively. This study aimed to develop a computerized evaluation and re-education biofeedback (CERB) prototype for application in clinical settings. A CERB prototype was developed integrating pinch apparatus hardware, a biofeedback user-controlled interface, and a data processing/analysis interface to detect momentary pinch performances in 79 people with normal hand sensation. Nine patients with hand sensory impairments were recruited to investigate the effects of training hand function with the CERB prototype. Hand dominance, pinch pattern, and age significantly affected the peak pinch force and force ratio for lifting a 480-g object with a steel surface. In the case of the 79 volunteers with normal hand sensation, hand dominance affected the time lag between peak pinch force and maximum load; however, it was unaffected by pinch pattern or age. Training with the CERB prototype produced significant improvements in force ratio and better performance in the pin insertion subtests, although the results for both 2-point discriminative and Semmes-Weinstein monofilament tests did not change significantly. The intervention findings are preliminary. This study developed a conjunct system suited for evaluating and restoring sensorimotor function for patients with impaired hand sensibility. The results from the participants with normal hand sensation could serve as a reference database for comparison with patients with nerve injuries.

Mental rotation of anthropoid hands: a chronometric study

Directory of Open Access Journals (Sweden)

L.G. Gawryszewski

2007-03-01

Full Text Available It has been shown that mental rotation of objects and human body parts is processed differently in the human brain. But what about body parts belonging to other primates? Does our brain process this information like any other object or does it instead maximize the structural similarities with our homologous body parts? We tried to answer this question by measuring the manual reaction time (MRT of human participants discriminating the handedness of drawings representing the hands of four anthropoid primates (orangutan, chimpanzee, gorilla, and human. Twenty-four right-handed volunteers (13 males and 11 females were instructed to judge the handedness of a hand drawing in palm view by pressing a left/right key. The orientation of hand drawings varied from 0º (fingers upwards to 90º lateral (fingers pointing away from the midline, 180º (fingers downwards and 90º medial (finger towards the midline. The results showed an effect of rotation angle (F(3, 69 = 19.57, P < 0.001, but not of hand identity, on MRTs. Moreover, for all hand drawings, a medial rotation elicited shorter MRTs than a lateral rotation (960 and 1169 ms, respectively, P < 0.05. This result has been previously observed for drawings of the human hand and related to biomechanical constraints of movement performance. Our findings indicate that anthropoid hands are essentially equivalent stimuli for handedness recognition. Since the task involves mentally simulating the posture and rotation of the hands, we wondered if "mirror neurons" could be involved in establishing the motor equivalence between the stimuli and the participants' own hands.

Comparative assessment of antimicrobial efficacy of different hand sanitizers: An in vitro study

OpenAIRE

Jain, Vardhaman Mulchand; Karibasappa, Gundabaktha Nagappa; Dodamani, Arun Suresh; Prashanth, Vishwakarma K.; Mali, Gaurao Vasant

2016-01-01

Background: To evaluate the antimicrobial efficacy of four different hand sanitizers against Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, and Enterococcus faecalis as well as to assess and compare the antimicrobial effectiveness among four different hand sanitizers. Materials and Methods: The present study is an in vitro study to evaluate antimicrobial efficacy of Dettol, Lifebuoy, PureHands, and Sterillium hand sanitizers against clinical i...

Frequency of Hand Decontamination of Intraoperative Providers and Reduction of Postoperative Healthcare-Associated Infections: A Randomized Clinical Trial of a Novel Hand Hygiene System.

Science.gov (United States)

Koff, Matthew D; Brown, Jeremiah R; Marshall, Emily J; O'Malley, A James; Jensen, Jens T; Heard, Stephen O; Longtine, Karen; O'Neill, Melissa; Longtine, Jaclyn; Houston, Donna; Robison, Cindy; Moulton, Eric; Patel, Hetal M; Loftus, Randy W

2016-08-01

BACKGROUND Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development. OBJECTIVE To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events. DESIGN Randomized, prospective study. SETTING Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts. PATIENTS Patients undergoing surgery. METHODS Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections. RESULTS A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); Phand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82-1.40], P=.626). CONCLUSIONS The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy. Infect Control Hosp Epidemiol 2016;37:888-895.

Measuring hand hygiene compliance rates at hospital entrances.

Science.gov (United States)

Vaidotas, Marina; Yokota, Paula Kiyomi Onaga; Marra, Alexandre R; Camargo, Thiago Zinsly Sampaio; Victor, Elivane da Silva; Gysi, Deisy Morselli; Leal, Flavio; Santos, Oscar Fernando Pavão dos; Edmond, Michael B

2015-07-01

Despite the importance of hand hygiene in the health care setting, there are no studies evaluating hand hygiene compliance at hospital entrances. The study was prospectively performed over a 33-week period from March 30, 2014-November 15, 2014, to evaluate hand hygiene compliance in 2 hospital reception areas. We compared electronic handwash counters with the application of radiofrequency identification (GOJO SMARTLINK) (electronic observer) that counts each activation of alcohol gel dispensers to direct observation (human observer) via remote review of video surveillance. We found low hand hygiene compliance rates of 2.2% (99/4,412) and 1.7% (140/8,277), respectively, at reception areas A and D, detected by direct observation. Using the electronic observer, we measured rates of 17% (15,624/91,724) and 7.1% (51,605/730,357) at reception areas A and D, respectively. For the overall time period of simultaneous electronic and human observation, the human observer captured 1% of the hand hygiene episodes detected by the electronic observer. Our study showed very low hand hygiene compliance in hospital reception areas, and we found an electronic hand hygiene system to be a useful method to monitor hand hygiene compliance. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Explaining the effects of two different strategies for promoting hand hygiene in hospital nurses: a process evaluation alongside a cluster randomised controlled trial.

Science.gov (United States)

Huis, Anita; Holleman, Gerda; van Achterberg, Theo; Grol, Richard; Schoonhoven, Lisette; Hulscher, Marlies

2013-04-08

There is only limited understanding of why hand hygiene improvement strategies are successful or fail. It is therefore important to look inside the 'black box' of such strategies, to ascertain which components of a strategy work well or less well. This study examined which components of two hand hygiene improvement strategies were associated with increased nurses' hand hygiene compliance. A process evaluation of a cluster randomised controlled trial was conducted in which part of the nursing wards of three hospitals in the Netherlands received a state-of-the-art strategy, including education, reminders, feedback, and optimising materials and facilities; another part received a team and leaders-directed strategy that included all elements of the state-of-the-art strategy, supplemented with activities aimed at the social and enhancing leadership. This process evaluation used four sets of measures: effects on nurses' hand hygiene compliance, adherence to the improvement strategies, contextual factors, and nurses' experiences with strategy components. Analyses of variance and multiple regression analyses were used to explore changes in nurses' hand hygiene compliance and thereby better understand trial effects. Both strategies were performed with good adherence to protocol. Two contextual factors were associated with changes in hand hygiene compliance: a hospital effect in long term (p feedback about their hand hygiene performance (p manager holds team members accountable for hand hygiene performance p < 0.01) correlated positively with changes in nurses' hand hygiene compliance. This study illustrates the use of a process evaluation to uncover mechanisms underlying change in hand hygiene improvement strategies. Our study results demonstrate the added value of specific aspects of social influence and leadership in hand hygiene improvement strategies, thus offering an interpretation of the trial effects. The study is registered in ClinicalTrials.gov, dossier number: NCT

Hand hygiene promotion and the participation of infection control link nurses: an effective innovation to overcome campaign fatigue.

Science.gov (United States)

Seto, Wing Hong; Yuen, Shanny W S; Cheung, Christina W Y; Ching, Patricia T Y; Cowling, Benjamin J; Pittet, Didier

2013-12-01

Campaign fatigue was evident in a large hospital in Hong Kong when hand hygiene compliance remained just above 50% after 4 years of aggressive and varied promotional activities. A new innovative strategy was developed that directly involved the infection control link nurses both in formulating the strategy and in implementing the various proposed programs. The new strategy was successful in increasing hand hygiene compliance to 83%. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Deep learning with convolutional neural networks: a resource for the control of robotic prosthetic hands via electromyography

Directory of Open Access Journals (Sweden)

Manfredo Atzori

2016-09-01

Full Text Available Motivation: Natural control methods based on surface electromyography and pattern recognition are promising for hand prosthetics. However, the control robustness offered by scientific research is still not sufficient for many real life applications and commercial prostheses are in the best case capable to offer natural control for only a few movements. Objective: In recent years deep learning revolutionized several fields of machine learning, including computer vision and speech recognition. Our objective is to test its capabilities for the natural control of robotic hands via surface electromyography by providing a baseline on a large number of intact and amputated subjects. Methods: We tested convolutional networks for the classification of an average of 50 hand movements in 67 intact subjects and 11 hand amputated subjects. The simple architecture of the neural network allowed to make several tests in order to evaluate the effect of pre-processing, layer architecture, data augmentation and optimization. The classification results are compared with a set of classical classification methods applied on the same datasets.Results: The classification accuracy obtained with convolutional neural networks using the proposed architecture is higher than the average results obtained with the classical classification methods but lower than the results obtained with the best reference methods in our tests. Significance: The results show that convolutional neural networks with a very simple architecture can produce accuracy comparable to the average classical classification methods. They show that several factors (including pre-processing, the architecture of the net and the optimization parameters can be fundamental for the analysis of surface electromyography data. Finally, the results suggest that deeper and more complex networks may increase dexterous control robustness, thus contributing to bridge the gap between the market and scientific research

The Effectiveness of Hand Massage on Pain in Critically Ill Patients After Cardiac Surgery: A Randomized Controlled Trial Protocol.

Science.gov (United States)

Boitor, Madalina; Martorella, Géraldine; Laizner, Andréa Maria; Maheu, Christine; Gélinas, Céline

2016-11-07

Postoperative pain is common in the intensive care unit despite the administration of analgesia. Some trials suggest that massage can be effective at reducing postoperative pain in acute care units; however, its effects on pain relief in the intensive care unit and when pain severity is highest remain unknown. The objective is to evaluate the effectiveness of hand massage on the pain intensity (primary outcome), unpleasantness and interference, muscle tension, anxiety, and vital signs of critically ill patients after cardiac surgery. A 3-arm randomized controlled trial will be conducted. A total of 79 patients who are 18 years or older, able to speak French or English and self-report symptoms, have undergone elective cardiac surgery, and do not have a high risk of postoperative complications and contraindications to hand massage will be recruited. They will be randomly allocated (1:1:1) to standard care plus either 3 20-minute hand massages (experimental), 3 20-minute hand holdings (active control), or 3 20-minute rest periods (passive control). Pain intensity, unpleasantness, anxiety, muscle tension, and vital signs will be evaluated before, immediately after, and 30 minutes later for each intervention administered within 24 hours postoperatively. Peer-reviewed competitive funding was received from the Quebec Nursing Intervention Research Network and McGill University in December 2015, and research ethics approval was obtained February 2016. Recruitment started in April 2016, and data collection is expected to be complete by January 2017. To date, 24 patients were randomized and had data collection done. This study will be one of the first randomized controlled trials to examine the effect of hand massage on the pain levels of critically ill patients after cardiac surgery and to provide empirical evidence for the use of massage among this population. ClinicalTrials.gov NCT02679534; https://clinicaltrials.gov/ct2/show/NCT02679534 (Archived by WebCite at http

Job Burnout Reduces Hand Hygiene Compliance Among Nursing Staff.

Science.gov (United States)

Manomenidis, Georgios; Panagopoulou, Efharis; Montgomery, Anthony

2017-10-13

Health professional burnout has been associated with suboptimal care and reduced patient safety. However, the extent to which burnout influences hand hygiene compliance among health professionals has yet to be explored. The aim of the study was to examine whether job burnout reduces hand washing compliance among nursing staff. A diary study was conducted. Forty registered nurses working in a general city hospital in Thessaloniki, Greece, completed a questionnaire, while they were monitored for hand hygiene compliance following the World Health Organization protocol for hand hygiene assessment. Burnout was measured using validated items from the Maslach Burnout Inventory. Data were collected from September to October 2015. Multiple regression analysis showed that controlling for years in practice, burnout was negatively associated with hand hygiene compliance (R = 0.322, F(3,36) = 5.704, P compliance to hand hygiene among nurses. Given the crucial role of hand hygiene compliance for the prevention of in-hospital infections, this study highlights the need for interventions targeting the prevention of burnout among nursing staff.

Hand hygiene knowledge and practices of nursing students in Singapore.

Science.gov (United States)

Nasirudeen, A M A; Koh, Josephine W N; Lau, Adeline Lee Chin; Li, Wenjie; Lim, Lay Seng; Ow, Cynthia Yi Xuan

2012-10-01

Hand hygiene is an important means of preventing nosocomial infections. Studies have shown a hand hygiene among health care workers. A hand hygiene survey was administered to nursing students in a tertiary institution in Singapore. The results of this survey strongly indicate that nursing students understand the importance of hand hygiene compliance and perceive clinical internship programs and practical laboratory sessions to be effective methods of hand hygiene education. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Hand Robotic Therapy in Children with Hemiparesis: A Pilot Study.

Science.gov (United States)

Bishop, Lauri; Gordon, Andrew M; Kim, Heakyung

2017-01-01

The aim of this study was to understand the impact of training with a hand robotic device on hand paresis and function in a population of children with hemiparesis. Twelve children with hemiparesis (mean age, 9 [SD, 3.64] years) completed participation in this prospective, experimental, pilot study. Participants underwent clinical assessments at baseline and again 6 weeks later with instructions to not initiate new therapies. After these assessments, participants received 6 weeks of training with a hand robotic device, consisting of 1-hour sessions, 3 times weekly. Assessments were repeated on completion of training. Results showed significant improvements after training on the Assisting Hand Assessment (mean difference, 2.0 Assisting Hand Assessment units; P = 0.011) and on the upper-extremity component of the Fugl-Meyer scale (raw score mean difference, 4.334; P = 0.001). No significant improvements between pretest and posttest were noted on the Jebsen-Taylor Test of Hand Function, the Quality of Upper Extremity Skills Test, or the Pediatric Evaluation of Disability Inventory after intervention. Total active mobility of digits and grip strength also failed to demonstrate significant changes after training. Participants tolerated training with the hand robotic device, and significant improvements in bimanual hand use, as well as impairment-based scales, were noted. Improvements were carried over into bimanual skills during play. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand key components of neuroplasticity; (2) Discuss the benefits of robotic therapy in the recovery of hand function in pediatric patients with hemiplegia; and (3) Appropriately incorporate robotic therapy into the treatment plan of pediatric patients with hemiplegia. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the

Modeling Attitude Dynamics in Simulink: A Study of the Rotational and Translational Motion of a Spacecraft Given Torques and Impulses Generated by RMS Hand Controllers

Science.gov (United States)

Mauldin, Rebecca H.

2010-01-01

In order to study and control the attitude of a spacecraft, it is necessary to understand the natural motion of a body in orbit. Assuming a spacecraft to be a rigid body, dynamics describes the complete motion of the vehicle by the translational and rotational motion of the body. The Simulink Attitude Analysis Model applies the equations of rigid body motion to the study of a spacecraft?s attitude in orbit. Using a TCP/IP connection, Matlab reads the values of the Remote Manipulator System (RMS) hand controllers and passes them to Simulink as specified torque and impulse profiles. Simulink then uses the governing kinematic and dynamic equations of a rigid body in low earth orbit (LE0) to plot the attitude response of a spacecraft for five seconds given known applied torques and impulses, and constant principal moments of inertia.

Creating Virtual-hand and Virtual-face Illusions to Investigate Self-representation.

Science.gov (United States)

Ma, Ke; Lippelt, Dominique P; Hommel, Bernhard

2017-03-01

Studies investigating how people represent themselves and their own body often use variants of "ownership illusions", such as the traditional rubber-hand illusion or the more recently discovered enfacement illusion. However, these examples require rather artificial experimental setups, in which the artificial effector needs to be stroked in synchrony with the participants' real hand or face-a situation in which participants have no control over the stroking or the movements of their real or artificial effector. Here, we describe a technique to establish ownership illusions in a setup that is more realistic, more intuitive, and of presumably higher ecological validity. It allows creating the virtual-hand illusion by having participants control the movements of a virtual hand presented on a screen or in virtual space in front of them. If the virtual hand moves in synchrony with the participants' own real hand, they tend to perceive the virtual hand as part of their own body. The technique also creates the virtual-face illusion by having participants control the movements of a virtual face in front of them, again with the effect that they tend to perceive the face as their own if it moves in synchrony with their real face. Studying the circumstances that illusions of this sort can be created, increased, or reduced provides important information about how people create and maintain representations of themselves.

Cytomegalovirus Survival and Transferability and the Effectiveness of Common Hand-Washing Agents against Cytomegalovirus on Live Human Hands

OpenAIRE

Stowell, Jennifer D.; Forlin-Passoni, Daniela; Radford, Kay; Bate, Sheri L.; Dollard, Sheila C.; Bialek, Stephanie R.; Cannon, Michael J.; Schmid, D. Scott

2014-01-01

Congenital cytomegalovirus (CMV) transmission can occur when women acquire CMV while pregnant. Infection control guidelines may reduce risk for transmission. We studied the duration of CMV survival after application of bacteria to the hands and after transfer from the hands to surfaces and the effectiveness of cleansing with water, regular and antibacterial soaps, sanitizer, and diaper wipes. Experiments used CMV AD169 in saliva at initial titers of 1 × 105 infectious particles/ml. Samples fr...

Staphylococcus aureus and hand eczema severity

DEFF Research Database (Denmark)

Haslund, P; Bangsgaard, N; Jarløv, J O

2009-01-01

BACKGROUND: The role of bacterial infections in hand eczema (HE) remains to be assessed. OBJECTIVES: To determine the prevalence of Staphylococcus aureus in patients with HE compared with controls, and to relate presence of S. aureus, subtypes and toxin production to severity of HE. METHODS......: Bacterial swabs were taken at three different visits from the hand and nose in 50 patients with HE and 50 controls. Staphylococcus aureus was subtyped by spa typing and assigned to clonal complexes (CCs), and isolates were tested for exotoxin-producing S. aureus strains. The Hand Eczema Severity Index...... and in the nose in all cases, and between visits in 90% of cases. Ten different CC types were identified, no association with severity was found, and toxin-producing strains were not found more frequently in patients with HE than in controls. CONCLUSIONS: Staphylococcus aureus was present on hands in almost half...

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation.

Science.gov (United States)

Franck, Johan Anton; Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2017-01-01

Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.

Left, right, left, right, eyes to the front! Müller-Lyer bias in grasping is not a function of hand used, hand preferred or visual hemifield, but foveation does matter.

Science.gov (United States)

van der Kamp, John; de Wit, Matthieu M; Masters, Rich S W

2012-04-01

We investigated whether the control of movement of the left hand is more likely to involve the use of allocentric information than movements performed with the right hand. Previous studies (Gonzalez et al. in J Neurophys 95:3496-3501, 2006; De Grave et al. in Exp Br Res 193:421-427, 2009) have reported contradictory findings in this respect. In the present study, right-handed participants (N = 12) and left-handed participants (N = 12) made right- and left-handed grasps to foveated objects and peripheral, non-foveated objects that were located in the right or left visual hemifield and embedded within a Müller-Lyer illusion. They were also asked to judge the size of the object by matching their hand aperture to its length. Hand apertures did not show significant differences in illusory bias as a function of hand used, handedness or visual hemifield. However, the illusory effect was significantly larger for perception than for action, and for the non-foveated compared to foveated objects. No significant illusory biases were found for reach movement times. These findings are consistent with the two-visual system model that holds that the use of allocentric information is more prominent in perception than in movement control. We propose that the increased involvement of allocentric information in movements toward peripheral, non-foveated objects may be a consequence of more awkward, less automatized grasps of nonfoveated than foveated objects. The current study does not support the conjecture that the control of left-handed and right-handed grasps is predicated on different sources of information.

SeleCon: Scalable IoT Device Selection and Control Using Hand Gestures

Science.gov (United States)

Alanwar, Amr; Alzantot, Moustafa; Ho, Bo-Jhang; Martin, Paul; Srivastava, Mani

2018-01-01

Although different interaction modalities have been proposed in the field of human-computer interface (HCI), only a few of these techniques could reach the end users because of scalability and usability issues. Given the popularity and the growing number of IoT devices, selecting one out of many devices becomes a hurdle in a typical smarthome environment. Therefore, an easy-to-learn, scalable, and non-intrusive interaction modality has to be explored. In this paper, we propose a pointing approach to interact with devices, as pointing is arguably a natural way for device selection. We introduce SeleCon for device selection and control which uses an ultra-wideband (UWB) equipped smartwatch. To interact with a device in our system, people can point to the device to select it then draw a hand gesture in the air to specify a control action. To this end, SeleCon employs inertial sensors for pointing gesture detection and a UWB transceiver for identifying the selected device from ranging measurements. Furthermore, SeleCon supports an alphabet of gestures that can be used for controlling the selected devices. We performed our experiment in a 9m-by-10m lab space with eight deployed devices. The results demonstrate that SeleCon can achieve 84.5% accuracy for device selection and 97% accuracy for hand gesture recognition. We also show that SeleCon is power efficient to sustain daily use by turning off the UWB transceiver, when a user’s wrist is stationary. PMID:29683151

Evaluation of antibacterial activity of hand sanitizers – an in vitro study

African Journals Online (AJOL)

Hand hygiene, particularly hand sanitizing, is essential in reducing infectious disease transmission. The recent outbreak of Ebola in Nigeria both increased public awareness of the practice of hand sanitizing and resulted in the introduction of new products to the Nigerian market. This study set out to explore the actual ...

Volitional and automatic control of the hand when reaching to grasp objects.

Science.gov (United States)

Chen, Zhongting; Saunders, Jeffrey Allen

2018-02-26

When picking up an object, we tend to grasp at contact points that allow a stable grip. Recent studies have demonstrated that appropriate grasp points can be selected during an ongoing movement in response to unexpected perturbations of the target object. In this study, we tested whether such online grip adjustments are automatic responses or can be controlled volitionally. Subjects performed virtual grasping movements toward target 2D shapes that sometimes changed shape or orientation during movement. Unlike in previous studies, the conditions and task requirements discouraged any online adjustments toward the perturbed shapes. In Experiment 1, target shapes were perturbed briefly (200 ms) during movement before reverting to the original shape, and subjects were instructed to ignore the transient perturbations. Despite subjects' intentions, we observed online adjustments of grip orientation that were toward the expected grip axis of the briefly presented shape. In Experiment 2, we added a stop-signal to the grasping task, with target perturbation as the stop cue. We again observed unnecessary online adjustments toward the grip axis of the perturbed shape, with similar latency. Furthermore, the grip adjustments continued after the forward motion of the hand had stopped, indicating that the automatic response to the perturbed target shape co-occurred with the volitional response to the perturbation onset. Our results provide evidence that automatic control mechanisms are used to guide the fingers to appropriate grasp points and suggest that these mechanisms are distinct from those involved with volitional control. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Ownership and Agency of an Independent Supernumerary Hand Induced by an Imitation Brain-Computer Interface.

Science.gov (United States)

Bashford, Luke; Mehring, Carsten

2016-01-01

To study body ownership and control, illusions that elicit these feelings in non-body objects are widely used. Classically introduced with the Rubber Hand Illusion, these illusions have been replicated more recently in virtual reality and by using brain-computer interfaces. Traditionally these illusions investigate the replacement of a body part by an artificial counterpart, however as brain-computer interface research develops it offers us the possibility to explore the case where non-body objects are controlled in addition to movements of our own limbs. Therefore we propose a new illusion designed to test the feeling of ownership and control of an independent supernumerary hand. Subjects are under the impression they control a virtual reality hand via a brain-computer interface, but in reality there is no causal connection between brain activity and virtual hand movement but correct movements are observed with 80% probability. These imitation brain-computer interface trials are interspersed with movements in both the subjects' real hands, which are in view throughout the experiment. We show that subjects develop strong feelings of ownership and control over the third hand, despite only receiving visual feedback with no causal link to the actual brain signals. Our illusion is crucially different from previously reported studies as we demonstrate independent ownership and control of the third hand without loss of ownership in the real hands.

Intelligent control of robotic arm/hand systems for the NASA EVA retriever using neural networks

Science.gov (United States)

Mclauchlan, Robert A.

1989-01-01

Adaptive/general learning algorithms using varying neural network models are considered for the intelligent control of robotic arm plus dextrous hand/manipulator systems. Results are summarized and discussed for the use of the Barto/Sutton/Anderson neuronlike, unsupervised learning controller as applied to the stabilization of an inverted pendulum on a cart system. Recommendations are made for the application of the controller and a kinematic analysis for trajectory planning to simple object retrieval (chase/approach and capture/grasp) scenarios in two dimensions.

Can theoretical intervention improve hand hygiene behavior among nurses?

Directory of Open Access Journals (Sweden)

Baghaei R

2016-06-01

Full Text Available Rahim Baghaei,1 Elham Sharifian,1 Aziz Kamran2 1Inpatient Safety Research Center, Nursing and Midwifery School, Urmia University of Medical Sciences, Urmia, 2Public Health Department, Khalkhal Faculty of Medical Sciences, Ardabil University of Medical Sciences, Ardabil, IranBackground: Hand washing is the best strategy to prevent known nosocomial infections but the nurses' hand hygiene is estimated to be poor in Iran.Objective: This study aimed to determine the effectiveness of BASNEF (Behavior, Attitude, Subjective Norms, and Enabling Factors model on hand hygiene adherence education.Methods: This controlled quasi-experimental study was conducted on 70 hemodialysis unit nurses (35 case and 35 control in the health and educational centers of the University of Medical Sciences of Urmia, Iran. To collect the data, a six-part validated and reliable questionnaire was used. The data were analyzed using SPSS version18, using Wilcoxon, Mann–Whitney, chi-square, and Fisher's exact tests. The significance level was considered P<0.05.Results: The mean age was 38.4±8.1 years for the intervention group and 40.2±8.0 years for the control group. There was no significant difference between the two groups for any demographic variables. Also, before the intervention, there was no significant difference between the two groups for any components of the BASNEF model. Post-intervention, the attitude, subjective norms, enabling factors, and intention improved significantly in the intervention group (P<0.001, but hand hygiene behavior did not show any significant change in the intervention group (P=0.16.Conclusion: Despite the improving attitudes and intention, the intervention had no significant effect on hand hygiene behavior among the studied nurses.Keywords: hand hygiene, adherence, education nurse, behavior

Does an intraneural interface short-term implant for robotic hand control modulate sensorimotor cortical integration? An EEG-TMS co-registration study on a human amputee.

Science.gov (United States)

Ferreri, F; Ponzo, D; Vollero, L; Guerra, A; Di Pino, G; Petrichella, S; Benvenuto, A; Tombini, M; Rossini, L; Denaro, L; Micera, S; Iannello, G; Guglielmelli, E; Denaro, V; Rossini, P M

2014-01-01

Following limb amputation, central and peripheral nervous system relays partially maintain their functions and can be exploited for interfacing prostheses. The aim of this study is to investigate, for the first time by means of an EEG-TMS co-registration study, whether and how direct bidirectional connection between brain and hand prosthesis impacts on sensorimotor cortical topography. Within an experimental protocol for robotic hand control, a 26 years-old, left-hand amputated male was selected to have implanted four intrafascicular electrodes (tf-LIFEs-4) in the median and ulnar nerves of the stump for 4 weeks. Before tf-LIFE-4s implant (T0) and after the training period, once electrodes have been removed (T1), experimental subject's cortico-cortical excitability, connectivity and plasticity were tested via a neuronavigated EEG-TMS experiment. The statistical analysis clearly demonstrated a significant modulation (with t-test p < 0.0001) of EEG activity between 30 and 100 ms post-stimulus for the stimulation of the right hemisphere. When studying individual latencies in that time range, a global amplitude modulation was found in most of the TMS-evoked potentials; particularly, the GEE analysis showed significant differences between T0 and T1 condition at 30 ms (p < 0.0404), 46 ms (p < 0.0001) and 60 ms (p < 0.007) latencies. Finally, also a clear local decrement in N46 amplitude over C4 was evident. No differences between conditions were observed for the stimulation of the left hemisphere. The results of this study confirm the hypothesis that bidirectional neural interface could redirect cortical areas -deprived of their original input/output functions- toward restorative neuroplasticity. This reorganization strongly involves bi-hemispheric networks and intracortical and transcortical modulation of GABAergic inhibition.

The fragrance hand immersion study - an experimental model simulating real-life exposure for allergic contact dermatitis on the hands

DEFF Research Database (Denmark)

Heydorn, S; Menné, T; Andersen, K E

2003-01-01

previously diagnosed with hand eczema to explore whether immersion of fingers in a solution with or without the patch-test-positive fragrance allergen would cause or exacerbate hand eczema on the exposed finger. The study was double blinded and randomized. All participants had a positive patch test to either...... hydroxycitronellal or Lyral (hydroxyisohexyl 3-cyclohexene carboxaldehyde). Each participant immersed a finger from each hand, once a day, in a solution containing the fragrance allergen or placebo. During the first 2 weeks, the concentration of fragrance allergen in the solution was low (approximately 10 p...... meter. 3 of 15 hand eczema patients developed eczema on the finger immersed in the fragrance-containing solution, 3 of 15 on the placebo finger and 3 of 15 on both fingers. Using this experimental exposure model simulating real-life exposure, we found no association between immersion of a finger...

An on-line BCI for control of hand grasp sequence and holding using adaptive probabilistic neural network.

Science.gov (United States)

Hazrati, Mehrnaz Kh; Erfanian, Abbas

2008-01-01

This paper presents a new EEG-based Brain-Computer Interface (BCI) for on-line controlling the sequence of hand grasping and holding in a virtual reality environment. The goal of this research is to develop an interaction technique that will allow the BCI to be effective in real-world scenarios for hand grasp control. Moreover, for consistency of man-machine interface, it is desirable the intended movement to be what the subject imagines. For this purpose, we developed an on-line BCI which was based on the classification of EEG associated with imagination of the movement of hand grasping and resting state. A classifier based on probabilistic neural network (PNN) was introduced for classifying the EEG. The PNN is a feedforward neural network that realizes the Bayes decision discriminant function by estimating probability density function using mixtures of Gaussian kernels. Two types of classification schemes were considered here for on-line hand control: adaptive and static. In contrast to static classification, the adaptive classifier was continuously updated on-line during recording. The experimental evaluation on six subjects on different days demonstrated that by using the static scheme, a classification accuracy as high as the rate obtained by the adaptive scheme can be achieved. At the best case, an average classification accuracy of 93.0% and 85.8% was obtained using adaptive and static scheme, respectively. The results obtained from more than 1500 trials on six subjects showed that interactive virtual reality environment can be used as an effective tool for subject training in BCI.

Altered brain functions in HIV positive patients free of HIV- associated neurocognitive disorders: A MRI study during unilateral hand movements

Directory of Open Access Journals (Sweden)

Jing Zhao

2015-03-01

Full Text Available This paper aimed to investigate the brain activity of human immunodeficiency virus (HIV positive patients with normal cognition during unilateral hand movement and whether highly active antiretroviral therapy (HAART could affect the brain function. Functional magnetic resonance imaging (fMRI was performed for 60 HIV positive (HIV+ subjects and −42 healthy age-matched right-handed control subjects. Each subject was evaluated by the neuropsychological test and examined with fMRI during left and right hand movement tasks. HIV+ subjects showed greater activation in anterior cingulum, precuneus, occipital lobes, ipsilateral postcentral gyrus and contralateral cerebellum compared with control group during right hand movement task. However, during left hand movement no statistically significant difference was detected between these two groups. HAART medication for HIV+ subjects lowered the increased activity to normal level. Meanwhile patients receiving the regimen of zidovudine, lamivudine and efavirenz showed lower activity at bilateral caudate and ipsilateral inferior frontal gyrus in comparison with subjects receiving other HAART regimens. Therefore, HIV+ subjects demonstrated brain asymmetry in motor cortex, with increased activity present during right hand movement but absent during left hand movement. HAART proves effective in HIV+ subjects even with normal cognition and the specific regimen of HAART could prevent cerebral abnormal functions. Meanwhile, this study validates that during motor tasks, fMRI can detect the brain signal changes prior to the occurrences of other HIV- associated dysfunctions.

The effect of hand hygiene on illness rate among students in university residence halls.

Science.gov (United States)

White, Cindy; Kolble, Robin; Carlson, Rebecca; Lipson, Natasha; Dolan, Mike; Ali, Yusuf; Cline, Mojee

2003-10-01

Several studies have indicated a connection between hand sanitization and infection control in numerous settings such as extended care facilities, schools, and hospitals. The purpose of this study was to assess the effectiveness of both a hand-hygiene message campaign and the use of an alcohol gel hand sanitizer in decreasing the incidence of upper-respiratory illness among students living in university residence halls. This study involved a total of 430 students recruited from 4 residence halls during the fall semester at the University of Colorado at the Boulder campus. Dormitories were paired into control and product groups. In the product groups, alcohol gel hand-sanitizer dispensers were installed in every room, bathroom, and dining hall. The data were statistically analyzed for the differences between product and control groups in reported symptoms, illness rates, and absenteeism from classes. The overall increase in hand-hygiene behavior and reduction in symptoms, illness rates, and absenteeism between the product group and control group was statistically significant. Reductions in upper respiratory-illness symptoms ranged from 14.8% to 39.9%. Total improvement in illness rate was 20%. The product group had 43% less missed school/work days. Hand-hygiene practices were improved with increased frequency of handwashing through increasing awareness of the importance of hand hygiene, and the use of alcohol gel hand sanitizer in university dormitories. This resulted in fewer upper respiratory-illness symptoms, lower illness rates, and lower absenteeism.

Left, right, left, right, eyes to the front! Müller-Lyer bias in grasping is not a function of hand used, hand preferred or visual hemifield, but foveation does matter.

OpenAIRE

van der Kamp, J.; de Wit, M.M.; Masters, R.S.W.

2012-01-01

We investigated whether the control of movement of the left hand is more likely to involve the use of allocentric information than movements performed with the right hand. Previous studies (Gonzalez et al. in J Neurophys 95:3496-3501, 2006; De Grave et al. in Exp Br Res 193:421-427, 2009) have reported contradictory findings in this respect. In the present study, right-handed participants (N = 12) and left-handed participants (N = 12) made right- and left-handed grasps to foveated objects and...

Hand-held medical robots.

Science.gov (United States)

Payne, Christopher J; Yang, Guang-Zhong

2014-08-01

Medical robots have evolved from autonomous systems to tele-operated platforms and mechanically-grounded, cooperatively-controlled robots. Whilst these approaches have seen both commercial and clinical success, uptake of these robots remains moderate because of their high cost, large physical footprint and long setup times. More recently, researchers have moved toward developing hand-held robots that are completely ungrounded and manipulated by surgeons in free space, in a similar manner to how conventional instruments are handled. These devices provide specific functions that assist the surgeon in accomplishing tasks that are otherwise challenging with manual manipulation. Hand-held robots have the advantages of being compact and easily integrated into the normal surgical workflow since there is typically little or no setup time. Hand-held devices can also have a significantly reduced cost to healthcare providers as they do not necessitate the complex, multi degree-of-freedom linkages that grounded robots require. However, the development of such devices is faced with many technical challenges, including miniaturization, cost and sterility, control stability, inertial and gravity compensation and robust instrument tracking. This review presents the emerging technical trends in hand-held medical robots and future development opportunities for promoting their wider clinical uptake.

Promoting a Hand Hygiene Program Using Social Media: An Observational Study.

Science.gov (United States)

Pan, Sung-Ching; Sheng, Wang-Huei; Tien, Kuei-Lien; Chien, Kuang-Tse; Chen, Yee-Chun; Chang, Shawn-Chwen

2016-01-01

Hand hygiene is an important component in infection control to protect patient safety and reduce health care-associated infection. Our aim was to evaluate the efficacy of different social media on the promotion of a hand hygiene (HH) program. The observational study was conducted from May 5 to December 31, 2014, at a 2600-bed tertiary care hospital. A 3-minute video of an HH campaign in 8 languages was posted to YouTube. The Chinese version was promoted through three platforms: the hospital website, the hospital group email, and the Facebook site of a well-known Internet illustrator. The video traffic was analyzed via Google Analytics. HH compliance was measured in November 2013 and 2014. There were 5252 views of the video, mainly of the Chinese-language version (3509/5252, 66.81%). The NTUH website had 24,000 subscribers, and 151 of them viewed the video (connection rate was 151/24,000, 0.63%). There were 9967 users of the hospital email group and the connection rate was 0.91% (91/9967). The connection rate was 6.17% (807/13,080) from Facebook, significantly higher than the other 2 venues (both P<.001). HH compliance sustained from 83.7% (473/565) in 2013 to 86.7% (589/679) in 2014 (P=.13) among all HCWs. Facebook had the highest connection rate in the HH video campaign. The use of novel social media such as Facebook should be considered for future programs that promote hand hygiene and other healthy behaviors.

The rubber hand illusion in complex regional pain syndrome: preserved ability to integrate a rubber hand indicates intact multisensory integration.

Science.gov (United States)

Reinersmann, Annika; Landwehrt, Julia; Krumova, Elena K; Peterburs, Jutta; Ocklenburg, Sebastian; Güntürkün, Onur; Maier, Christoph

2013-09-01

In patients with complex regional pain syndrome (CRPS) type 1, processing of static tactile stimuli is impaired, whereas more complex sensory integration functions appear preserved. This study investigated higher order multisensory integration of body-relevant stimuli using the rubber hand illusion in CRPS patients. Subjective self-reports and skin conductance responses to watching the rubber hand being harmed were compared among CRPS patients (N=24), patients with upper limb pain of other origin (N=21, clinical control group), and healthy subjects (N=24). Additionally, the influence of body representation (body plasticity [Trinity Assessment of Body Plasticity], neglect-like severity symptoms), and clinical signs of illusion strength were investigated. For statistical analysis, 1-way analysis of variance, t test, Pearson correlation, with α=0.05 were used. CRPS patients did not differ from healthy subjects and the control group with regard to their illusion strength as assessed by subjective reports or skin conductance response values. Stronger left-sided rubber hand illusions were reported by healthy subjects and left-side-affected CRPS patients. Moreover, for this subgroup, illness duration and illusion strength were negatively correlated. Overall, severity of neglect-like symptoms and clinical signs were not related to illusion strength. However, patients with CRPS of the right hand reported significantly stronger neglect-like symptoms and significantly lower illusion strength of the affected hand than patients with CRPS of the left hand. The weaker illusion of CRPS patients with strong neglect-like symptoms on the affected hand supports the role of top-down processes modulating body ownership. Moreover, the intact ability to perceive illusory ownership confirms the notion that, despite impaired processing of proprioceptive or tactile input, higher order multisensory integration is unaffected in CRPS. Copyright © 2013 International Association for the Study

Gasoline on hands: preliminary study on collection and persistence.

Science.gov (United States)

Darrer, Melinda; Jacquemet-Papilloud, Joëlle; Delémont, Olivier

2008-03-05

The identification of an arsonist remains one of the most difficult challenges a fire investigation has to face. Seeking and detection of traces of gasoline could provide a valuable information to link a suspect with an arson scene where gasoline was used to set-up the fire. In this perspective, a first study was undertaken to evaluate a simple, fast and efficient method for collecting gasoline from hands, and to assess its persistence over time. Four collection means were tested: PVC, PE and Latex gloves, as well as humidified filter paper. A statistical assessment of the results indicates that Latex and PVC gloves worn for about 20 min, as well as paper filter rubbed on hands, allow an efficient collection of gasoline applied to hands. Due to ease of manipulation and to a reduced amount of volatile compounds detected from the matrix, PVC gloves were selected for the second set of experiments. The evaluation of the persistence of gasoline on hands was then carried out using two initial quantities (500 and 1000 microl). Collection was made with PVC gloves after 0, 30 min, 1, 2 and 4h, on different volunteers. The results show a common tendency of massive evaporation of gasoline during the first 30 min: a continued but non-linear decrease was observed along different time intervals. The results of this preliminary study are in agreement with other previous researches conducted on the detection of flammable liquid residues on clothes, shoes and skin.

EMG Analysis and Sagittal Plane Kinematics of the Two-Handed and Single-Handed Kettlebell Swing: A Descriptive Study.

Science.gov (United States)

Van Gelder, Leonard H; Hoogenboom, Barbara J; Alonzo, Bryan; Briggs, Dayna; Hatzel, Brian

2015-11-01

Kettlebell (KB) swing exercises have been proposed as a possible method to improve hip and spinal motor control as well as improve power, strength, and endurance. To describe electromyographic (EMG) and sagittal plane kinematics during two KB exercises: the two-handed KB swing (THKS) and the single-handed KB swing (SHKS). In addition, the authors sought to investigate whether or not hip flexor length related to the muscular activity or the kinematics of the exercise. Twenty-three healthy college age subjects participated in this study. Demographic information and passive hip flexor length were recorded for each subject. A maximum voluntary isometric contraction (MVIC) of bilateral gluteus maximus (GMAX), gluteus medius (GMED), and biceps femoris (BF) muscles was recorded. EMG activity and sagittal plane video was recorded during both the THKS and SHKS in a randomized order. Normalized muscular activation of the three studied muscles was calculated from EMG data. During both SHKS and THKS, the average percent of peak MVIC for GMAX was 75.02% ± 55.38, GMED 55.47% ± 26.33, and BF 78.95% ± 53.29. Comparisons of the mean time to peak activation (TTP) for each muscle showed that the biceps femoris was the first muscle to activate during the swings. Statistically significant (p < .05), moderately positive correlations (r = .483 and .417) were found between passive hip flexor length and % MVIC for the GMax during the SHKS and THKS, respectively. The THKS and SHKS provide sufficient muscular recruitment for strengthening of all of the muscles explored. This is the first study to show significant correlations between passive hip flexor length and muscular activation of hip extensors, particularly the GMax. Finally, the BF consistently reached peak activity before the GMax and GMed during the SHKS. Level 3.

Effects of hand orientation on motor imagery--event related potentials suggest kinesthetic motor imagery to solve the hand laterality judgment task.

Science.gov (United States)

Jongsma, Marijtje L A; Meulenbroek, Ruud G J; Okely, Judith; Baas, C Marjolein; van der Lubbe, Rob H J; Steenbergen, Bert

2013-01-01

Motor imagery (MI) refers to the process of imagining the execution of a specific motor action without actually producing an overt movement. Two forms of MI have been distinguished: visual MI and kinesthetic MI. To distinguish between these forms of MI we employed an event related potential (ERP) study to measure interference effects induced by hand orientation manipulations in a hand laterality judgement task. We hypothesized that this manipulation should only affect kinesthetic MI but not visual MI. The ERPs elicited by rotated hand stimuli contained the classic rotation related negativity (RRN) with respect to palm view stimuli. We observed that laterally rotated stimuli led to a more marked RRN than medially rotated stimuli. This RRN effect was observed when participants had their hands positioned in either a straight (control) or an inward rotated posture, but not when their hands were positioned in an outward rotated posture. Posture effects on the ERP-RRN have not previously been studied. Apparently, a congruent hand posture (hands positioned in an outward rotated fashion) facilitates the judgement of the otherwise more demanding laterally rotated hand stimuli. These ERP findings support a kinesthetic interpretation of MI involved in solving the hand laterality judgement task. The RRN may be used as a non-invasive marker for kinesthetic MI and seems useful in revealing the covert behavior of MI in e.g. rehabilitation programs.

An Alternative Myoelectric Pattern Recognition Approach for the Control of Hand Prostheses: A Case Study of Use in Daily Life by a Dysmelia Subject

Science.gov (United States)

Ahlberg, Johan; Lendaro, Eva; Hermansson, Liselotte; Håkansson, Bo; Ortiz-Catalan, Max

2018-01-01

The functionality of upper limb prostheses can be improved by intuitive control strategies that use bioelectric signals measured at the stump level. One such strategy is the decoding of motor volition via myoelectric pattern recognition (MPR), which has shown promising results in controlled environments and more recently in clinical practice. Moreover, not much has been reported about daily life implementation and real-time accuracy of these decoding algorithms. This paper introduces an alternative approach in which MPR allows intuitive control of four different grips and open/close in a multifunctional prosthetic hand. We conducted a clinical proof-of-concept in activities of daily life by constructing a self-contained, MPR-controlled, transradial prosthetic system provided with a novel user interface meant to log errors during real-time operation. The system was used for five days by a unilateral dysmelia subject whose hand had never developed, and who nevertheless learned to generate patterns of myoelectric activity, reported as intuitive, for multi-functional prosthetic control. The subject was instructed to manually log errors when they occurred via the user interface mounted on the prosthesis. This allowed the collection of information about prosthesis usage and real-time classification accuracy. The assessment of capacity for myoelectric control test was used to compare the proposed approach to the conventional prosthetic control approach, direct control. Regarding the MPR approach, the subject reported a more intuitive control when selecting the different grips, but also a higher uncertainty during proportional continuous movements. This paper represents an alternative to the conventional use of MPR, and this alternative may be particularly suitable for a certain type of amputee patients. Moreover, it represents a further validation of MPR with dysmelia cases. PMID:29637030

Brachyphalangism and brachymetapodia of the hand. A radiological study

Energy Technology Data Exchange (ETDEWEB)

Pryde, A W; Kitabatake, Takashi

1960-10-01

Left hand roentgenograms were studied of Japanese children of Hiroshima divided into three groups; Group I was 1302 male and 1237 female normal, healthy controls; Group II was 219 children exposed to the atomic bomb on August 6, 1945 while still intra-utero; Group III was 174 non-exposed control children who were intra-utero on August 6, 1945. Brachymesophalangism of the left little finger was found in the control children in 14.13 percent of males and 21.26 percent of females when epiphyseal irregularity as well as actual shortening is considered as a criterion. Incidence of brachymesophalangism of the left little finger was not significantly different for children exposed to the atomic bomb while intra-utero. Bone age of children with brachymesophalangism and those exposed to the atomic bomb while intra-utero showed no difference from the normal. Brachytelephalangism of the thumb occurs in 2.1 percent of normal boys and in 2.9 percent of normal girls. A possible relation between brachymesophalangism of the little finger and brachytelephalangism of the thumb occurring in the same child is suggested by an association significant at the 5 percent level. Brachymetapodia occurred in 0.2 percent of normal boys and 0.6 percent in girls and was seen most often in the fifth metacarpal. 21 references, 6 tables.

Designing sequence to control protein function in an EF-hand protein.

Science.gov (United States)

Bunick, Christopher G; Nelson, Melanie R; Mangahas, Sheryll; Hunter, Michael J; Sheehan, Jonathan H; Mizoue, Laura S; Bunick, Gerard J; Chazin, Walter J

2004-05-19

The extent of conformational change that calcium binding induces in EF-hand proteins is a key biochemical property specifying Ca(2+) sensor versus signal modulator function. To understand how differences in amino acid sequence lead to differences in the response to Ca(2+) binding, comparative analyses of sequence and structures, combined with model building, were used to develop hypotheses about which amino acid residues control Ca(2+)-induced conformational changes. These results were used to generate a first design of calbindomodulin (CBM-1), a calbindin D(9k) re-engineered with 15 mutations to respond to Ca(2+) binding with a conformational change similar to that of calmodulin. The gene for CBM-1 was synthesized, and the protein was expressed and purified. Remarkably, this protein did not exhibit any non-native-like molten globule properties despite the large number of mutations and the nonconservative nature of some of them. Ca(2+)-induced changes in CD intensity and in the binding of the hydrophobic probe, ANS, implied that CBM-1 does undergo Ca(2+) sensorlike conformational changes. The X-ray crystal structure of Ca(2+)-CBM-1 determined at 1.44 A resolution reveals the anticipated increase in hydrophobic surface area relative to the wild-type protein. A nascent calmodulin-like hydrophobic docking surface was also found, though it is occluded by the inter-EF-hand loop. The results from this first calbindomodulin design are discussed in terms of progress toward understanding the relationships between amino acid sequence, protein structure, and protein function for EF-hand CaBPs, as well as the additional mutations for the next CBM design.

A Pragmatic Randomized Controlled Trial of 6-Step vs 3-Step Hand Hygiene Technique in Acute Hospital Care in the United Kingdom.

Science.gov (United States)

Reilly, Jacqui S; Price, Lesley; Lang, Sue; Robertson, Chris; Cheater, Francine; Skinner, Kirsty; Chow, Angela

2016-06-01

OBJECTIVE To evaluate the microbiologic effectiveness of the World Health Organization's 6-step and the Centers for Disease Control and Prevention's 3-step hand hygiene techniques using alcohol-based handrub. DESIGN A parallel group randomized controlled trial. SETTING An acute care inner-city teaching hospital (Glasgow). PARTICIPANTS Doctors (n=42) and nurses (n=78) undertaking direct patient care. INTERVENTION Random 1:1 allocation of the 6-step (n=60) or the 3-step (n=60) technique. RESULTS The 6-step technique was microbiologically more effective at reducing the median log10 bacterial count. The 6-step technique reduced the count from 3.28 CFU/mL (95% CI, 3.11-3.38 CFU/mL) to 2.58 CFU/mL (2.08-2.93 CFU/mL), whereas the 3-step reduced it from 3.08 CFU/mL (2.977-3.27 CFU/mL) to 2.88 CFU/mL (-2.58 to 3.15 CFU/mL) (P=.02). However, the 6-step technique did not increase the total hand coverage area (98.8% vs 99.0%, P=.15) and required 15% (95% CI, 6%-24%) more time (42.50 seconds vs 35.0 seconds, P=.002). Total hand coverage was not related to the reduction in bacterial count. CONCLUSIONS Two techniques for hand hygiene using alcohol-based handrub are promoted in international guidance, the 6-step by the World Health Organization and 3-step by the Centers for Disease Control and Prevention. The study provides the first evidence in a randomized controlled trial that the 6-step technique is superior, thus these international guidance documents should consider this evidence, as should healthcare organizations using the 3-step technique in practice. Infect Control Hosp Epidemiol 2016;37:661-666.

Hand-Arm vibration assessment among tiller operator

Directory of Open Access Journals (Sweden)

P. Nassiri

2013-08-01

Result: Results of the present study indicated that in all measured situations, exposure to hand arm vibration was higher than the standard limit suggested by Iranian occupational health committee and there was risk of vibration-induced disorders. The maximum exposure to vibration is in plowing ground. Exposure to hand arm vibration in three modes of plowing, transmission and natural, were respectively 16.95, 14.16 and 8.65 meters per second squared. Additionally, in all situations, vibration exposure was highest in the X-axis in comparison with Z- and Y-axes. .Conclusion: This study emphasizes on the need to provide intervention and controlling and managing strategies in order to eliminate or reduce vibration transmitted from tiller to operators hand and arm and also prevent to serious problems including neurovascular disorders, discomfort and white finger syndrome. Meanwhile, more studies are necessary to identify the sources of vibration on different models of tiller.

Anthropomorphic Robot Hand And Teaching Glove

Science.gov (United States)

Engler, Charles D., Jr.

1991-01-01

Robotic forearm-and-hand assembly manipulates objects by performing wrist and hand motions with nearly human grasping ability and dexterity. Imitates hand motions of human operator who controls robot in real time by programming via exoskeletal "teaching glove". Telemanipulator systems based on this robotic-hand concept useful where humanlike dexterity required. Underwater, high-radiation, vacuum, hot, cold, toxic, or inhospitable environments potential application sites. Particularly suited to assisting astronauts on space station in safely executing unexpected tasks requiring greater dexterity than standard gripper.

Is hand hygiene before putting on nonsterile gloves in the intensive care unit a waste of health care worker time?--a randomized controlled trial.

Science.gov (United States)

Rock, Clare; Harris, Anthony D; Reich, Nicholas G; Johnson, J Kristie; Thom, Kerri A

2013-11-01

Hand hygiene (HH) is recognized as a basic effective measure in prevention of nosocomial infections. However, the importance of HH before donning nonsterile gloves is unknown, and few published studies address this issue. Despite the lack of evidence, the World Health Organization and other leading bodies recommend this practice. The aim of this study was to assess the utility of HH before donning nonsterile gloves prior to patient contact. A prospective, randomized, controlled trial of health care workers entering Contact Isolation rooms in intensive care units was performed. Baseline finger and palm prints were made from dominant hands onto agar plates. Health care workers were then randomized to directly don nonsterile gloves or perform HH and then don nonsterile gloves. Postgloving finger and palm prints were then made from the gloved hands. Plates were incubated and colony-forming units (CFU) of bacteria were counted. Total bacterial colony counts of gloved hands did not differ between the 2 groups (6.9 vs 8.1 CFU, respectively, P = .52). Staphylococcus aureus was identified from gloves (once in "hand hygiene prior to gloving" group, twice in "direct gloving" group). All other organisms were expected commensal flora. HH before donning nonsterile gloves does not decrease already low bacterial counts on gloves. The utility of HH before donning nonsterile gloves may be unnecessary. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

The effects of compression gloves on hand symptoms and hand function in rheumatoid arthritis and hand osteoarthritis: a systematic review.

Science.gov (United States)

Hammond, Alison; Jones, Vivienne; Prior, Yeliz

2016-03-01

to evaluate the effects of compression gloves in adults with rheumatoid arthritis and hand osteoarthritis. Systematic review of randomized controlled trials identified from MEDLINE, CINAHL, AMED, PEDro, OT Seeker, The Cochrane Library, ISI Web of Knowledge, Science Direct and PubMed from their inceptions to January 2015. Methodological quality of identified trials was evaluated using the PEDro scale by three independent assessors. Effects were summarized descriptively. Four trials (n=8-24; total n=74), comparing night wear of full-length finger compression gloves with placebo gloves, were assessed. Three were of moderate (PEDro score 4-5) and one low (score 3) methodological quality. Effect sizes or standardized mean differences could not be calculated to compare trials due to poor data reporting. In rheumatoid arthritis, finger joint swelling was significantly reduced, but results for pain and stiffness were inconclusive and no differences in grip strength and dexterity were identified. One study reported similar effects in pain, stiffness and finger joint swelling from both compression and thermal placebo gloves. Only one study evaluated gloves in hand osteoarthritis (n=5) with no differences. All the trials identified were small with a high risk of Type I and II errors. Evidence for the effectiveness of compression gloves worn at night is inconclusive in rheumatoid arthritis and hand osteoarthritis. © The Author(s) 2015.

A person-oriented approach to hand hygiene behaviour: Emotional empathy fosters hand hygiene practice.

Science.gov (United States)

Sassenrath, Claudia; Diefenbacher, Svenja; Siegel, André; Keller, Johannes

2016-01-01

Adopting a social-psychological approach, this research examines whether emotional empathy, an affective reaction regarding another's well-being, fosters hand hygiene as this affects other's health-related well-being extensively. Three studies tested this notion: (a) a cross-sectional study involving a sample of health care workers at a German hospital, (b) an experiment testing the causal effect of empathy on hand hygiene behaviour and (c) an 11-week prospective study testing whether an empathy induction affected disinfectant usage frequency in two different wards of a hospital. Self-reported hand hygiene behaviour based on day reconstruction method was measured in Study 1, actual hand sanitation behaviour was observed in Study 2 and disinfectant usage frequency in two different hospital wards was assessed in Study 3. Study 1 reveals an association of empathy with hand hygiene cross-sectionally, Study 2 documents the causal effect of empathy on increased hand sanitation. Study 3 shows an empathy induction increases hand sanitiser usage in the hospital. Increasing emotional empathy promotes hand hygiene behaviour, also in hospitals. Besides providing new impulses for the design of effective interventions, these findings bear theoretical significance as they document the explanatory power of empathy regarding a distal explanandum (hand hygiene).

Ground Robotic Hand Applications for the Space Program study (GRASP)

Science.gov (United States)

Grissom, William A.; Rafla, Nader I. (Editor)

1992-01-01

This document reports on a NASA-STDP effort to address research interests of the NASA Kennedy Space Center (KSC) through a study entitled, Ground Robotic-Hand Applications for the Space Program (GRASP). The primary objective of the GRASP study was to identify beneficial applications of specialized end-effectors and robotic hand devices for automating any ground operations which are performed at the Kennedy Space Center. Thus, operations for expendable vehicles, the Space Shuttle and its components, and all payloads were included in the study. Typical benefits of automating operations, or augmenting human operators performing physical tasks, include: reduced costs; enhanced safety and reliability; and reduced processing turnaround time.

The tropical diabetic hand syndrome: a surgical perspective.

Science.gov (United States)

Nthumba, Peter; Cavadas, Pedro C; Landin, Luis

2013-01-01

Tropical diabetic hand syndrome (TDHS) is an aggressive type of hand sepsis that results in significant morbidity and mortality among patients with diabetes in the tropics. This study set out to establish a protocol for the holistic management of TDHS to improve digit/hand salvage and function at AIC Kijabe Hospital. This prospective study examined the following demographics of patients presenting to the authors institution between October 2009 and September 2010 with TDHS: their sex, age, comorbidities, length of in-hospital stay, surgical and medical treatment, total cost of treatment, and immediate postdischarge outcomes. A total of 10 patients (3 men and 7 women) were presented with TDHS during the study period. Surgical procedures included a thorough debridement of the hand at initial presentation, followed by procedures aimed at preserving length and hand function, with digit or hand amputation when there was no possibility of salvage. Three hands were salvaged, without the need for an amputation; 2 of these, however, developed severe stiffness with resultant poor function. Fifty percent of the patients developed considerable disability; 3 of these patients had disabilities of the arm, shoulder, and hand, (DASH) scores of >90 at 6 months after treatment. TDHS appears to be more aggressive in some patients than in others; a multidisciplinary approach, with early involvement of the surgical team, and a radical surgical debridement are essential to improved outcomes. Although the goal of medical treatment (ie, glycemic control) is simple and easily achieved, surgical goals (salvage of limb or life, preservation of hand function) are more complex, costly, and difficult to achieve. Educating health care workers, diabetic patients, and their relatives on hand care is an important preventive measure. Diligence in taking antidiabetic medicine, early presentation, and appropriate care of TDHS are required for meaningful improvement in outcomes of patients with

Hospital hand hygiene opportunities: where and when (HOW2)? The HOW2 Benchmark Study.

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Steed, Connie; Kelly, J William; Blackhurst, Dawn; Boeker, Sue; Diller, Thomas; Alper, Paul; Larson, Elaine

2011-02-01

Measurement and monitoring of health care workers' hand hygiene compliance (i.e., actions/opportunities) is a key component of strategies to eliminate hospital-acquired infections. Little data exist on the expected number of hand hygiene opportunities (HHOs) in various hospital settings, however. The purpose of this study was to estimate HHOs in 2 types of hospitals--large teaching and small community--and 3 different clinical areas-medical-surgical intensive care units, general medical wards, and emergency departments. HHO data were collected through direct observations using the World Health Organization's monitoring methodology. Estimates of HHOs were developed for 12-hour AM/PM shifts and 24-hour time frames. During 436.7 hours of observation, 6,640 HHOs were identified. Estimates of HHOs ranged from 30 to 179 per patient-day on inpatient wards and from 1.84 to 5.03 per bed-hour in emergency departments. Significant differences in HHOs were found between the 2 hospital types and among the 3 clinical areas. This study is the first to use the World Health Organization's data collection methodology to estimate HHOs in general medical wards and emergency departments. These data can be used as denominator estimates to calculate hand hygiene compliance rates when product utilization data are available. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Pathophysiology and Treatment of Alien Hand Syndrome

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Harini Sarva

2014-12-01

Full Text Available Background: Alien hand syndrome (AHS is a disorder of involuntary, yet purposeful, hand movements that may be accompanied by agnosia, aphasia, weakness, or sensory loss. We herein review the most reported cases, current understanding of the pathophysiology, and treatments.Methods: We performed a PubMed search in July of 2014 using the phrases “alien hand syndrome,” “alien hand syndrome pathophysiology,” “alien hand syndrome treatment,” and “anarchic hand syndrome.” The search yielded 141 papers (reviews, case reports, case series, and clinical studies, of which we reviewed 109. Non‐English reports without English abstracts were excluded.Results: Accumulating evidence indicates that there are three AHS variants: frontal, callosal, and posterior. Patients may demonstrate symptoms of multiple types; there is a lack of correlation between phenomenology and neuroimaging findings. Most pathologic and functional imaging studies suggest network disruption causing loss of inhibition as the likely cause. Successful interventions include botulinum toxin injections, clonazepam, visuospatial coaching techniques, distracting the affected hand, and cognitive behavioral therapy.Discussion: The available literature suggests that overlap between AHS subtypes is common. The evidence for effective treatments remains anecdotal, and, given the rarity of AHS, the possibility of performing randomized, placebo‐controlled trials seems unlikely. As with many other interventions for movement disorders, identifying the specific functional impairments caused by AHS may provide the best guidance towards individualized supportive care.

Do hospital visitors wash their hands? Assessing the use of alcohol-based hand sanitizer in a hospital lobby.

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Birnbach, David J; Nevo, Igal; Barnes, Susan; Fitzpatrick, Maureen; Rosen, Lisa F; Everett-Thomas, Ruth; Sanko, Jill S; Arheart, Kristopher L

2012-05-01

Reports regarding hand hygiene compliance (HHC) among hospital visitors are limited. Although there is an implicit assumption that the availability of alcohol-based hand sanitizer (AHS) promotes visitor HHC, the degree of AHS use by visitors remains unclear. To assess AHS use, we observed visitor HHC and how it is affected by visual cues in a private university hospital. Using an observational controlled study, we tested 3 interventions: a desk sign mandating all visitors to use AHS, a free-standing AHS dispenser directly in front of a security desk, and a combination of a freestanding AHS dispenser and a sign. HHC was 0.52% at baseline and did not improve significantly when the desk sign was provided as a cue 0.67% (P = .753). However, HHC did improve significantly with use of the freestanding AHS dispenser (9.33%) and the sign and dispenser combination (11.67%) (P hand hygiene behavior. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

The impact of the International Nosocomial Infection Control Consortium (INICC multicenter, multidimensional hand hygiene approach in two cities of India

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Murali Chakravarthy

2015-03-01

Full Text Available Summary: The fundamental tool for preventing and controlling healthcare-acquired infections is hand hygiene (HH. Nonetheless, adherence to HH guidelines is often low. Our goal was to assess the effect of the International Nosocomial Infection Control Consortium (INICC Multidimensional Hand Hygiene Approach (IMHHA in three intensive care units of three INICC member hospitals in two cities of India and to analyze the predictors of compliance with HH. From August 2004 to July 2011, we carried out an observational, prospective, interventional study to evaluate the implementation of the IMHHA, which included the following elements: (1 administrative support, (2 supplies availability, (3 education and training, (4 reminders in the workplace, (5 process surveillance and (6 performance feedback. The practices of health care workers were monitored during randomly selected 30-min periods. We observed 3612 opportunities for HH. Overall adherence to HH increased from 36.9% to 82% (95% CI 79.3–84.5; P = 0.0001. Multivariate analysis indicated that certain variables were significantly associated with poor HH adherence: nurses vs. physicians (70.5% vs. 74%; 95% CI 0.62–0.96; P = 0.018, ancillary staff vs. physicians (43.6% vs. 74.0%; 95% CI 0.48–0.72; P < 0.001, ancillary staff vs. nurses (43.6% vs. 70.5%; 95% CI 0.51–0.75; P < 0.001 and private vs. academic hospitals (74.2% vs. 66.3%; 95% CI 0.83–0.97; P < 0.001. It is worth noticing that in India, the HH compliance of physicians is higher than in nurses. Adherence to HH was significantly increased by implementing the IMHHA. Programs targeted at improving HH are warranted to identify predictors of poor compliance. Keywords: Care, Developing countries, Hand hygiene, Hand washing, Healthcare workers, India, Infection control, Intensive care units, International Nosocomial Infection Control Consortium, Multidimensional approach

Clean Hands Count

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Full Text Available ... CDC) 97,825 views 5:12 CDC Flu Education Video - Duration: 10:26. Nicole Shelton 213 views ... Infection Control Video - Duration: 20:55. Paramedical Services Education Page 4,735 views 20:55 Hand Washing ...

Hand-suture versus stapling for closure of loop ileostomy: HASTA-Trial: a study rationale and design for a randomized controlled trial

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Krüger Matthias

2011-02-01

Full Text Available Abstract Background Colorectal cancer is the second most common tumor in developed countries, with a lifetime prevalence of 5%. About one third of these tumors are located in the rectum. Surgery in terms of low anterior resection with mesorectal excision is the central element in the treatment of rectal cancer being the only option for definite cure. Creating a protective diverting stoma prevents complications like anastomotic failure and meanwhile is the standard procedure. Bowel obstruction is one of the main and the clinically and economically most relevant complication following closure of loop ileostomy. The best surgical technique for closure of loop ileostomy has not been defined yet. Methods/Design A study protocol was developed on the basis of the only randomized controlled mono-center trial to solve clinical equipoise concerning the optimal surgical technique for closure of loop ileostomy after low anterior resection due to rectal cancer. The HASTA trial is a multi-center pragmatic randomized controlled surgical trial with two parallel groups to compare hand-suture versus stapling for closure of loop ileostomy. It will include 334 randomized patients undergoing closure of loop ileostomy after low anterior resection with protective ileostomy due to rectal cancer in approximately 20 centers consisting of German hospitals of all level of health care. The primary endpoint is the rate of bowel obstruction within 30 days after ileostomy closure. In addition, a set of surgical and general variables including quality of life will be analyzed with a follow-up of 12 months. An investigators meeting with a practical session will help to minimize performance bias and enforce protocol adherence. Centers are monitored centrally as well as on-site before and during recruitment phase to assure inclusion, treatment and follow up according to the protocol. Discussion Aim of the HASTA trial is to evaluate the efficacy of hand-suture versus stapling for

Digital tomosynthesis of hand joints for arthritis assessment

International Nuclear Information System (INIS)

Duryea, J.; Dobbins, J.T. III; Lynch, J.A.

2003-01-01

The two principal forms of hand arthritis, rheumatoid arthritis (RA) and osteoarthritis (OA) have large clinical and economic costs. Radiography has been shown to be a useful tool to assess the condition of the disease. A hand radiograph, however, is a two-dimensional projection of a three-dimensional object. In this report we present the results of a study that applied digital tomosynthesis to hand radiography in order to extract three-dimensional outcome measures that should be more sensitive to arthritis progression. The study was performed using simulated projection radiographs created using micro computed tomography (μCT) and a set of five dry-bone hand skeletons. These simulated projection images were then reconstructed into tomographic slices using the matrix inversion tomosynthesis (MITS) algorithm. The accuracy of the tomosynthesis reconstruction was evaluated by comparing the reconstructed images to a gold standard created using the μCT data. A parameter from image registration science, normalized mutual information, provided a quantifiable figure of merit. This study examined the effects of source displacement, number of reconstructed planes, number of acquisitions, noise added to the gray scale images, and errors in the location of a fiducial marker. We also optimized the reconstruction as a function of two variables k and α, that controlled the mixing of MITS with conventional shift-and-add tomosynthesis. A study using hand delineated joint margins demonstrated that MITS images provided a better measurement of average joint space width. We found good agreement between the MITS slices and the true planes. Both joint margins and trabecular structure were visible and the reconstructed slices showed additional structures not visible with the standard projection image. Using hand-delineated joint margins we compared the average joint space width of the gold standard slices to the MITS and projection images. A root-mean square deviation (RMSD), calculated

An educational intervention to improve hand hygiene compliance in Vietnam.

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Phan, Hang Thi; Tran, Hang Thi Thuy; Tran, Hanh Thi My; Dinh, Anh Pham Phuong; Ngo, Ha Thanh; Theorell-Haglow, Jenny; Gordon, Christopher J

2018-03-07

Hand hygiene compliance is the basis of infection control programs. In developing countries models to improve hand hygiene compliance to reduce healthcare acquired infections are required. The aim of this study was to determine hand hygiene compliance following an educational program in an obstetric and gynecological hospital in Vietnam. Health care workers from neonatal intensive care, delivery suite and a surgical ward from Hung Vuong Hospital, Ho Chi Minh City, Vietnam undertook a 4-h educational program targeting hand hygiene. Compliance was monitored monthly for six months following the intervention. Hand hygiene knowledge was assessed at baseline and after six months of the study. There were 7124 opportunities over 370 hand hygiene recording sessions with 1531 opportunities at baseline and 1620 at 6 months following the intervention. Hand hygiene compliance increased significantly from baseline across all sites (43.6% [95% Confidence interval CI: 41.1-46.1] to 63% [95% CI: 60.6-65.3]; p hygiene compliance increased significantly after intervention (p hygiene compliance for an extended period of time. Hand hygiene knowledge increased during the intervention. This hand hygiene model could be used in developing countries were resources are limited.

Interventions to improve hand hygiene compliance in patient care.

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Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H; Taljaard, Monica

2017-09-01

Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. This is an update of a previously published review. To assess the short- and long-term success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of the Cochrane Register of Controlled Trials, PubMed, Embase, and CINAHL. We conducted the searches from November 2009 to October 2016. We included randomised trials, non-randomised trials, controlled before-after studies, and interrupted time series analyses (ITS) that evaluated any intervention to improve compliance with hand hygiene using soap and water or alcohol-based hand rub (ABHR), or both. Two review authors independently screened citations for inclusion, extracted data, and assessed risks of bias for each included study. Meta-analysis was not possible, as there was substantial heterogeneity across studies. We assessed the certainty of evidence using the GRADE approach and present the results narratively in a 'Summary of findings' table. This review includes 26 studies: 14 randomised trials, two non-randomised trials and 10 ITS studies. Most studies were conducted in hospitals or long-term care facilities in different countries, and collected data from a variety of healthcare workers. Fourteen studies assessed the success of different combinations of strategies recommended by the World Health Organization (WHO) to improve hand hygiene compliance. Strategies consisted of the following: increasing the availability of ABHR, different types of education for staff, reminders (written and verbal), different types of performance feedback, administrative support, and staff involvement. Six studies assessed different types of performance feedback, two studies evaluated education, three studies evaluated cues such

Comparison of hand hygiene procedures for removing Bacillus cereus spores.

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Sasahara, Teppei; Hayashi, Shunji; Hosoda, Kouichi; Morisawa, Yuji; Hirai, Yoshikazu

2014-01-01

Bacillus cereus is a spore-forming bacterium. B. cereus occasionally causes nosocomial infections, in which hand contamination with the spores plays an important role. Therefore, hand hygiene is the most important practice for controlling nosocomial B. cereus infections. This study aimed to determine the appropriate hand hygiene procedure for removing B. cereus spores. Thirty volunteers' hands were experimentally contaminated with B. cereus spores, after which they performed 6 different hand hygiene procedures. We compared the efficacy of the procedures in removing the spores from hands. The alcohol-based hand-rubbing procedures scarcely removed them. The soap washing procedures reduced the number of spores by more than 2 log10. Extending the washing time increased the spore-removing efficacy of the washing procedures. There was no significant difference in efficacy between the use of plain soap and antiseptic soap. Handwashing with soap is appropriate for removing B. cereus spores from hands. Alcohol-based hand-rubbing is not effective.

Hand Gesture Recognition with Leap Motion

OpenAIRE

Du, Youchen; Liu, Shenglan; Feng, Lin; Chen, Menghui; Wu, Jie

2017-01-01

The recent introduction of depth cameras like Leap Motion Controller allows researchers to exploit the depth information to recognize hand gesture more robustly. This paper proposes a novel hand gesture recognition system with Leap Motion Controller. A series of features are extracted from Leap Motion tracking data, we feed these features along with HOG feature extracted from sensor images into a multi-class SVM classifier to recognize performed gesture, dimension reduction and feature weight...

Patterning a hydrogen-bonded molecular monolayer with a hand-controlled scanning probe microscope

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Matthew F. B. Green

2014-10-01

Full Text Available One of the paramount goals in nanotechnology is molecular-scale functional design, which includes arranging molecules into complex structures at will. The first steps towards this goal were made through the invention of the scanning probe microscope (SPM, which put single-atom and single-molecule manipulation into practice for the first time. Extending the controlled manipulation to larger molecules is expected to multiply the potential of engineered nanostructures. Here we report an enhancement of the SPM technique that makes the manipulation of large molecular adsorbates much more effective. By using a commercial motion tracking system, we couple the movements of an operator's hand to the sub-angstrom precise positioning of an SPM tip. Literally moving the tip by hand we write a nanoscale structure in a monolayer of large molecules, thereby showing that our method allows for the successful execution of complex manipulation protocols even when the potential energy surface that governs the interaction behaviour of the manipulated nanoscale object(s is largely unknown.

Body schema and corporeal self-recognition in the alien hand syndrome.

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Olgiati, Elena; Maravita, Angelo; Spandri, Viviana; Casati, Roberta; Ferraro, Francesco; Tedesco, Lucia; Agostoni, Elio Clemente; Bolognini, Nadia

2017-07-01

The alien hand syndrome (AHS) is a rare neuropsychological disorder characterized by involuntary, yet purposeful, hand movements. Patients with the AHS typically complain about a loss of agency associated with a feeling of estrangement for actions performed by the affected limb. The present study explores the integrity of the body representation in AHS, focusing on 2 main processes: multisensory integration and visual self-recognition of body parts. Three patients affected by AHS following a right-hemisphere stroke, with clinical symptoms akin to the posterior variant of AHS, were tested and their performance was compared with that of 18 age-matched healthy controls. AHS patients and controls underwent 2 experimental tasks: a same-different visual matching task for body postures, which assessed the ability of using your own body schema for encoding others' body postural changes (Experiment 1), and an explicit self-hand recognition task, which assessed the ability to visually recognize your own hands (Experiment 2). As compared to controls, all AHS patients were unable to access a reliable multisensory representation of their alien hand and use it for decoding others' postural changes; however, they could rely on an efficient multisensory representation of their intact (ipsilesional) hand. Two AHS patients also presented with a specific impairment in the visual self-recognition of their alien hand, but normal recognition of their intact hand. This evidence suggests that the AHS following a right-hemisphere stroke may involve a disruption of the multisensory representation of the alien limb; instead, self-hand recognition mechanisms may be spared. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A quasi-experimental study to determine the effects of a multifaceted educational intervention on hand hygiene compliance in a radiography unit.

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O'Donoghue, Margaret; Ng, Suk-Hing; Suen, Lorna Kp; Boost, Maureen

2016-01-01

Whilst numerous studies have investigated nurses' compliance with hand hygiene and use of alcohol-based hand rub (ABHR), limited attention has been paid to these issues in allied health staff. Reports have linked infections to breaches in infection control in the radiography unit (RU). With advances in medical imaging, a higher proportion of patients come into contact with RU staff increasing the need for good hand hygiene compliance. This study aimed to evaluate effectiveness on compliance of an intervention to improve awareness of hand hygiene in the RU of a district hospital. A quasi-experimental study design including questionnaires assessing knowledge and attitudes of hand hygiene and direct observation of participants was used to evaluate an educational programme on hand hygiene of the RU of a large district hospital. All healthcare workers (HCW), comprising 76 radiographers, 17 nurses, and nine healthcare assistants (HCA), agreed to participate in the study. Of these, 85 completed the initial and 76 the post-test anonymous questionnaire. The hand hygiene compliance of all 102 HCW was observed over a 3-week period prior to and after the intervention. The 2-month intervention consisted of talks on hand hygiene and benefits of ABHR, provision of visual aids, wall-mounted ABHR dispensers, and personal bottles of ABHR. Before the intervention, overall hand hygiene compliance was low (28.9 %). Post-intervention, compliance with hand hygiene increased to 51.4 %. This improvement was significant for radiographers and HCA. Additionally, knowledge and attitudes improved in particular, understanding that ABHR can largely replace handwashing and there is a need to perform hand hygiene after environmental contact. The increased use of ABHR allowed HCW to feel they had enough time to perform hand hygiene. The educational intervention led to increased awareness of hand hygiene opportunities and better acceptance of ABHR use. The reduced time needed to perform hand

A quasi-experimental study to determine the effects of a multifaceted educational intervention on hand hygiene compliance in a radiography unit

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Margaret O’Donoghue

2016-10-01

Full Text Available Abstract Background Whilst numerous studies have investigated nurses’ compliance with hand hygiene and use of alcohol-based hand rub (ABHR, limited attention has been paid to these issues in allied health staff. Reports have linked infections to breaches in infection control in the radiography unit (RU. With advances in medical imaging, a higher proportion of patients come into contact with RU staff increasing the need for good hand hygiene compliance. This study aimed to evaluate effectiveness on compliance of an intervention to improve awareness of hand hygiene in the RU of a district hospital. Methods A quasi-experimental study design including questionnaires assessing knowledge and attitudes of hand hygiene and direct observation of participants was used to evaluate an educational programme on hand hygiene of the RU of a large district hospital. All healthcare workers (HCW, comprising 76 radiographers, 17 nurses, and nine healthcare assistants (HCA, agreed to participate in the study. Of these, 85 completed the initial and 76 the post-test anonymous questionnaire. The hand hygiene compliance of all 102 HCW was observed over a 3-week period prior to and after the intervention. The 2-month intervention consisted of talks on hand hygiene and benefits of ABHR, provision of visual aids, wall-mounted ABHR dispensers, and personal bottles of ABHR. Results Before the intervention, overall hand hygiene compliance was low (28.9 %. Post-intervention, compliance with hand hygiene increased to 51.4 %. This improvement was significant for radiographers and HCA. Additionally, knowledge and attitudes improved in particular, understanding that ABHR can largely replace handwashing and there is a need to perform hand hygiene after environmental contact. The increased use of ABHR allowed HCW to feel they had enough time to perform hand hygiene. Conclusions The educational intervention led to increased awareness of hand hygiene opportunities and better

REMARKS ON NEUROCONTROL OF THE HAND AND SIGNIFICANCE OF AFFERENT INPUT

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Nejc Sarabon

2004-12-01

Full Text Available This paper outlines some remarks on our understanding of motor control of the hand. It begins with current knowledge about motor behavior of prehension movements. It further highlights the distributed nature of the control system that integrates sensory information from the periphery, existing motor memory from subcortical centers, and information from diverse primary and secondary motor as well as sensory areas. It further explains the sequential nature of the processes like decision, planning, computing, and execution involved in neurocontrol of a purposeful hand motor task. In the successive part it stresses the importance of sensory input, in particular proprioceptive, for movement setting and guidance. It concludes by pointing out research concepts used to study roles of sensory information for modulating states of neurobiological systems. Finally, a novel method of whole hand electrical stimulation, which seems promising as a tool for studying sensory-motor integration mechanisms in human’s hand, is explained and recent experimental data are provided.

Human-inspired feedback synergies for environmental interaction with a dexterous robotic hand.

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Kent, Benjamin A; Engeberg, Erik D

2014-11-07

Effortless control of the human hand is mediated by the physical and neural couplings inherent in the structure of the hand. This concept was explored for environmental interaction tasks with the human hand, and a novel human-inspired feedback synergy (HFS) controller was developed for a robotic hand which synchronized position and force feedback signals to mimic observed human hand motions. This was achieved by first recording the finger joint motion profiles of human test subjects, where it was observed that the subjects would extend their fingers to maintain a natural hand posture when interacting with different surfaces. The resulting human joint angle data were used as inspiration to develop the HFS controller for the anthropomorphic robotic hand, which incorporated finger abduction and force feedback in the control laws for finger extension. Experimental results showed that by projecting a broader view of the tasks at hand to each specific joint, the HFS controller produced hand motion profiles that closely mimic the observed human responses and allowed the robotic manipulator to interact with the surfaces while maintaining a natural hand posture. Additionally, the HFS controller enabled the robotic hand to autonomously traverse vertical step discontinuities without prior knowledge of the environment, visual feedback, or traditional trajectory planning techniques.

Human-inspired feedback synergies for environmental interaction with a dexterous robotic hand

International Nuclear Information System (INIS)

Kent, Benjamin A; Engeberg, Erik D

2014-01-01

Effortless control of the human hand is mediated by the physical and neural couplings inherent in the structure of the hand. This concept was explored for environmental interaction tasks with the human hand, and a novel human-inspired feedback synergy (HFS) controller was developed for a robotic hand which synchronized position and force feedback signals to mimic observed human hand motions. This was achieved by first recording the finger joint motion profiles of human test subjects, where it was observed that the subjects would extend their fingers to maintain a natural hand posture when interacting with different surfaces. The resulting human joint angle data were used as inspiration to develop the HFS controller for the anthropomorphic robotic hand, which incorporated finger abduction and force feedback in the control laws for finger extension. Experimental results showed that by projecting a broader view of the tasks at hand to each specific joint, the HFS controller produced hand motion profiles that closely mimic the observed human responses and allowed the robotic manipulator to interact with the surfaces while maintaining a natural hand posture. Additionally, the HFS controller enabled the robotic hand to autonomously traverse vertical step discontinuities without prior knowledge of the environment, visual feedback, or traditional trajectory planning techniques. (paper)

Myoelectric intuitive control and transcutaneous electrical stimulation of the forearm for vibrotactile sensation feedback applied to a 3D printed prosthetic hand.

Science.gov (United States)

Germany, Enrique I; Pino, Esteban J; Aqueveque, Pablo E

2016-08-01

This paper presents the development of a myoelectric prosthetic hand based on a 3D printed model. A myoelectric control strategy based on artificial neural networks is implemented on a microcontroller for online position estimation. Position estimation performance achieves a correlation index of 0.78. Also a study involving transcutaneous electrical stimulation was performed to provide tactile feedback. A series of stimulations with controlled parameters were tested on five able-body subjects. A single channel stimulator was used, positioning the electrodes 8 cm on the wrist over the ulnar and median nerve. Controlling stimulation parameters such as intensity, frequency and pulse width, the subjects were capable of distinguishing different sensations over the palm of the hand. Three main sensations where achieved: tickling, pressure and pain. Tickling and pressure were discretized into low, moderate and high according to the magnitude of the feeling. The parameters at which each sensation was obtained are further discussed in this paper.

Clean Hands Count

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Full Text Available ... action today; no cure tomorrow - Duration: 3:10. World Health Organization 74,478 views 3:10 Wash your Hands - ... handwash? With soap and water - Duration: 1:27. World Health Organization 215,487 views 1:27 Infection Control Video - ...

RAPID3 scores and hand outcome measurements in RA patients: a preliminary study.

Science.gov (United States)

Qorolli, Merita; Hundozi-Hysenaj, Hajrije; Rexhepi, Sylejman; Rehxepi, Blerta; Grazio, Simeon

2017-06-01

The Routine Assessment of Patient Index Data 3 (RAPID3) is a patient-reported disease activity measure used to assess physical function, pain, and global health in patients with rheumatoid arthritis (RA) without formal joint counts. Since hand involvement and its decreased function are hallmarks of RA, the aim of our study was to investigate the performance of RAPID3 scores with regard to hand function and to confirm previous findings that the RAPID3 score as a disease activity measure is strongly correlated with the DAS28 score. Sixty-eight consecutive patients with RA (85% female), aged 18-75 years, were included in the study and were recruited during their outpatient visit. Apart from demographic and clinical data, the obtained parameters of interest included RAPID3 scores and assessments of the function of the hand, namely, the signal of functional impairment (SOFI)-hand, grip strength, and pulp-to-palm distance, as well the Health Assessment Questionnaire- Disability Index (HAQ-DI) and DAS28 scores. Pearson's correlation coefficient, Student's t test and linear regression were used in the statistical analysis of the results. The significance was set to p < 0.05. A positive correlation was found between RAPID3 scores and HAQ-DI scores, SOFI-hand scores, and pulp-to-palm distance, and negative correlation was observed between RAPID3 scores and grip strength. The order regarding the strength of correlations between RAPID3 scores and other variables (from the strongest to the weakest) was as follows: HAQ-DI, grip strength, SOFI-hand and pulp-to-palm distance. The hand assessment variables had stronger correlations with RAPID3 scores than with DAS28 scores. Our preliminary study showed that RAPID3 scores were strongly correlated with measurements of the functional ability of the hand, demonstrating that RAPID3 can be used as a measure of disease activity in clinical practice and to characterize hand function. Further studies are needed to confirm this result.

The Feedback Intervention Trial (FIT) — Improving Hand-Hygiene Compliance in UK Healthcare Workers: A Stepped Wedge Cluster Randomised Controlled Trial

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Fuller, Christopher; Michie, Susan; Savage, Joanne; McAteer, John; Besser, Sarah; Charlett, Andre; Hayward, Andrew; Cookson, Barry D.; Cooper, Ben S.; Duckworth, Georgia; Jeanes, Annette; Roberts, Jenny; Teare, Louise; Stone, Sheldon

2012-01-01

Introduction Achieving a sustained improvement in hand-hygiene compliance is the WHO’s first global patient safety challenge. There is no RCT evidence showing how to do this. Systematic reviews suggest feedback is most effective and call for long term well designed RCTs, applying behavioural theory to intervention design to optimise effectiveness. Methods Three year stepped wedge cluster RCT of a feedback intervention testing hypothesis that the intervention was more effective than routine practice in 16 English/Welsh Hospitals (16 Intensive Therapy Units [ITU]; 44 Acute Care of the Elderly [ACE] wards) routinely implementing a national cleanyourhands campaign). Intervention-based on Goal & Control theories. Repeating 4 week cycle (20 mins/week) of observation, feedback and personalised action planning, recorded on forms. Computer-generated stepwise entry of all hospitals to intervention. Hospitals aware only of own allocation. Primary outcome: direct blinded hand hygiene compliance (%). Results All 16 trusts (60 wards) randomised, 33 wards implemented intervention (11 ITU, 22 ACE). Mixed effects regression analysis (all wards) accounting for confounders, temporal trends, ward type and fidelity to intervention (forms/month used). Intention to Treat Analysis Estimated odds ratio (OR) for hand hygiene compliance rose post randomisation (1.44; 95% CI 1.18, 1.76;phand-hygiene compliance, in wards implementing a national hand-hygiene campaign. Further implementation studies are needed to maximise the intervention’s effect in different settings. Trial Registration Controlled-Trials.com ISRCTN65246961 PMID:23110040

The effect of an instant hand sanitizer on blood glucose monitoring results.

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Mahoney, John J; Ellison, John M; Glaeser, Danielle; Price, David

2011-11-01

People with diabetes mellitus are instructed to clean their skin prior to self-monitoring of blood glucose to remove any dirt or food residue that might affect the reading. Alcohol-based hand sanitizers have become popular when soap and water are not available. The aim of this study was to determine whether a hand sanitizer is compatible with glucose meter testing and effective for the removal of exogenous glucose. We enrolled 34 nonfasting subjects [14 male/20 female, mean ages 45 (standard deviation, 9.4)] years, 2 with diagnosed diabetes/32 without known diabetes]. Laboratory personnel prepared four separate fingers on one hand of each subject by (1) cleaning the second finger with soap and water and towel drying (i.e., control finger), (2) cleaning the third finger with an alcohol-based hand sanitizer, (3) coating the fourth finger with cola and allowing it to air dry, and (4) coating the fifth finger with cola and then cleaning it with the instant hand sanitizer after the cola had dried. Finger sticks were performed on each prepared finger and blood glucose was measured. Several in vitro studies were also performed to investigate the effectiveness of the hand sanitizer for removal of exogenous glucose.z Mean blood glucose values from fingers cleaned with instant hand sanitizer did not differ significantly from the control finger (p = .07 and .08, respectively) and resulted in 100% accurate results. Blood glucose data from the fourth (cola-coated) finger were substantially higher on average compared with the other finger conditions, but glucose data from the fifth finger (cola-coated then cleaned with hand sanitizer) was similar to the control finger. The data from in vitro experiments showed that the hand sanitizer did not adversely affect glucose meter results, but when an exogenous glucose interference was present, the effectiveness of the hand sanitizer on glucose bias (range: 6% to 212%) depended on the surface area and degree of dilution. In our study

Tactile mouse generating velvet hand illusion on human palm

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Nadar Rajaei

2016-09-01

Full Text Available To enhance virtual reality (VR generated by tactile displays, we have focused on a novel tactile illusion, called the Velvet Hand Illusion (VHI. In VHI, moving two parallel wires back and forth between the two hands leads humans to perceive a velvet-like surface between their hands. In earlier studies, we revealed that the intensity of VHI could be controlled by a ratio (r/D, where r and D are the wire stroke and wire distance, respectively. According to these findings, we investigate in this study whether a common tactile display is able to produce VHI, and whether the ratio can also control VHI intensity. We prepare a dot-matrix display as a tactile display in which moving one line of the display’s pins is considered as a wire pattern. We investigate the VHI intensity with regard to changing the stroke r and the line distance D using paired comparison. Experimental results show that the VHI intensity is increased or decreased by changing r and D. We conclude that VHI can be created by the tactile display, and the intensity of VHI is controlled by changing the ratio of r/D.

Hand biometric recognition based on fused hand geometry and vascular patterns.

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Park, GiTae; Kim, Soowon

2013-02-28

A hand biometric authentication method based on measurements of the user's hand geometry and vascular pattern is proposed. To acquire the hand geometry, the thickness of the side view of the hand, the K-curvature with a hand-shaped chain code, the lengths and angles of the finger valleys, and the lengths and profiles of the fingers were used, and for the vascular pattern, the direction-based vascular-pattern extraction method was used, and thus, a new multimodal biometric approach is proposed. The proposed multimodal biometric system uses only one image to extract the feature points. This system can be configured for low-cost devices. Our multimodal biometric-approach hand-geometry (the side view of the hand and the back of hand) and vascular-pattern recognition method performs at the score level. The results of our study showed that the equal error rate of the proposed system was 0.06%.

Cytomegalovirus survival and transferability and the effectiveness of common hand-washing agents against cytomegalovirus on live human hands.

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Stowell, Jennifer D; Forlin-Passoni, Daniela; Radford, Kay; Bate, Sheri L; Dollard, Sheila C; Bialek, Stephanie R; Cannon, Michael J; Schmid, D Scott

2014-01-01

Congenital cytomegalovirus (CMV) transmission can occur when women acquire CMV while pregnant. Infection control guidelines may reduce risk for transmission. We studied the duration of CMV survival after application of bacteria to the hands and after transfer from the hands to surfaces and the effectiveness of cleansing with water, regular and antibacterial soaps, sanitizer, and diaper wipes. Experiments used CMV AD169 in saliva at initial titers of 1 × 10(5) infectious particles/ml. Samples from hands or surfaces (points between 0 and 15 min) were placed in culture and observed for at least 2 weeks. Samples were also tested using CMV real-time PCR. After application of bacteria to the hands, viable CMV was recovered from 17/20 swabs at 0 min, 18/20 swabs at 1 min, 5/20 swabs at 5 min, and 4/20 swabs at 15 min. After transfer, duration of survival was at least 15 min on plastic (1/2 swabs), 5 min on crackers and glass (3/4 swabs), and 1 min or less on metal and cloth (3/4 swabs); no viable virus was collected from wood, rubber, or hands. After cleansing, no viable virus was recovered using water (0/22), plain soap (0/20), antibacterial soap (0/20), or sanitizer (0/22). Viable CMV was recovered from 4/20 hands 10 min after diaper wipe cleansing. CMV remains viable on hands for sufficient times to allow transmission. CMV may be transferred to surfaces with reduced viability. Hand-cleansing methods were effective at eliminating viable CMV from hands.

A four-dimensional virtual hand brain-machine interface using active dimension selection.

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Rouse, Adam G

2016-06-01

Brain-machine interfaces (BMI) traditionally rely on a fixed, linear transformation from neural signals to an output state-space. In this study, the assumption that a BMI must control a fixed, orthogonal basis set was challenged and a novel active dimension selection (ADS) decoder was explored. ADS utilizes a two stage decoder by using neural signals to both (i) select an active dimension being controlled and (ii) control the velocity along the selected dimension. ADS decoding was tested in a monkey using 16 single units from premotor and primary motor cortex to successfully control a virtual hand avatar to move to eight different postures. Following training with the ADS decoder to control 2, 3, and then 4 dimensions, each emulating a grasp shape of the hand, performance reached 93% correct with a bit rate of 2.4 bits s(-1) for eight targets. Selection of eight targets using ADS control was more efficient, as measured by bit rate, than either full four-dimensional control or computer assisted one-dimensional control. ADS decoding allows a user to quickly and efficiently select different hand postures. This novel decoding scheme represents a potential method to reduce the complexity of high-dimension BMI control of the hand.

Hand hygiene compliance in a universal gloving setting.

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Kuruno, Noriko; Kasahara, Kei; Mikasa, Keiichi

2017-08-01

The use of gloves for every patient contact (ie, universal gloving) has been suggested as an infection prevention adjunct and alternative to contact precautions. However, gloves may carry organisms unless they are changed properly. In addition, hand hygiene is required before donning and after removing gloves, and there are scarce data regarding glove changing and hand hygiene in a universal gloving setting. This nonrandomized observational before-after study evaluated the effect of education and feedback regarding hand hygiene. Compliance with hand hygiene and glove use was directly observed in a universal gloving setting at a 10-bed intensive care unit in a Japanese tertiary care university teaching hospital. A total of 6,050 hand hygiene opportunities were identified. Overall, hand hygiene compliance steadily increased from study period 1 (16.1%) to period 5 (56.8%), although there were indication-specific differences in the baseline compliance, the degree of improvement, and the reasons for noncompliance. There were decreases in the compliance with universal gloving and the incidence of methicillin-resistant Staphylococcus aureus. It is difficult to properly perform glove use and hand hygiene in a universal gloving setting, given its complexity. Direct observation with specific feedback and education may be effective in improving compliance. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

A pilot study of robotic-assisted exercise for hand weakness after stroke.

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Stein, Joel; Bishop, Joel; Gillen, Glen; Helbok, Raimund

2011-01-01

Upper limb paresis is a major source of disability in stroke survivors, and robotic aided exercise therapy is a promising approach to enhance motor abilities. Few devices have been available to provide robotic therapy to the fingers and hand. We report an open-label pilot study of 12 individuals with chronic moderate hemiparesis after stroke who underwent a six-week training program using a hand robotic device. Participants received a total of 18 hours of robotic therapy. Improvements were found in multiple measures of motor performance, including the Upper Extremity Fugl-Meyer, the Motor Activity Log, the Manual Ability Measure-36, and the Jebsen Hand Function Test. All subjects tolerated the treatment well and no complications were observed. We conclude that robotic therapy for hand paresis after stroke is safe and feasible, and that further studies of efficacy are justified by these preliminary results. © 2011 IEEE

Predicting and explaining behavioral intention and hand sanitizer use among US Army soldiers.

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Lin, Naiqing; Roberts, Kevin R

2017-04-01

Using hand sanitizers can reduce bacterial contamination and is an efficient and inexpensive method of preventing infections. The purpose of this study was to explore the behavioral intention (low and absolute), attitudes, subjective norms, and perceived behavioral control of hand sanitizer use among US Army soldiers. A questionnaire was developed following an expert panel (N = 5) review and 2 pilot studies (N = 35) to ensure questionnaire validity and clarity. Surveys were distributed among nontrainee soldiers during lunch periods. A total of 201 surveys were collected. Results indicated that attitudes, subjective norms, and perceived behavioral controls explained 64% of the variance in behavioral intention. Attitude remained the strongest predictor of behavior (β = 0.70, P hand sanitizers hold significantly different behavioral and normative beliefs than low intenders. Other soldiers create negative social pressure about using hand sanitizers, indicating that if other soldiers use hand sanitizers, they will refuse to do so. Intervention to ensure use of hand sanitizer should focus on strengthening behavioral and normative beliefs among low intenders. This should increase the overall well being of the military. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Interethnic differences at the thermometric response to cold test: functional disorders of blood circulation in hand fingers and exposure to hand-arm vibration.

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Riolfi, A; Princivalle, A; Romeo, L; Caramaschi, P; Perbellini, L

2008-02-01

To report some notable aspects regarding thermometric response to cold test in black African subjects compared with Caucasians: both groups comprised persons exposed to hand-arm vibration and controls. An overall sample of 48 workers was examined in order to study their blood circulation in hand fingers: a control group of 12 healthy Caucasian workers never exposed before to hand-arm vibration; 12 Caucasian workers exposed for several years to vibrating tools and affected by occupational Raynaud's phenomenon; 12 healthy black African workers exposed to hand-arm vibration for almost 3 years; and 12 healthy black African workers never exposed to hand-arm vibration. Computerized skin thermometry was performed and thermometric curves were analyzed according to thermometric interpretation criteria such as the area-over-curve (AOC), the fifth minute of recovery/baseline temperature ratio (5REC/BT) and the temperature at the tenth minute of recovery (10REC) after cold test. Thermometric parameters in Caucasian subjects confirmed the basis of the existing literature in controls (basal finger temperature higher than 32 degrees C and complete recovery to the initial temperature after the cold test) and also in patients with Raynaud's phenomenon (basal temperature often lower than control subjects and slow recovery of finger temperature after cold test). Statistically significant difference was found between healthy Caucasians and healthy black subjects in all the parameters tested: healthy black subjects showed values of AOC and 10REC suggesting almost constantly lower finger temperatures during the thermometry test. Black people, both exposed and non-exposed to hand-arm vibration showed thermometric parameters suggesting poor blood microcirculation, which seems even poorer than in Caucasian people complaining Raynaud's phenomenon. Our chronothermometric tests suggest some significant interethnic differences in peripheral microcirculation, which seems rather poor in black

Referral of sensation to an advanced humanoid robotic hand prosthesis.

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Rosén, Birgitta; Ehrsson, H Henrik; Antfolk, Christian; Cipriani, Christian; Sebelius, Fredrik; Lundborg, Göran

2009-01-01

Hand prostheses that are currently available on the market are used by amputees to only a limited extent, partly because of lack of sensory feedback from the artificial hand. We report a pilot study that showed how amputees can experience a robot-like advanced hand prosthesis as part of their own body. We induced a perceptual illusion by which touch applied to the stump of the arm was experienced from the artificial hand. This illusion was elicited by applying synchronous tactile stimulation to the hidden amputation stump and the robotic hand prosthesis in full view. In five people who had had upper limb amputations this stimulation caused referral touch sensation from the stump to the artificial hand, and the prosthesis was experienced more like a real hand. We also showed that this illusion can work when the amputee controls the movements of the artificial hand by recordings of the arm muscle activity with electromyograms. These observations indicate that the previously described "rubber hand illusion" is also valid for an advanced hand prosthesis, even when it has a robotic-like appearance.