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PubMed2003

Writer identification using hand-printed and non-hand-printed questioned documents.

Several federal district court judges have recently referred to the purported lack of information on the proficiency of forensic document examiners (FDEs) in identifying writers of hand-printed documents. In order to provide the necessary information, we have re-analyzed data on writer identification that were collected in 1996 from 90 forensic document examiners and 34 laypersons. These data were used previously to assess the proficiency of FDEs using handwritten documents in several different types of writing. In the new analysis we separated data on hand-printed (HP) documents from data on non-hand-printed (NHP) documents and compiled error rates and statistics in each category. The main findings are: (1) whether or not the documents were hand-printed, the performance of FDEs was much better than that of laypersons; (2) statistical tests found no difference between the data provided by the FDEs in the HP and NHP categories; (3) statistical tests found no difference between the data provided by laypersons in the HP and NHP categories; and (4) statistical tests found differences between the data provided by the FDEs and the laypersons in both the HP and NHP categories. Similar results were obtained when hand-printed documents were compared to cursive documents and when cursive documents were compared to non-cursive documents. All the evidence indicates that in our proficiency test the performance of FDEs in writer identification was much better than the performance of laypersons in each one of the following document categories: (1) hand-printed; (2) non-hand-printed; (3) cursive; and (4) non-cursive.

Data Interpretation, Statistical↗
PubMed1997

Comparison between estimates of hand volume and hand strengths with sex and age with and without anthropometric data in healthy working people.

Edema and hand strength measurements are useful for the recovery assessment of patients with a hand lesion. This work determined and compared estimates of hand volume, grip strengths (measured with a Jamar and a Collins dynamometer), and pinch strength (with a Jamar pinch gauge) in terms of sex and age with or without anthropometric indices in healthy working people. The sample included 100 subjects from within the staffs of two rehabilitation centres. For both grip strengths, multiple linear regression models including body height, weight, and arm muscle area were very good (multiple correlation coefficient R of about 0.84) and clearly better than those obtained with sex and age only. For pinch strength, the best estimate was obtained with sex and arm muscle area (R of 0.76); for hand volume, the model with sex, body height, and weight provided the best result (R of 0.93). These findings suggested that anthropometric indices easy to measure must be taken into account to estimate hand volume and hand strengths.

Adult↗
PubMed2002

Intra-laboratory reproducibility of the hand hygiene reference procedures of EN 1499 (hygienic handwash) and EN 1500 (hygienic hand disinfection).

The bactericidal efficacy of hand antiseptic products is determined in Europe using two norms--EN1499 (hygienic handwash), and EN 1500 (hygienic hand disinfection) based on reducing the counts of bacteria on artificially contaminated hands. Each requires 12-15 data sets per test and comparison with a reference procedure. Recent research using EN 1500 suggested that most alcohol-based hand gels are significantly less effective than the reference alcohol (2-propanol 60%), whereas liquid alcohol-based rubs are not. However concerns about the accuracy and reproducibility of the norm reference procedures have been raised. We therefore analysed 23 experiments carried out using EN 1500 representing 342 hand disinfection procedures, and 12 experiments using EN 1499 representing 178 handwashes, all performed in the same laboratory for reproducibility of the reference procedures. The reference alcohol gave a mean log(10) reduction factor (RF) of 4.64 +/- 0.93; only one data set gave a significantly higher result (5.14, P = 0.034), and one significantly lower (4.05; P = 0.034). Analysis of all 23 means revealed no significant difference (P = 0.188; ANOVA model). The reference soap gave a mean reduction of 2.82 +/- 0.49. Two data sets were significantly higher than this (3.35,P < 0.001; 3.12, P < 0.001) and two significantly lower (2.55, P = 0.031; 2.47,P = 0.004). Analysis of all the means did reveal a significant difference (P < 0.001, ANOVA model), which is probably explained by the smaller standard deviations of these results. Pre-values (bacteria recovered from fingers before a reference procedure) correlated significantly with RFs for both hand disinfection (correlation coefficient: 0.291;P = 0.01) and handwash (correlation coefficient: 0.372, P = 0.01). Overall both procedures gave accurate and reproducible results.

Analysis of Variance↗
PubMed1997

An anthropomorphic hand exoskeleton to prevent astronaut hand fatigue during extravehicular activities.

This correspondence presents a prototype of a powered hand exoskeleton that is designed to fit over the gloved hand of an astronaut and offset the stiffness of the pressurized space suit. This will keep the productive time spent in extravehicular activity from being constrained by hand fatigue. The exoskeleton has a three-finger design, the third and fourth fingers being combined to lighten and simplify the assembly. The motions of the hand are monitored by an array of pressure sensors mounted between the exoskeleton and the hand. Controller commands are determined by a state-of-the-art programmable microcontroller using pressure sensor input. These commands are applied to a PWM driven dc motor array which provides the motive power to move the exoskeleton fingers. The resultant motion of the exoskeleton allows the astronaut to perform both precision grasping tasks with the thumb and forefinger, as well as a power grasp with the entire hand.

Anthropometry↗
PubMed1993

A study of the efficacy of antimicrobial detergents for hand washing: using the full-hand touch plates method.

We studied the effects of four kinds of antimicrobial detergents, 4% chlorhexidine gluconate (CHG), chlorbenzarconium (CBC), 10% povidone-iodine (PVI), 0.3% triclosan (TRI), and one non-medicated detergent (NMD) using the full-hand touch plates method. Before and after 3 minutes of hand scrubbing with a brush, bacterial colonies on the hand surface and subungual bacteria were counted. CHG, CBC, and PVI were excellent antimicrobial detergents against hand surface bacteria, but most of the subungual bacteria remained. The subungual space was the most difficult region from which to eradicate bacteria. TRI was much less effective than hand soap against hand surface bacteria.

Adult↗
PubMed2000

Effects of 4 hand-drying methods for removing bacteria from washed hands: a randomized trial.

OBJECTIVE: To evaluate the effects of 4 different drying methods to remove bacteria from washed hands. SUBJECTS AND METHODS: One hundred adult volunteers participated in this randomized prospective study. All bacterial counts were determined using a modified glove-juice sampling procedure. The difference was determined between the amounts of bacteria on hands artificially contaminated with the bacterium Micrococcus luteus before washing with a nonantibacterial soap and after drying by 4 different methods (cloth towels accessed by a rotary dispenser, paper towels from a stack on the hand-washing sink, warm forced air from a mechanical hand-activated dryer, and spontaneous room air evaporation). The results were analyzed using a nonparametric analysis (the Friedman test). By this method, changes in bacterial colony-forming unit values for each drying method were ranked for each subject. RESULTS: The results for 99 subjects were evaluable. No statistically significant differences were noted in the numbers of colony-forming units for each drying method (P = .72). CONCLUSION: These data demonstrate no statistically significant differences in the efficiency of 4 different hand-drying methods for removing bacteria from washed hands.

Adult↗
PubMed1999

Familial patent ductus arteriosus and bicuspid aortic valve with hand anomalies: a novel heart-hand syndrome.

The association between cardiac and limb defects, particularly those affecting the hand, has been well documented by the delineation of several heart-hand syndromes. Based on observations with a three-generation family with seven affected individuals, we describe a novel heart-hand syndrome comprising patent ductus arteriosus, bicuspid aortic valve, 5th metacarpal hypoplasia, and brachydactyly. The inheritance pattern was consistent with autosomal dominance, although X-linked dominance could not be excluded. Penetrance appeared to be complete, but there was variability of the cardiac and hand phenotypes. Because this new syndrome closely resembled Char syndrome (patent ductus arteriosus, 5th finger middle phalangeal hypoplasia, and minor facial anomalies), multipoint linkage analysis was performed using polymorphic DNA markers spanning the recently identified Char syndrome critical region at chromosomal bands 6p12-p21.1. This analysis formally excluded this 3-cM region, documenting that the two traits are not allelic. In sum, a novel heart-hand syndrome involving left ventricular outflow and aortic arch as well as an ulnar ray derivative has been identified. Because the hand anomalies can be subtle, thorough evaluation is suggested for families inheriting these cardiac defects as a mendelian trait.

Alleles↗
PubMed2007

Hand use by tufted capuchins (Cebus apella) to extract a small food item from a tube: digit movements, hand preference, and performance.

The aim of this study was to analyze the manual patterns used by tufted capuchin monkeys (Cebus apella) to retrieve a small food item from a narrow tube, with special attention focused on the independent use of single fingers, fine digit movements, hand preference, and intermanual differences in the time it took the monkeys to obtain the food. The capuchins (n = 20) mainly used their forefinger to extract the food from the tube. The simultaneous use of the index and middle fingers occurred less frequently, and the use of the forefinger in combination with other digits occurred rarely. The capuchins demonstrated a capacity to move single digits independently when the fingers were locating the food inside the tube, and displayed a high mobility of the distal phalanx joints. However, they possessed only a limited capacity to coordinate single fingers in space, and displayed only a slight degree of manual preshaping when they approached the tube. A hand-preference analysis failed to reveal any significant lateral bias for the group, since both adults (> or = 5 years) and immature individuals (<5 years) of both sexes used either hand with the same frequency. Conversely, a latency analysis showed a significant interaction between the subject's age and performance difference between hands: in adults, but not in immature individuals, the left hand was faster than the right hand in retrieving food.

Animals↗
PubMed2004

Cutaneous silent period in hand muscle is evoked by laser stimulation of the palm, but not the hand dorsum.

Painful electrical stimulation of the fingers evokes an inhibitory response in hand muscles (cutaneous silent period, CSP). The aim of this study was to determine whether purely nociceptive thermal stimuli applied to the hand evoke a CSP. High-intensity laser pulses (205 +/- 44 mJ) were delivered to the dorsum and palm of the hand in five volunteers. Electromyographic signals were recorded from the ipsilateral first dorsal interosseous muscle. We then compared the laser-evoked CSP with the CSP induced by electrical stimulation. A clear laser CSP (latency 90 +/- 7 ms) was evoked in all subjects when laser pulses were applied to the palm of the hand, whereas no response was recorded after stimulation of the dorsum. Electrical stimulation of both the dorsum and the palm evoked a CSP (latency 65 +/- 5 ms), although the reflex threshold was significantly lower after stimulation of the palm. This study confirms that the CSP is a nociceptive response specific to limbs that grasp. In humans, palm nociceptors are probably more functionally effective than dorsal nociceptors in inducing the hand-muscle inhibition that interrupts hand prehension (so that a potentially noxious source is dropped) before proximal muscles withdraw the limb.

Adult↗
PubMed2003

[The artificial hand. An overview of hand prostheses].

In spite of constant demands made by patients for optimal reconstruction of the hand in cases of injury or amputation, prosthetic devices allow only basic functions of the hand. The most important function, i.e., to connect sensitive-tactile abilities of the hand with the eye and central nervous system, has not yet been achieved and will not be feasible in the near future. There have been numerous attempts to reconstruct single hand functions such as subtle finger control in all known directions etc. Until now none of these attempts have led to any serial production of a functional "tool" because the interface between prosthesis and CNS has not been sufficiently resolved. Minute finger control requires considerable mechanical engineering that includes an efficient motor drive and an adequate power supply,which renders possible prototypes for hand prostheses heavy and complicated in everyday performance. This survey offers a short and comprehensive introduction to high-performance but simple "down-to-earth" orthotic and prosthetic devices for the replacement of lost forearm,hand, and finger function.

Amputation, Traumatic↗
PubMed1990

Analysis of vascular responses evoked in the cutaneous circulation of one hand by cooling the contralateral hand.

In 11 healthy human subjects, cutaneous red cell flux in the thenar eminence of the left hand was measured by a Laser Doppler meter, while the right hand was transferred sequentially from water at 33 degrees C, to water at 16 degrees C for 5 min, to water at 33 degrees C (1st experimental run) and then to water at 16 degrees C for 2 min (2nd experimental run). Red cell flux decreased from 33 +/- 10 (mean +/- SEM) to 19 +/- 5* perfusion units (pu) by the end of the 2nd min of cooling (* P less than 0.05 paired t-test), but had returned to 27 +/- 8 pu by the 5th min. Arterial pressure, measured by sphygmomanometry from the left arm at the 5th min (1st run) and 2nd min (2nd run) did not change, indicating the changes in red cell flux reflected changes in cutaneous vascular resistance. By contrast, when these experiments were repeated with a cuff on the right arm inflated to 56-62 mmHg to impede venous outflow from the cooled limb, there were no changes in red cell flux in the contralateral hand, nor in arterial pressure. Occlusion per se had no effect on red cell flux. Thus, we propose that cooling one hand evokes a short-lasting reflex constriction in the cutaneous circulation of the contralateral hand which is mainly mediated by core thermoreceptors affected by a reduction in blood temperature, rather than by peripheral thermoreceptors in the cooled hand. The contrast between this proposal and views based on earlier studies is discussed.

Adult↗
PubMed2004

Hand washing and hand disinfection: more than your mother taught you.

Hand washing is considered the single most important intervention for prevention of nosocomial infections in patients and health care workers. Unfortunately, compliance with standard protocols for hand hygiene in the health care environment, and especially within intensive care areas such as operating rooms and post-anesthesia care units, has been generally poor. In this article, we consider the current standards for hand hygiene as they pertain to the practice of anesthesiology. We discuss the consequences of poor compliance with hand washing practices for patient and health care provider safety. And we describe modern innovations in hand washing procedures and products that improve the opportunities for anesthesiologists to employ safe hand hygiene.

Anti-Infective Agents, Local↗
PubMed2004

An evaluation of the influence of practitioner-led hand clinics on rupture rates following primary tendon repair in the hand.

Practitioner-led hand clinics were introduced in our unit in the year 2000 as a response to the high and increasing number of postoperative hand trauma patients coming to consultant clinics. The aim of this study was to evaluate the influence of these clinics on rupture rates following primary tendon repair in the hand. The study specifically examined:zone II flexor tendon repairsflexor pollicis longus (FPL) tendon repairsextensor pollicis longus (EPL) tendon repairs. Prospective data collection were undertaken for these particular operations over a 17-month study period. Prior to the introduction of the practitioner-led hand clinics previous audits had demonstrated rupture rates of 30% zone II flexor tendon repairs, 16% for FPL repairs and 5% for EPL repairs. Rupture rates after the introduction of practitioner-led hand clinics fell in all of the study categories-to 17% for zone II flexor tendon repairs, 4% for FPL repairs and 0% for EPL repairs. It is suggested that improved continuity of care by experienced hand therapists may have contributed to the observed improvements in outcome.

Adult↗
PubMed2000

Manual laterality in haptic and visual reaching tasks by tufted capuchin monkeys (Cebus apella). An association between hand preference and hand accuracy for food discrimination.

Manual laterality was examined in 26 tufted capuchins (Cebus apella) in three tasks differing in their sensorimotor demands and the availability of visual cues. The Haptic discrimination task required the monkeys to discriminate haptically between two pumpkin seeds and two tinfoil items stuck into a tray inside an opaque box. The other two tasks required the monkeys to reach for two pumpkin seeds stuck into the tray within a transparent box with vision (Visually guided reaching task) or without vision (Visual-Tactual reaching task) during reaching. A significant group-level left hand bias was found for food retrieval in both the Haptic discrimination and Visual-Tactual tasks, and a significant group-level right hand bias in the Visually guided reaching task. The strength of hand preferences did not differ among the tasks. It was found that the accuracy of food recognition in the Haptic discrimination task was greater for the left than the right hand. The results suggest that the differences in the manipulo-spatial requirements of the tasks and in the availability of visual cues can variously affect manual laterality in capuchins. The left-hand preferences for the Haptic discrimination and Visual-Tactual tasks as well as the left-hand advantage for food discrimination may reflect a greater involvement of the right hemisphere in processing haptic information.

Animals↗
PubMed2002

The effects of hand preference side and hand preference switch history on measures of psychological and physical well-being and cognitive performance in a sample of older adult right-and left-handers.

Claims have been made that left-handedness often arises from pathological causes, and that owing to this underlying pathology, the presence of sinistrality may entail disadvantages for both the length and quality of life. A prime implication of these claims is that left-handers, as a group, should display signs of poorer fitness than right-handers. This poorer fitness might take the form of an increased incidence of illnesses and/or accidents. In addition, it might also be predicted that left-handers would experience a psychological and, perhaps, cognitive quality of life that is inferior to that of right-handers. In the present study, we measured a large sample (N=1277) of older adults on four indexes of lateral preference (hand, foot, eye, and ear), on whether or not they experienced pressure to switch their preferred writing hand, and variables related to psychological well-being, physical health, and cognitive performance. The results revealed that the presence of left hand writing, in isolation, did not predict decreases in quality of life factors; however, in conjunction with left-handed writing, the presence of a hand preference switch report was shown to be important. In particular, one subset of left-handers-those who attempted to change their preferred writing hand but were unsuccessful-was found to have a lower quality of psychological and physical well-being on multiple measures.

Aged↗
PubMed1993

[The plexal hand (involvement of the hand in traumatic lesions of the brachial plexus in adults)].

After spontaneous recovery following brachial plexus injuries, or after nerve regeneration following nervous surgery on traumatic brachial plexus, there usually is a variable residual distal deficit involving the hand and wrist. This deficit is defined by both a functional approach, and its anatomical nervous correspondence, in order to predict which motor muscles will be available for palliative surgery, and to establish the most reasonable therapeutic plan. Total palsy of the hand will only be mentioned, whereas three main presentations of the "plexic hand" are of a greater surgical interest and will be detailed: the "wrist drop", due to C5 C6 +/- C7 supra-clavicular lesions, the hand presenting with a deficit of digit flexion, pinch and intrinsic functions, due to C8 T1 +/- C7 supra-clavicular lesions, non-standardized deficits due to infra- and retro-clavicular lesions, whose therapeutic indications and prognosis are closer to more classical trunk palsies. The review of 44 "plexic hands" after distal palliative surgery indicates the need to modify the fundamental rules of tendinous transfer surgery, and suggests new principles properly adapted to the surgery of plexic hand palsies.

Adult↗
PubMed1999

The surgeon as a hand patient: the clinical and psychological impact of hand and wrist fractures.

To gain insight into the management of patients with hand and wrist injuries, a series of clinical and psychological analyses was performed on 9 surgeons, each of whom underwent operative fixation of a hand or wrist fracture. The results of these analyses suggest that the functional outcome after hand surgery was affected by the surgeons' personality, motivation, and ability to accept and adapt to the injury; the nature of the injury; and the importance of the hand to the surgeons' careers. Surgeons are highly motivated and compulsive individuals who consider their career involvement a major source of identity and self-worth. Most returned to their operative duties ahead of the schedule set by their hand surgeons (average, 25 days after surgery), regarded their injuries as a positive challenge, and changed their lifestyles after injury to protect their hands.

Adult↗
PubMed2002

Active tool use with the contralesional hand can reduce cross-modal extinction of touch on that hand.

After a unilateral brain lesion, patients may show cross-modal, visual-tactile extinction. Such patients may fail to report tactile stimuli on the contralesional hand when presented together with competing visual stimuli near the ipsilesional hand. In this work we tested the hypothesis that this cross-modal extinction may be reduced when a patient has used a tool with the contralesional hand to reach for objects in the ipsilesional visual field. Consistent with previous work, we hypothesize that active use of a tool may extend cross-modal interactions between visual stimuli at the tip of the tool and tactile stimuli on the hand wielding the tool. In the new situation of a tool connecting the contralesional hand with ipsilesional visual space, competition between stimuli on these opposite sides may be reduced, so that extinction decreases. We studied patient BV, who showed reliable cross-modal, visual-tactile extinction after right-hemisphere stroke. In two separate sessions we showed that prolonged tool use (10-20 min) with the contralesional hand in ipsilesional space reduced cross-modal extinction for up to 60-90 min post-training. We propose that an actively used tool may be effective in linking cross-modal stimuli presented along its extension. This can then overcome competition between stimuli presented on opposite sides of the body midline, thus modulating extinction.

Aged↗