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1.
Adv Exp Med Biol ; 1317: 163-179, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33945137

RESUMEN

Recent years have seen an explosion of interest in digitising museum collections. Among the objects of interest are anatomical and pathological specimens found in medical museums. As researchers increasingly produce digital replicas of these preparations, ways of integrating these resources into the medical curriculum must be explored. This article takes a medical humanities approach to this topical question, comparing the historic use of anatomical specimens to modern intentions, and exploring the potential for using digital anatomy to help integrate humanities into the curriculum. The use of anatomical specimens by William Hunter (1718-1783), whose collection is now kept at the Hunterian in the University of Glasgow, provides a key historic focus. The teaching intentions for his private courses of anatomy are examined, to investigate how specimens were used in an eighteenth-century "curriculum". The motivations behind digitisation and the use of digital anatomy in modern curriculums are then examined and compared. Many of these motivations are shared with Hunter's: the desire to maintain a unique anatomical resource, the need to provide multisensory engagement in learning, and a desire to attempt to show "natural" anatomy without the interference of human processes. The balance between fostering empathy and maintaining detachment is also key for both. Using digital replicas of historic specimens to teach anatomy also opens up a unique opportunity to educate students in the medical humanities in a fully integrated way. Understanding the full story of the specimens they use, as explored in the first half of the article, allows students to place themselves, their dissection subjects, and healthcare as a whole in a historical context. As well as fostering empathy in the dissection lab, the stories behind the specimens can be used to introduce key humanities topics, including ethics, institutional bias, and social aspects of health and disease. It is essential that this potential is explored now while digital anatomy is still a relatively young field, and therefore collaborations between anatomists and medical humanities practitioners can be built and included from the ground up.


Asunto(s)
Curriculum , Mano , Disección , Humanos , Motivación , Museos
2.
Medicine (Baltimore) ; 100(17): e25283, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33907090

RESUMEN

ABSTRACT: We report the clinical results and problems of combined administration of rifampicin, ethambutol, and clarithromycin (REC) for the treatment of Mycobacterium avium complex (MAC) infection of the hand (hand MAC).Participants included 7 patients with hand MAC. After resection of the infected lesion, REC was prescribed for 12 months. For these patients, the site of infection, clinical course after initiation of REC, adverse drug effects (ADEs), and incidence of recurrence were evaluated.Sites of infection were the flexor tenosynovium in 5 patients, extensor tenosynovium in 1 patient, and both flexor and extensor tenosynovium in 1 patient. ADEs of REC occurred in 5 patients, and included visual disturbance caused by ethambutol in 2 patients, liver function abnormality caused by rifampicin in 2 patients, and fever with diarrhea caused by rifampicin in 1 patient. For 2 of these 5 patients, desensitization therapy was applied and REC was able to be reinstated. In the remaining 3 patients, the causative drugs were discontinued and levofloxacin, a new quinolone, was administered. Complete healing was achieved in 5 patients, and recurrence was observed in 2 patients. These 2 patients with recurrence included 1 patient in whom REC was completed and 1 patient in whom REC therapy was modified due to ADE.REC provided relatively good clinical results as a treatment for hand MAC. However, recurrences were observed even after the completion of REC and the use of an alternative drug. Optimal duration of REC and appropriate alternative drugs need to be identified in the future.


Asunto(s)
Antibacterianos/administración & dosificación , Claritromicina/administración & dosificación , Etambutol/administración & dosificación , Complejo Mycobacterium avium , Infección por Mycobacterium avium-intracellulare/tratamiento farmacológico , Rifampin/administración & dosificación , Tenosinovitis/tratamiento farmacológico , Anciano , Quimioterapia Combinada , Femenino , Mano/microbiología , Humanos , Masculino , Persona de Mediana Edad , Infección por Mycobacterium avium-intracellulare/microbiología , Tenosinovitis/microbiología
3.
Orthopade ; 50(5): 415-424, 2021 May.
Artículo en Alemán | MEDLINE | ID: mdl-33847790

RESUMEN

Wide awake local anesthesia no tourniquet (WALANT) refers to an anesthesia technique with low bleeding and complication rates, which enables interventions on the hand in an awake patient without the use of a tourniquet. Bleeding control is achieved through addition of vasoconstrictors to the infiltration solution. Since the motor function of the extremity is not affected, it offers the additional possibility of intraoperative active function testing. The WALANT procedure constitutes an established, effective, easily learnt and resource-sparing technique. The spectrum of surgical possibilities with WALANT is wide and covers nearly all elective and many emergency procedures. Due to multiple advantages in contrast to other regional and general anesthesia procedures, WALANT features an increasing spectrum of surgical applications and practitioners. It is therefore of interest for hand surgeons working both in hospitals and private practices.


Asunto(s)
Anestesia Local , Procedimientos Ortopédicos , Anestésicos Locales , Mano/cirugía , Humanos , Torniquetes , Vigilia
4.
Sensors (Basel) ; 21(6)2021 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-33801070

RESUMEN

Motor imagery (MI) is widely used to produce input signals for brain-computer interfaces (BCI) due to the similarities between MI-BCI and the planning-execution cycle. Despite its usefulness, MI tasks can be ambiguous to users and MI produces weaker cortical signals than motor execution. Existing MI guidance systems, which have been reported to provide visual guidance for MI and enhance MI, still have limitations: insufficient immersion for MI or poor expandability to MI for another body parts. We propose a guidance system for MI enhancement that can immerse users in MI and will be easy to extend to other body parts and target motions with few physical constraints. To make easily extendable MI guidance system, the virtual hand illusion is applied to the MI guidance system with a motion tracking sensor. MI enhancement was evaluated in 11 healthy people by comparison with another guidance system and conventional motor commands for BCI. The results showed that the proposed MI guidance system produced an amplified cortical signal compared to pure MI (p < 0.017), and a similar cortical signal as those produced by both actual execution (p > 0.534) and an MI guidance system with the rubber hand illusion (p > 0.722) in the contralateral region. Therefore, we believe that the proposed MI guidance system with the virtual hand illusion is a viable alternative to existing MI guidance systems in various applications with MI-BCI.


Asunto(s)
Interfaces Cerebro-Computador , Ilusiones , Electroencefalografía , Mano , Humanos
5.
Sensors (Basel) ; 21(5)2021 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-33802372

RESUMEN

Surgical gestures detection can provide targeted, automated surgical skill assessment and feedback during surgical training for robot-assisted surgery (RAS). Several sources including surgical videos, robot tool kinematics, and an electromyogram (EMG) have been proposed to reach this goal. We aimed to extract features from electroencephalogram (EEG) data and use them in machine learning algorithms to classify robot-assisted surgical gestures. EEG was collected from five RAS surgeons with varying experience while performing 34 robot-assisted radical prostatectomies over the course of three years. Eight dominant hand and six non-dominant hand gesture types were extracted and synchronized with associated EEG data. Network neuroscience algorithms were utilized to extract functional brain network and power spectral density features. Sixty extracted features were used as input to machine learning algorithms to classify gesture types. The analysis of variance (ANOVA) F-value statistical method was used for feature selection and 10-fold cross-validation was used to validate the proposed method. The proposed feature set used in the extra trees (ET) algorithm classified eight gesture types performed by the dominant hand of five RAS surgeons with an accuracy of 90%, precision: 90%, sensitivity: 88%, and also classified six gesture types performed by the non-dominant hand with an accuracy of 93%, precision: 94%, sensitivity: 94%.


Asunto(s)
Gestos , Reconocimiento de Normas Patrones Automatizadas , Algoritmos , Electroencefalografía , Mano , Aprendizaje Automático
6.
Sensors (Basel) ; 21(5)2021 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-33802495

RESUMEN

Over the last few years, the Leap Motion Controller™ (LMC) has been increasingly used in clinical environments to track hand, wrist and forearm positions as an alternative to the gold-standard motion capture systems. Since the LMC is marker-less, portable, easy-to-use and low-cost, it is rapidly being adopted in healthcare services. This paper demonstrates the comparison of finger kinematic data between the LMC and a gold-standard marker-based motion capture system, Qualisys Track Manager (QTM). Both systems were time synchronised, and the participants performed abduction/adduction of the thumb and flexion/extension movements of all fingers. The LMC and QTM were compared in both static measuring finger segment lengths and dynamic flexion movements of all fingers. A Bland-Altman plot was used to demonstrate the performance of the LMC versus QTM with Pearson's correlation (r) to demonstrate trends in the data. Only the proximal interphalangeal joint (PIP) joint of the middle and ring finger during flexion/extension demonstrated acceptable agreement (r = 0.9062; r = 0.8978), but with a high mean bias. In conclusion, the study shows that currently, the LMC is not suitable to replace gold-standard motion capture systems in clinical settings. Further studies should be conducted to validate the performance of the LMC as it is updated and upgraded.


Asunto(s)
Mano , Articulación de la Muñeca , Fenómenos Biomecánicos , Articulaciones de los Dedos , Dedos , Humanos , Movimiento (Física) , Rango del Movimiento Articular , Estándares de Referencia
7.
Sensors (Basel) ; 21(5)2021 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-33803456

RESUMEN

The 10-s grip and release is a method to evaluate hand dexterity. Current evaluations only visually determine the presence or absence of a disability, but experienced physicians may also make other diagnoses. In this study, we investigated a method for evaluating hand movement function by acquiring and analyzing fingertip data during a 10-s grip and release using a wearable sensor that can measure triaxial acceleration and strain. The subjects were two healthy females. The analysis was performed on the x-, y-, and z-axis data, and absolute acceleration and contact force of all fingertips. We calculated the variability of the data, the number of grip and release, the frequency response, and each finger's correlation. Experiments with some grip-and-release patterns have resulted in different characteristics for each. It was suggested that this could be expressed in radar charts to intuitively know the state of grip and release. Contact-force data of each finger were found to be useful for understanding the characteristics of grip and release and improving the accuracy of calculating the number of times to grip and release. Frequency analysis suggests that knowing the periodicity of grip and release can detect unnatural grip and release and tremor states. The correlations between the fingers allow us to consider the finger's grip-and-release characteristics, considering the hand's anatomy. By taking these factors into account, it is thought that the 10-s grip-and-release test could give us a new value by objectively assessing the motor functions of the hands other than the number of times of grip and release.


Asunto(s)
Dedos , Fuerza de la Mano , Aceleración , Femenino , Mano , Humanos , Movimiento
8.
Artículo en Inglés | MEDLINE | ID: mdl-33807595

RESUMEN

BACKGROUND: Teaching nursing students how to correctly perform hand hygiene procedures may guarantee a reduction in transmitting pathogens through direct contact and, thus, it may lead to a decrease in the number of hospital infections. The aim of the study, which was conducted in low fidelity simulation conditions, was to assess the performance and the efficiency of a hand-rubbing disinfection technique among nursing students on the last day of their course. MATERIALS AND METHODS: The study was conducted in a group of 190 nursing students studying at the Jagiellonian University and it focused on the performed hand-rubbing disinfection procedure. The accuracy of the task performance was assessed by measuring the percentage of the amount of Fluo-Rub (B. Braun) fluorescent alcohol-based gel remaining on students' hands after disinfection. The gel was rubbed into particular hand parts including four surfaces (left palm, right palm, left back and right back) divided into thirteen areas (I-XIII) and each surface was examined separately. The results were then dichotomized based on the cut-off point of 10% and two categories: "clean" and "dirty" were established. Additionally, the range of negligence in the disinfection procedure was assessed by counting the total number of the areas classified as "dirty". The comparison of continuous and categorical variables was conducted by means of Friedman's and Cochrane's tests, respectively. RESULTS: It was found out that the palm surfaces that were commonly missed during hand disinfection included the whole thumb (I and VI), the fingertip of the little finger (V) and the midpalm (XIII), whereas in the case of back surfaces (on both right and left hand) the most commonly missed areas were the fingertips and the whole thumb I-VI. Only 30 students (13%) had all 52 areas of both hands completely clean, whereas more than one third-66 students (33%)-failed to disinfect properly more than 10 areas out of all assessed ones on the surfaces of both hands. CONCLUSIONS: In the examined group of nursing students, a significant lack of compliance with hand disinfection procedures was observed and it was related mainly to thumbs and back parts of both hands. Therefore, it is essential to conduct systematic training sessions and assessment of hand hygiene procedures for nursing students at the end of every educational stage as it can lead to their developing these skills properly.


Asunto(s)
Infección Hospitalaria , Higiene de las Manos , Estudiantes de Enfermería , Mano , Desinfección de las Manos , Humanos
9.
Artículo en Inglés | MEDLINE | ID: mdl-33809975

RESUMEN

In a study to evaluate beach play activities, 120 children were videotaped to observe and quantify factors that could influence their exposure to contaminants in the beach environment. Children aged 1 to 6 years were followed by researchers with video cameras at beaches (two in Miami, Florida and two in Galveston, Texas) for approximately one hour each. Factors evaluated included time spent in various beach locations, various activities engaged in, and various surfaces contacted (including contacts by hand and mouth). Activities recorded in the videos were transcribed to text files to allow for quantitative analyses. Across all sexes, age groups, and beaches, Wading was the most common activity and Seawater was the most common location where children played. The left hand was found to not be in contact with objects most of the time, while the right hand, considered the most dominant hand in most cases, contacted Plastic-Toys the most. Although activity patterns collection through videotaping and videotranslation can be labor-intensive, once collected, they can be widely useful for estimates of exposures to all contaminants in the beach environment (e.g., microorganisms and chemicals) as well as UV exposure, with considerations for whether the contaminants are found in water, sand or both. These activity patterns were collected to potentially look at exposures following the Deepwater Horizon 2010 Spill.


Asunto(s)
Exposición a Riesgos Ambientales , Mano , Playas , Niño , Preescolar , Florida , Humanos , Lactante , Agua de Mar , Texas
10.
Eur Rev Med Pharmacol Sci ; 25(8): 3350-3364, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33928623

RESUMEN

OBJECTIVE: The purpose of this article was to review our clinical experience with COVID-19 patients observed in the Cardiovascular Division of Pompidou Hospital (University of Paris, France) and the Department of Neurology of the Eastern Piedmont University (Novara, Italy), related to the impact on the cardiovascular, hematological, and neurologic systems and sense organs. PATIENTS AND METHODS: We sought to characterize cardiovascular, hematological, and neurosensory manifestations in patients with COVID-19 and variants. Special attention was given to initial signs and symptoms to facilitate early diagnosis and therapy. Indications of ECMO (extracorporeal membrane oxygenation) for cardiorespiratory support were evaluated. RESULTS: Preliminary neurosensorial symptoms, such as anosmia and dysgeusia, are useful for diagnosis, patient isolation, and treatment. Early angiohematological acro-ischemic syndrome includes hand and foot cyanosis, Raynaud digital ischemia phenomenon, skin bullae, and dry gangrene. This was associated with neoangiogenesis, vasculitis, and vessel thrombosis related to immune dysregulation, resulting from "cytokine storm syndrome". The most dangerous complication is disseminated intravascular coagulation, with mortality risks for both children and adults. CONCLUSIONS: COVID-19 is a prothrombotic disease with unique global lethality. A strong inflammatory response to viral infection severely affects cardiovascular and neurological systems, as well as respiratory, immune, and hematological systems. Rapid identification of acro-ischemic syndrome permits the treatment of disseminated intravascular coagulation complications. Early sensorial symptoms, such as gustatory and olfactory loss, are useful for COVID-19 diagnosis. New variants of SARS-CoV-2 are emerging, principally from United Kingdom, South Africa, and Brazil. These variants seem to spread more easily and quickly, which may lead to more cases of COVID.


Asunto(s)
/fisiopatología , Cianosis/fisiopatología , Coagulación Intravascular Diseminada/fisiopatología , Disgeusia/fisiopatología , Miocarditis/fisiopatología , Enfermedad de Raynaud/fisiopatología , Vasculitis/fisiopatología , /patología , /virología , Síndrome de Liberación de Citoquinas , Coagulación Intravascular Diseminada/patología , Oxigenación por Membrana Extracorpórea , Pie/irrigación sanguínea , Francia , Gangrena/patología , Gangrena/fisiopatología , Mano/irrigación sanguínea , Humanos , Isquemia/patología , Isquemia/fisiopatología , Ventilación no Invasiva , Intercambio Plasmático , Enfermedad de Raynaud/patología , Glicoproteína de la Espiga del Coronavirus/ultraestructura , Sincrotrones , Vasculitis/patología
11.
Artículo en Inglés | MEDLINE | ID: mdl-33805348

RESUMEN

The goal of the study was to investigate some of the factors suspected to be related to children's handedness: presentation during the last weeks of gestation and at birth (cephalic or breech), side of presentation (right or left), number of weeks of gestation, season of birth, parents' handedness and sex. We analyzed the relationships between these factors and the child's handedness at five years. Children (n = 1897) from the EDEN cohort participated in the study, among which 1129 were tested for handedness at five. The father's handedness, but not the mother's, was significantly related to the child's hand preference. The percentage of left-handed children was significantly larger when the father was non-right-handed compared to right-handed, and tended to be larger among children in non-left-cephalic presentation compared to left-cephalic presentation. Girls, but not boys, were significantly less lateralized when they were born before 37 weeks of pregnancy than after. Finally, children born in winter or spring were slightly but significantly less lateralized than children born in summer or autumn. All six children who were not lateralized at 5 presented one or several of these factors. These results are discussed in light of the mixed model of handedness.


Asunto(s)
Lateralidad Funcional , Mano , Niño , Estudios de Cohortes , Femenino , Humanos , Motivación , Parto , Embarazo
12.
Sensors (Basel) ; 21(6)2021 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-33806741

RESUMEN

Intuitive user interfaces are indispensable to interact with the human centric smart environments. In this paper, we propose a unified framework that recognizes both static and dynamic gestures, using simple RGB vision (without depth sensing). This feature makes it suitable for inexpensive human-robot interaction in social or industrial settings. We employ a pose-driven spatial attention strategy, which guides our proposed Static and Dynamic gestures Network-StaDNet. From the image of the human upper body, we estimate his/her depth, along with the region-of-interest around his/her hands. The Convolutional Neural Network (CNN) in StaDNet is fine-tuned on a background-substituted hand gestures dataset. It is utilized to detect 10 static gestures for each hand as well as to obtain the hand image-embeddings. These are subsequently fused with the augmented pose vector and then passed to the stacked Long Short-Term Memory blocks. Thus, human-centred frame-wise information from the augmented pose vector and from the left/right hands image-embeddings are aggregated in time to predict the dynamic gestures of the performing person. In a number of experiments, we show that the proposed approach surpasses the state-of-the-art results on the large-scale Chalearn 2016 dataset. Moreover, we transfer the knowledge learned through the proposed methodology to the Praxis gestures dataset, and the obtained results also outscore the state-of-the-art on this dataset.


Asunto(s)
Aprendizaje Profundo , Gestos , Femenino , Mano , Humanos , Masculino , Redes Neurales de la Computación , Reconocimiento de Normas Patrones Automatizadas
13.
Sensors (Basel) ; 21(7)2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33810546

RESUMEN

Immersive video is changing the way we enjoy TV. It is no longer just about receiving sequential images with audio, but also playing with other human senses through smells, vibrations of movement, 3D audio, feeling water, wind, heat, and other emotions that can be experienced through all human senses. This work aims to validate the usefulness of an immersive and interactive solution for people with severe visual impairment by developing a haptic glove that allows receiving signals and generating vibrations in hand, informing about what happens in a scene. The study case presented here shows how the haptic device can take the information about the ball's location in the playing field, synchronized with the video reception, and deliver it to the user in the form of vibrations during the re-transmission of a soccer match. In this way, we take visually impaired people to live a new sensory experience, allowing digital and social inclusion and accessibility to audiovisual technologies that they could not enjoy before. This work shows the methodology used for the design, implementation, and results evaluation. Usability tests were carried out with fifteen visually impaired people who used the haptic device to attend a soccer match synchronized with the glove's vibrations.


Asunto(s)
Interfaz Usuario-Computador , Personas con Daño Visual , Mano , Humanos , Movimiento , Trastornos de la Visión
14.
Radiologe ; 61(5): 470-482, 2021 May.
Artículo en Alemán | MEDLINE | ID: mdl-33792744

RESUMEN

BACKGROUND: Progressive systemic scleroderma (PSS) and mixed connective tissue disease (MCTD) represent vasculitic autoimmune diseases from the group of collagenoses with manifestations in various organ systems such as the skin, the internal organs and the joints. OBJECTIVE: To present the atypical arthritis patterns of the hands in PSS and MCTD that differ from those in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) in the context of clinical and serologic findings and in consideration of the classification of PSS and MCTD. MATERIALS AND METHODS: Narrative review based on the current literature on the subject from the radiological and rheumatological point of view. RESULTS: In PSS, combinations of acral soft tissue atrophy, nonreactive acro-osteolysis, and interstitial calcifications can be visualized by projection radiography, which in the final stage can lead to a scleroderma claw hand. Digital pharmacoangiography of the hands can be used to reliably diagnose manifest vascular occlusions of the digital arteries. MCTD is characterized by various overlapping symptoms of at least two systemic autoimmune diseases and most frequently presents in the hand with symmetrical involvement of the PIP (proximal interphalangeal), MCP (metacarpophalangeal) and wrist joints with the manifestation of so-called "puffy fingers". CONCLUSIONS: The presented morphological atypical arthritis patterns of the hands in PSS and MCTD differ considerably from the typical patterns in the hands in RA and PsA. MRI is useful to diagnose early stages and pharmacoangiography can be used to differentiate between temporary and manifest digital vascular occlusions.


Asunto(s)
Artritis Reumatoide , Enfermedades del Colágeno , Enfermedad Mixta del Tejido Conjuntivo , Artritis Reumatoide/diagnóstico por imagen , Enfermedades del Colágeno/diagnóstico por imagen , Mano/diagnóstico por imagen , Humanos , Radiografía
15.
Medicine (Baltimore) ; 100(15): e25461, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847653

RESUMEN

RATIONALE: Deep brain stimulation (DBS) of the ventralis intermedius nucleus (Vim) provides a safe and effective therapy for medically refractory essential tremor (ET). However, DBS may be risky in elderly patients and those with ischemic brain lesions. Gamma Knife radiosurgery (GKS) is a minimally invasive procedure, but bilateral thalamotomy is dangerous. PATIENT CONCERNS: We report a case of ventralis oralis anterior nucleus (Voa) DBS for dominant hand tremor plus Voa GKS for nondominant hand tremor in a very elderly patient with medically intractable ET. DIAGNOSIS: An 83-year-old right-handed woman visited our hospital with a medically intractable ET. Because of the ischemic lesion in the right basal ganglia, we decided to perform left unilateral DBS instead of bilateral DBS. INTERVENTION: We chose Voa as the target for DBS because, clinically, her tremor was mainly confined to her hands, and Voa had better intraoperative microelectrode recording results than Vim. OUTCOMES: After 2 years, her right-hand tremor remained in an improved state, but she still had severe tremor in her left hand. Therefore, we performed GKS targeting the right Voa. One year after surgery, the patient's hand tremor successfully improved without any complications. LESSONS: Salvage Voa GKS after unilateral Voa DBS is a valuable option for very elderly patients and patients with ischemic brain lesions. We suggest that Voa GKS thalamotomy is as useful and safe a surgical technique as Vim GKS for dystonic hand tremor. To the best of our knowledge, this is the first case report using salvage Voa as the only target for ET.


Asunto(s)
Estimulación Encefálica Profunda/métodos , Temblor Esencial/cirugía , Psicocirugía/métodos , Radiocirugia/métodos , Tálamo/cirugía , Anciano de 80 o más Años , Temblor Esencial/fisiopatología , Femenino , Lateralidad Funcional , Mano/fisiopatología , Humanos , Ilustración Médica , Resultado del Tratamiento , Núcleos Talámicos Ventrales
16.
Artículo en Inglés | MEDLINE | ID: mdl-33804542

RESUMEN

Every year, thousands of people from the UK travel to other countries for work and leisure. Europe, and particularly Spain, is one of the most popular travel destinations for people from the UK. However, it is known that travel to other countries can enhance the risk of communicable disease transmission from person to person, especially when a new one emerges. Adequate hand hygiene behaviour and compliance is widely accepted as being a simple, effective method in preventing the spread of communicable diseases that may be contracted during travel abroad. There is a well-established body of work investigating hand hygiene practice and compliance in community settings, but no recent studies have examined the hand hygiene practice and compliance of the general population when travelling abroad or in a cross-European context. The findings of this study indicated that most UK members of the general population when travelling abroad have a good level of understanding of the importance of adequate hand hygiene practice and compliance and its role regarding communicable disease prevention and control. As such, self-reported levels of compliance were high. Similar findings were made for Spanish members of the general population. However, while self-reported perceptions of adequacy of hand hygiene performance were relatively high, particularly among UK respondents, this was not supported by responses specifically focused on hand hygiene behaviour. However, differences in self-reported adequacy regarding the importance of handwashing versus hand drying, the number of steps that should be followed and the length of time that should be spent washing and drying hands were found for each group. This suggests that self-reported compliance may reflect intention to practice hand hygiene rather than true compliance. It also suggests that there are gaps in knowledge regarding the adequate method of hand hygiene among the cohort as a whole, and indeed these differences may account be a factor in for the high transmission rates of communicable disease when travelling abroad.


Asunto(s)
Infección Hospitalaria , Higiene de las Manos , Europa (Continente) , Adhesión a Directriz , Mano , Desinfección de las Manos , Humanos , Autoinforme , España
17.
Zhongguo Zhen Jiu ; 41(3): 349-53, 2021 Mar 12.
Artículo en Chino | MEDLINE | ID: mdl-33798324

RESUMEN

The evolution from "vessel dominated by heart" of "heart dominating pericardium meridian of hand-jueyin" was sorted out. It was the process in which the heart concept was understood from two aspects rather than from one. The statement, "heart dominating pericardium meridian of hand-jueyin" is originated from Chapter Ten of Lingshu (The Spiritual Pivot). But such pericardium meridian has not be mentioned in the early bamboo slip and silk, i.e. Zubi Shiyimai Jiujing (Moxibustion Classics of Eleven Meridians of Legs and Arms) and Yinyang Shiyimai Jiujing (Moxibustion Classic on Eleven Yin and Yang Meridians). "Twelve meridians" unearthed from Laoguanshan is named as the trajectory of "vessel dominated by heart", which was originally recorded for the diseases of heart system. In later evolution, in order to match three hand yin meridians with two organs in the upper jiao, the ancient physicians proposed the theory as heart dominating meridian, "enveloping heart system" "heart being not be attacked by pathogens" and "pathogen attacking the vessel covered around heart" along with following the records of "twelve meridians" unearthed from Laoguanshan, i.e heart dominating heart system and hand-shaoyin entering heart. Hence, it stands to reason that heart matches with shaoyin and the acupoints are selected from the meridian dominated by heart. In this evolution process, "pericardium" is generated and becomes the third organ in the upper jiao, thus the meridian dominated by heart is named as "hand-jueyin meridian".


Asunto(s)
Meridianos , Moxibustión , Puntos de Acupuntura , Mano , Pericardio
18.
Medicine (Baltimore) ; 100(14): e25252, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832085

RESUMEN

RATIONALE: Wrist-hand extension function rehabilitation is a vital and difficult part of hand function recovery in spastic stroke patients. Although botulinum toxin type A (BoNTA) injection plus post injection therapy was applied to the wrist-hand rehabilitation in previous reports, conclusion was inconsistent in promoting function. For this phenomenon, proper selection of patients for BoNTA injection and correct choice of post-injection intervention could be the crucial factors for the function recovery. PATIENT CONCERNS: We reported a 46-year-old male suffered a spastic hemiplegia with wrist- hand extension deficit. DIAGNOSES: Computed tomography showed cerebral hemorrhage in the left basal ganglia region. INTERVENTIONS: Four hundred units of BoNTA were injected into the spasticity flexors, and four-week post injection surface electromyography (sEMG) biofeedback therapy was applied to the patient. OUTCOMES: The patient exhibited post-intervention improvement in wrist-hand extensors performance (strength, range of motion, sEMG signals), the flexors spasticity, and upper extremity function. LESSONS: The present case showed that 4-week of BoNTA injection plus sEMG biofeedback exercise improved the performance and function of wrist-hand extensors in the patient for short- and long-term. Proper selection of patients for BoNTA injection and correct choice of post injection exercise could play a vital role in the hand rehabilitation for patient with spastic hemiplegia.


Asunto(s)
Toxinas Botulínicas Tipo A/administración & dosificación , Mano , Espasticidad Muscular/tratamiento farmacológico , Muñeca , Electromiografía/métodos , Hemiplejía/complicaciones , Humanos , Inyecciones Intramusculares , Masculino , Persona de Mediana Edad , Espasticidad Muscular/etiología , Espasticidad Muscular/rehabilitación
19.
MMW Fortschr Med ; 163(7): 26, 2021 04.
Artículo en Alemán | MEDLINE | ID: mdl-33844212

Asunto(s)
Mano , Instinto , Humanos
20.
Sensors (Basel) ; 21(7)2021 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-33916379

RESUMEN

In recent years, surface electromyography (sEMG)-based human-computer interaction has been developed to improve the quality of life for people. Gesture recognition based on the instantaneous values of sEMG has the advantages of accurate prediction and low latency. However, the low generalization ability of the hand gesture recognition method limits its application to new subjects and new hand gestures, and brings a heavy training burden. For this reason, based on a convolutional neural network, a transfer learning (TL) strategy for instantaneous gesture recognition is proposed to improve the generalization performance of the target network. CapgMyo and NinaPro DB1 are used to evaluate the validity of our proposed strategy. Compared with the non-transfer learning (non-TL) strategy, our proposed strategy improves the average accuracy of new subject and new gesture recognition by 18.7% and 8.74%, respectively, when up to three repeated gestures are employed. The TL strategy reduces the training time by a factor of three. Experiments verify the transferability of spatial features and the validity of the proposed strategy in improving the recognition accuracy of new subjects and new gestures, and reducing the training burden. The proposed TL strategy provides an effective way of improving the generalization ability of the gesture recognition system.


Asunto(s)
Gestos , Calidad de Vida , Algoritmos , Electromiografía , Mano , Humanos , Aprendizaje Automático , Redes Neurales de la Computación
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