Antimicrobial efficacy of alcohol-based hand gels with a 30-s application

Aims: The objective of this study was to assess the antimicrobial efficacy of alcohol‐based hand gels according to European Norm 1500 (EN 1500). Methods and Results: We assessed the antimicrobial efficacy of 12 alcohol‐based hand gels produced in Brazil, containing 70% w/w or v/v ethyl alcohol as the active ingredient, according to EN 1500, with a 30‐s application. In addition, 70% w/w ethyl alcohol and three alcohol‐based hand rubs commonly used in Europe and effective according to EN 1500 were also tested. Eight of 12 (67%) alcohol‐based hand gels produced in Brazil failed by EN 1500. In contrast, 70% w/w ethyl alcohol and European alcohol‐based hand rubs were approved by EN 1500. Conclusions: In this study, the majority of Brazilian alcohol‐based hand gels showed limited efficacy on hand hygiene within 30 s. Significance and Impact of the Study: The findings of this study may be used as an important argument to motivate Brazilian manufacturers to improve the antimicrobial efficacy of alcohol‐based hand gels, because it is prudent to suppose that alcohol‐based hand gels can be recommended for use in healthcare settings only if they show antimicrobial activity at least similar to that of alcohol‐based liquid preparations, including the traditional 70% w/w ethyl alcohol.     

Clinical features and teratogenic mechanisms of congenital absence of digits

To have a better understanding of classification of congenital hand anomalies, clinical features and teratogenic mechanisms of congenital absence of digits including ulnar and radial deficiencies, cleft hand, symbrachydactyly and constriction band were reviewed. There seemed to be four different teratogenic mechanisms of congenital absence of digits. Ulnar and radial deficiencies have the same clinical features and the cause of these deficiencies is closely related to a deficit of mesenchymal cells in the limb-bud due to impairment before the formation of the limb-bud. Cleft hand, central polydactyly and osseous syndactyly were induced by the same treatment at the same developmental stage in rats. Roentgenograms of the clinical cases and skeletal changes of the anomalies in rats appear to demonstrate that cleft hand formation proceeds from osseous syndactylies and central polydactylies. The teratogenic mechanism of a cleft hand seemed to be failure of induction of digital rays in the hand plate. The sequence of anomalies from brachysyndactyly, or the atypical cleft hand, to the congenital amputation, can be regarded as equivalent to the category of transverse deficiency that is bony dysplasia of the hand. Congenital constriction ring syndrome appears after the formation of the digital rays.     

Comparison of electric hand dryers and paper towels for hand hygiene: a critical review of the literature

Numerous studies are published on the benefits of electric hand dryers vs paper towels (PT) for drying hands after washing. Data are conflicting and lacking key variables needed to assess infection risks. We provide a rapid scoping review on hand-drying methods relative to hygiene and health risks. Controlled vocabulary terms and keywords were used to search PubMed (1946–2018) and Embase (1947–2018). Multiple researchers independently screened abstracts for relevance using predetermined criteria and created a quality assessment scoring system for relative study comparisons. Of 293 papers, 23 were included in the final analysis. Five studies did not compare multiple methods; however, 2 generally favoured electric dryers (ED); 7 preferred PT; and 9 had mixed or statistically insignificant results (among these, 3 contained scenarios favourable to ED, 4 had results supporting PT, and the remaining studies had broadly conflicting results). Results were mixed among and within studies and many lacked consistent design or statistical analysis. The breadth of data does not favour one method as being more hygienic. However, some authors extended generalizable recommendations without sufficient scientific evidence. The use of tools in quantitative microbial risk assessment is suggested to evaluate health exposure potentials and risks relative to hand-drying methods. We found no data to support any human health claims associated with hand-drying methods. Inconclusive and conflicting results represent data gaps preventing the advancement of hand-drying policy or practice recommendations.     

Across-subject calibration of an instrumented glove to measure hand movement for clinical purposes

Motion capture of all degrees of freedom of the hand collected during performance of daily living activities remains challenging. Instrumented gloves are an attractive option because of their higher ease of use. However, subject-specific calibration of gloves is lengthy and has limitations for individuals with disabilities. Here, a calibration procedure is presented, consisting in the recording of just a simple hand position so as to allow capture of the kinematics of 16 hand joints during daily life activities even in case of severe injured hands. ‘across-subject gains’ were obtained by averaging the gains obtained from a detailed subject-specific calibration involving 44 registrations that was repeated three times on multiple days to 6 subjects. In additional 4 subjects, joint angles that resulted from applying the ‘across-subject calibration’ or the subject-specific calibration were compared. Global errors associated with the ‘across-subject calibration’ relative to the detailed, subject-specific protocol were small (bias: 0.49°; precision: 4.45°) and comparable to those that resulted from repeating the detailed protocol with the same subject on multiple days (0.36°; 3.50°). Furthermore, in one subject, performance of the ‘across-subject calibration’ was directly compared to another fast calibration method, expressed relative to a videogrammetric protocol as a gold-standard, yielding better results.     

Metastasis of bronchogenic carcinoma to the thumb

Bone metastasis in the hand is rare. The etiology is quite different from that of metastasis to other bones; bronchogenic carcinoma is by far the most frequent case. Distal phalanges are mainly involved with irregular osteolysis and cortical destruction. Differential diagnosis of phalangeal metastasis includes osteomyelitis, rheumatoid arthritis and gout. The prognosis is always that of metastatic bronchial cancer with an average survival of three months. Treatment may involve distal digital amputation or antalgic radiotherapy. A case of bronchogenic carcinoma with metastasis to the thumb is presented. The metastasis was located in the distal phalanx of the left thumb. The primary tumor was located in the lung. Treatment consisted of amputation. The overall survival was five months.     

Comparative evaluation of the hygienic efficacy of an ultra-rapid hand dryer vs conventional warm air hand dryers

Aims: To compare an ultra‐rapid hand dryer against warm air dryers, with regard to: (A) bacterial transfer after drying and (B) the impact on bacterial numbers of rubbing hands during dryer use. Methods and Results: The Airblade? dryer (Dyson Ltd) uses two air ‘knives’ to strip water from still hands, whereas conventional dryers use warm air to evaporate moisture whilst hands are rubbed together. These approaches were compared using 14 volunteers; the Airblade? and two types of warm air dryer. In study (A), hands were contaminated by handling meat and then washed in a standardized manner. After dryer use, fingers were pressed onto foil and transfer of residual bacteria enumerated. Transfers of 0–10⁷ CFU per five fingers were observed. For a drying time of 10 s, the Airblade? led to significantly less bacterial transfer than the other dryers (P < 0·05; range 0·0003–0·0015). When the latter were used for 30–35 s, the trend was for the Airblade to still perform better, but differences were not significant (P > 0·05, range 0·1317–0·4099). In study (B), drying was performed ± hand rubbing. Contact plates enumerated bacteria transferred from palms, fingers and fingertips before and after drying. When keeping hands still, there was no statistical difference between dryers, and reduction in the numbers released was almost as high as with paper towels. Rubbing when using the warm air dryers inhibited an overall reduction in bacterial numbers on the skin (P < 0·05). Conclusions: Effective hand drying is important for reducing transfer of commensals or remaining contaminants to surfaces. Rubbing hands during warm air drying can counteract the reduction in bacterial numbers accrued during handwashing. Significance and Impact of the Study: The Airblade? was superior to the warm air dryers for reducing bacterial transfer. Its short, 10 s drying time should encourage greater compliance with hand drying and thus help reduce the spread of infectious agents via hands.     

Removal,early hand rearing,and successful reintroduction of an orangutan (Pongo pygmaeus pygmaeus/x abelii) to her mother

A newborn orangutan was removed from her mother 55 h after birth because no nursing had been observed. She was hand reared in a nursery for 3 d and then successfully reintroduced to her mother. Several factors that may have contributed to the successful reintroduction are discussed.     

The association of split hand foot malformation (SHFM) and congenital heart defects

BACKGROUND: Split hand foot malformation (SHFM) (cleft hand, central ray deficiency) is a highly variable malformation that shows genetic heterogeneity with at least five loci mapped to date. SHFM occurs as an isolated finding or in association with other anomalies, including congenital heart defects (CHDs). METHODS: In total 48 SHFM1, 52 SHFM3, 48 SHFM4, 21 SHFM5, and four chromosome 8 patients were evaluated. In addition, we performed a literature review to identify “unmapped” SHFM patients with CHD to evaluate the various etiologies of this combination of findings. The London Dysmorphology Database also served as a resource to identify syndromes with this combination of phenotypic findings. Only patients presenting with both SHFM and CHD were included in the analysis. Classification of CHD among mapped and unmapped SHFM patients was performed utilizing the revised Clark classification. A closer inspection of the types of CHD found in this patient group was performed in order to investigate possible pathogenetic mechanisms. RESULTS: CHDs were found in 10% of SHFM1 patients, 47% of SHFM5 patients, but were not reported in SHFM2, SHFM4 patients, or patients mapped to chromosome 8. Forty‐two syndromic cases and 15 cases of unrecognized syndromes were identified. CONCLUSIONS: The higher frequency of heart defects seen in SHFM1 and SHFM5 of the mapped patient group raises the question as to whether common mechanisms/genetic players are involved. Candidate genes for SHFM1 and SHFM5 include members of the DLX homeobox gene family. Birth Defects Research (Part A), 2008. © 2008 Wiley‐Liss, Inc.     

Grasping behavior in tufted capuchin monkeys (Cebus apella): grip types and manual laterality for picking up a small food item

This study investigates prehension in 20 tufted capuchins (Cebus apella) in a reaching task requiring individuals to grasp a small food item fixed to a tray. The aim was twofold: 1) to describe capuchins' grasping techniques in detail, focusing on digit movements and on different areas of contact between the grasping fingers; and 2) to assess the relationship between grip types and manual laterality in this species. Capuchins picked up small food items using a wide variety of grips. In particular, 16 precision grip variants and 4 power grip variants were identified. The most frequently used precision grip involved the distal lateral areas of the thumb and the index finger, while the most preferred kind of power grip involved the thumb and the palm, with the thumb being enclosed by the other fingers. Immature capuchins picked up small food items using power grips more often than precision grips, while adult individuals exhibited no significant preference for either grip type. The analysis performed on the time capuchins took to grasp the food and withdraw it from the tray hole revealed that 1) precision grips were as efficient as power grips; 2) for precision grips, the left hand was faster than the right hand; and 3) for power grips, both hands were equally quick. Hand preference analysis, based on the frequency for the use of either hand for grasping actions, revealed no significant hand bias at group level. Likewise, there was no significant relationship between grip type and hand preference.     

海南黎、苗、汉族扣手、交叉臂和惯用手的研究

调查了海南居住较为集中的黎、苗、汉族(共3 207人)扣手、交叉臂、惯用手等人类左右不对称行为特征。结果显示：(1)扣手、交手臂、惯用手三型3个民族的出现率均为R>L型,惯用手的R型出现率远较其他两型高,呈高度显著性差异,(P<0.01)。(2)扣手、交叉臂出现率与性别无关。(3)惯用手R型出现率苗族女性明显高于男性,差异显著(P<0.05)。三民族总和出现率为89.06％,是国内外属最低的。(4)扣手与交叉臂、扣手与惯用手,交叉臂与惯用手之间均具有相当明显的相关性。 Abstract：It was investigated that three types of many general indexes of anthrotogical genetics,which include hand-clasping、arm-folding and handedness,just among Li,Miao and Han nationalities in Hainan.There were 3207 people investigated in total.The results showed as follows:(1)The frequency of hand?clasping,arm-folding and handedness is far higher than others(P<0.01).(2) It was proved that there was no signilicant difference between male and female in the frequency of either hand-clasping or arm-floding.(3)It was obvious that the frequency of type R handedness in female of Miao nationality was higher than in male.And the difference was much clear(P<0.05).The total frequency of handedness was about 89.06 percent,which was the lowest rate as far as we known.(4)There was correlation among handedness and hand?clasping,handedness and arm-folding andhand-clasping and arm-folding respectively.     

Observation of a Paradoxical Temperature Increase During Cognitive Stress in Some Chronic Pain Patients

A total of 224 chronic pain somatoform disorder patients without obvious pathophysiology or psychopathology were found to have colder hands than nonpatients. A paradoxical temperature increase (PTI) in response to a cognitive stressor (mental arithmetic) was noted in a subset of these chronic pain patients. Patients were defined as PTI responders if, during cognitive stress, an increase in digital temperature occurred over a prior eyes closed resting condition. It was found that 49.4% of males and 42.6% of females in a total sample of 224 patients demonstrated PTI. The PTI patients had significantly colder hands than non-PTI patients prior to stress. A concurrent SCL measure of sympathetic activation found no difference between the PTI and non-PTI groups either at baseline or during cognitive stress. It appears from this data that PTI is specific to the peripheral vascular system of these patients and may be a marker of psychophysiological dissociation or trauma blocked from consciousness.     

Manual lateralization in wild redfronted lemurs (Eulemur rufifrons) during spontaneous actions and in an experimental task

The dominant use of one hand is a striking feature of humans, but manual lateralization can be found in a variety of other species as well. In primates, the lateralization in hand use varies among species and several theories such as the “postural origin,” “task complexity,” or “development theory” have been suggested to explain this variation. In order to contribute comparative data on this phenomenon from a basal primate, we studied manual lateralization in wild redfronted lemurs (Eulemur rufifrons). Data were collected on four groups at Kirindy Forest, western Madagascar, during spontaneous actions and by confronting them with artificial feeding boxes. The lemurs did not exhibit manual lateralization on a group level in either condition. More individuals showed a hand preference in the experimental task, and the preferences were stronger compared to spontaneous actions. The direction of individual hand preferences was not consistent across the two conditions. The results of this study show that measuring manual laterality in different contexts can yield different results. Manual lateralization in wild redfronted lemurs therefore seems to be flexible and situation dependent and probably not ecologically relevant in their natural habitat. Am J Phys Anthropol 153:61–67, 2014. © 2013 Wiley Periodicals, Inc.     

Sub-millimetre accurate human hand kinematics: from surface to skeleton

A highly accurate human hand kinematics model and identification are proposed. The model includes the five digits and the palm arc based on mapping function between surface landmarks and estimated joint centres of rotation. Model identification was experimentally performed using a motion tracking system. The evaluation of the marker position estimation error, which is on sub-millimetre level across all digits, underlines model quality and accuracy. Noticeably, with the development of this model, we were able to improve various modelling assumptions from literature and found a basic linear relationship between surface and skeleton rotational angles.     

Assessment of motor function of the hand in aged rhesus monkeys

In the elderly, intact motor functions of the upper extremity are critical for the completion of activities of daily living. Many studies have provided insight into age-related changes in motor function. However, the precise nature and extent of motor impairments of the upper extremity remains unclear. In the current study we have modified two tasks to assess hand/digit function in both young and aged rhesus monkeys. We tested monkeys from 9 to 26 years of age on these tasks to determine the level of fine motor performance across the adult age range. Compared to young monkeys (9–12 years of age), aged monkeys (15–26 years of age) were mildly impaired on fine motor control of the digits. These findings are consistent with previous studies that have found age-related impairment in fine motor function. However, the magnitude and extent of impairment in the current study does differ from previous findings and is likely due to methodological differences in the degree of task complexity.     

Simple Reaching Is Not So Simple: Association Between Hand Use and Grip Preferences in Captive Chimpanzees

We assessed the relationship between grip preference and hand use in chimpanzees in 2 experiments. In experiment 1, we evaluated consistency in hand use and grip preference across 4 food types. The chimpanzees showed population-level right-handedness and there are significant positive associations for both hand and grip use across food types. In experiment 2, we assessed validity of hand use in relation to grip preference in 2 colonies of chimpanzees via the same methodology. Differences in hand preferences between colonies were associated with variation in the observed grip preferences. There was no evidence of rearing effects on handedness in either colony. We discuss the overall results in the context of the evolution of handedness in relation to increasing motor demands as manifest in variation on grasping behavior.     

Toward a realistic optoelectronic-based kinematic model of the hand: representing the transverse metacarpal arch reduces accessory rotations of the metacarpophalangeal joints

A kinematic model representing the versatility of the human hand is needed to evaluate biomechanical function and predict injury risk in the workplace. We improved upon an existing optoelectronic-based kinematic hand model with grouped metacarpals by defining segmented metacarpals and adding the trapeziometacarpal joint of the thumb. Eight participants performed three static postures (neutral pose, cylinder grip, cap grip) to evaluate kinematic performance of three different models, with one, two, and four metacarpal segment(s). Mean distal transverse metacarpal arch angles in the four-segment metacarpal model were between 22.0° ± 3.3° (neutral pose) and 32.1° ± 3.7° (cap grip). Representation of the metacarpals greatly influenced metacarpophalangeal joint rotations. Both the two- and four-segment metacarpal models displayed significantly lower metacarpophalangeal joint ‘supination’ angles (than the one-segment model) for the fourth and fifth fingers. However, the largest reductions were for the four- versus one-segment models, with mean differences ranging from 9.3° (neutral pose) to 17.0° (cap grip) for the fourth finger and 16.3° (neutral pose) to 33.0° (cylinder grip) for the fifth finger. MCP joint abduction/adduction angles of the fourth and fifth fingers also decreased with segmentation of the metacarpals, although the lowest magnitudes generally occurred in the four-segment model. Overall, the four-segment metacarpal model produced the lowest accessory rotations in non-dominant axes, and best matched previous radiological studies that found MCP joint pronation/supination angles were typically less than 10°. The four-segment metacarpal model, with improved anatomic fidelity, will better serve future studies of detailed actions of the hand in clinical or work applications.     

Real-time simulation of hand motion for prosthesis control

Individuals with hand amputation suffer substantial loss of independence. Performance of sophisticated prostheses is limited by the ability to control them. To achieve natural and simultaneous control of all wrist and hand motions, we propose to use real-time biomechanical simulation to map between residual EMG and motions of the intact hand. Here we describe a musculoskeletal model of the hand using only extrinsic muscles to determine whether real-time performance is possible. Simulation is 1.3 times faster than real time, but the model is locally unstable. Methods are discussed to increase stability and make this approach suitable for prosthesis control.