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Prediction of EF-hand calcium-binding proteins and analysis of bacterial EF-hand proteins.

The EF-hand protein with a helix-loop-helix Ca(2+) binding motif constitutes one of the largest protein families and is involved in numerous biological processes. To facilitate the understanding of the role of Ca(2+) in biological systems using genomic information, we report, herein, our improvement on the pattern search method for the identification of EF-hand and EF-like Ca(2+)-binding proteins. The canonical EF-hand patterns are modified to cater to different flanking structural elements. In addition, on the basis of the conserved sequence of both the N- and C-terminal EF-hands within S100 and S100-like proteins, a new signature profile has been established to allow for the identification of pseudo EF-hand and S100 proteins from genomic information. The new patterns have a positive predictive value of 99% and a sensitivity of 96% for pseudo EF-hands. Furthermore, using the developed patterns, we have identified zero pseudo EF-hand motif and 467 canonical EF-hand Ca(2+) binding motifs with diverse cellular functions in the bacteria genome. The prediction results imply that pseudo EF-hand motifs are phylogenetically younger than canonical EF-hand motifs. Our prediction of Ca(2+) binding motifs provides not only an insight into the role of Ca(2+) and Ca(2+)-binding proteins in bacterial systems, but also a way to explore and define the role of Ca(2+) in other biological systems (calciomics).

Amino Acid Motifs↗

Assessment of the severity of hand injuries using "hand injury severity score", and its correlation with the functional outcome.

INTRODUCTION: Objective assessment of hand injuries is a complex subject. However, an objective assessment, leading to a score, can help in predicting outcome and can be used as a research tool. Campbell and Kay have devised one such score known as "hand injury severity score" or HISS [J. Hand. Surg. [Br.] 21 (3) (1996) 295]. A study on this score has been carried out in our institute. The idea was to see if the hand injury severity score, correlates with the functional outcome as measured by disability arm shoulder and hand score (DASH), after a period of minimum 2 years. METHOD: All the hand injury patients admitted in the hospital were assessed at the time of admission, and objective information was documented on a hand injury documentation form. The form captured all the data required to calculate "hand injury severity score" . A sample of 70 patients admitted during the first 6 months of 1999 was taken and their scores were calculated. The sample was selected such, that it had a reasonable representation of hand injuries of all severities. After obtaining a due approval from ethics committee, all these 70 patients were sent a DASH questionnaire. A total of 23 patients replied. Spearman's rank correlation test was used to analyse the correlation between the severity of hand injury as assessed using HISS, and functional outcome as measured using DASH. Correlations between the outcome and skeletal component score, outcome and motor component scores, and outcome and Integument component scores, were assessed separately. RESULTS: The study shows a statistically significant association ( r = 0.7182, P = 0.000165) between the severities of injury and the functional outcome. The functional outcome also shows a statistically significant association with the severity of injury to skeletal component (r = 0.5151, P = 0.014083) and motor component (r = 0.6797, P = 0.000507). However, the severity of injury to integument component, as measured by HISS, does not show any association with the outcome (r = 0.3571, P = 0.102736). This study supports the overall structure of the HISS. However an improvement in the integument component scoring is required to improve overall accuracy.

Accidents, Occupational↗

Human fetal hand size and hand maturity in the first half of the prenatal period.

The purpose of the present study has been to establish radiographic standards of hand length and finger bone size in the first half of the prenatal period, and to relate these measurements to general fetal size (CRL) and foot length (FL), as well as to the skeletal maturity assessed from a Composite Number of Ossified bones in hand and foot radiographs (CNO). The right hand and foot of each of 251 normal human fetuses (CRL 47-194 mm) were radiographed. From each hand radiograph hand length (DM), third proximal phalangeal bone length (PP) and third metacarpal bone length (MC) were measured. The study showed that third proximal phalangeal and metacarpal bone lengths both provide a valuable basis for estimating hand length. Both hand length and the length of the third metacarpal bone were found to be good predictors of general fetal size (CRL). The study provides standards for the relationships between hand and finger bone sizes, general fetal length and foot length. By combining third metacarpal bone size and skeletal maturity of the hand and foot general fetal development (age and crown-rump length) can be estimated. Insight into normal hand size and finger bone size at different stages of normal development including skeletal maturation is useful in future evaluation of handsize under pathological conditions.

Abortion, Therapeutic↗

Treatment effectiveness for patients with a history of repetitive hand use and focal hand dystonia: a planned, prospective follow-up study.

Recent studies show that rapid, nearly simultaneous, stereotypical repetitive fine motor movements can degrade the sensory representation of the hand and lead to a loss of normal motor control with a target task, referred to as occupational hand cramps or focal hand dystonia. The purpose of this prospective follow-up study was to determine whether symptomatic patients in jobs demanding high levels of repetition could be relieved of awkward, involuntary hand movements following sensory discriminative retraining complemented by a home program of sensory exercises, plus traditional posture, relaxation, mobilization, and fitness exercises. Twelve patients participated in the study. They all had occupational hand cramps, as diagnosed by a neurologist. Each patient was evaluated by a trained, independent research assistant before treatment and three to six months after treatment, by use of a battery of sensory, motor, physical, and functional performance tests. Care was provided by a physical therapist or a supervised physical therapist student in an outpatient clinic. Patients were asked to stop performing the target task and to come once a week for supervised treatment that included 1) heavy schedules of sensory training with and without biofeedback to restore the sensory representation of the hand, and 2) instructions in stress-free hand use, mirror imagery, mental rehearsal, and mental practice techniques designed to stop the abnormal movements and facilitate normal hand control. Patients were instructed in therapeutic exercises to be performed in the home to improve postural alignment, reduce neural tension, facilitate relaxation, and promote cardiopulmonary fitness. Following the defined treatment period, all patients were independent in activities of daily living, and all but one patient returned to work. Significant gains were documented in motor control, motor accuracy; sensory discrimination, and physical performance (range of motion, strength, posture, and balance). This descriptive study that includes patients with occupation-related focal hand dystonia provides evidence that aggressive sensory discriminative training complemented by traditional fitness exercises to facilitate musculoskeletal health can improve sensory processing and motor control of the hand.

Adult↗

Postural stability and hand preference as constraints on one-handed catching performance in children.

Effects of postural state and hand preference as constraints on 1-handed catching performance were investigated in different ability groups of children aged 9-10 years. On the basis of pretest data, the authors classified 48 participants into groups of good, intermediate, and poor catchers (n = 16 in each) and asked them to perform 1-handed catches with their preferred and nonpreferred hands while standing and sitting. The good catchers' performance was not affected by the imposed postural constraints but did improve when they used the preferred hand. A similar effect of hand preference was evident in the intermediate and poor catchers, but there was also an effect of postural constraint. Independent of hand preference, intermediate catchers' performance while seated improved significantly compared with that during standing. For poor catchers, there was an interaction between hand preference and posture; significant improvement was evident only when they used the preferred hand in the sitting condition. The finding that manipulation of posture and hand preference affected performance outcomes indicates that perceptual skill is not the only influence on catching performance in children. Manipulation of those key constraints may facilitate the acquisition of catching skill, but more research is needed to determine the permanence of those effects.

Aptitude↗

Do the hands talk on mind's behalf? Differences in language ability between left- and right-handed children.

Two hundred seventy children of school age, 135 of whom were left-handed and an equivalent number of whom were right-handed, have been examined in the present study using a test battery of nine language ability measures: Vocabulary, Similarities, Comprehension (WISC-R), Deductive Reasoning, Inductive Reasoning, Sentence Completion, Comprehension of Sentential Semantics, Comprehension of Syntax, and Text Processing. The data analysis has indicated that: (1) One-factor solution applies both to the right- and left-handed population according to Standard Error Scree Method (Zoski & Jurs, 1996) with regard to language ability measures. (2) Handedness discriminates between right-handers (superior) and left-handers (inferior) in language ability. (3) There have been subgroups of left-handed children who differ in language ability distribution compared with right-handed children according to Hierarchical Cluster Analysis. (4) Extreme versus mild bias to hand preference and hand skill do not differentiate performance subgroups neither within the left-handed nor within the right-handed main group. (5) Sex and familial sinistrality do not affect performance. The results are discussed in relation to (a) "human balanced polymorphism" theory advocated by Annett (mainly Annett, 1985, 1993a; Annett & Manning, 1989), (b) potential pathology (mainly Bishop, 1984, 1990a; Coren & Halpern, 1991; Satz, Orsini, Saslow & Henry, 1985) and "developmental instability" (Yeo, Gangestad & Daniel, 1993), and delay of left-hemisphere maturation in left-handed individuals (Geschwind & Galaburda, 1985a,b, 1987), by pointing out the strength and weaknesses of these theoretical approaches in accounting for the present data.

Brain↗

Hand preference and hand skill in families with schizophrenia.

Direction and degree of handedness in humans are variable between individuals and thought to be in part inherited. Several studies have shown an increase in non-right handedness among patients with schizophrenia, and some have included unaffected relatives. The present study was designed to determine whether reduced right handedness is more frequent among individuals with schizophrenia as compared with their well relatives and whether it clusters within families having multiple ill members. A total of 259 families comprising 418 individuals diagnosed with schizophrenia or schizoaffective disorder, 54 individuals with other psychoses, 145 family members with depression and other minor diagnoses, and 288 unaffected individuals were included. Hand preference was assessed by the Annett Scale and right relative to left hand skill measured using the Tapley-Bryden test. For all assessments of hand preference and hand skill, females were significantly more lateralised towards the right than males. Those individuals with schizophrenia or schizoaffective disorder had significantly less right hand preference than their unaffected relatives when measured as a quantitative index of items from the Annett Scale (p = .019), but not categorically (right, left or mixed). In contrast, there was no difference in hand skill between diagnostic groups. Hand preference was significantly correlated among male-male affected sibling pairs (p = .01) and similar results were found for hand skill among the total group of affected pairs (p = .001). Although these results only partially support a relationship between handedness and schizophrenia, they nevertheless draw attention to sex differences in hand preference and the familial aspects of hand preference in this disorder. More direct approaches to the genetics of cerebral dominance and psychosis are required.

Journal Article↗

Hand skill and hand preference in blind and sighted children.

Congenitally blind and sighted blindfold children between the ages of 6 and 15 years were compared with each other for hand preferences and hand ability. All the children performed a 20-item hand preference test and every child performed three hand ability tasks: a sorting task, a finger dexterity task, and the Minnesota rate of manipulation task, each separately with the left and the right hand. Results indicated no differences between the hand preferences of the two groups. The sighted children were faster than the blind children on some of the hand ability tasks. There were no differences between the left and right hands for any of the tasks for either group. Results indicate an equipotentiality between the hands and suggest the possibility of training both hands during development on tasks that require tactile ability.

Journal Article↗

Hand-transmitted vibration and biodynamic response of the human hand-arm: a critical review.

Hand-arm vibration syndrome (HAVS) has been associated with prolonged exposure to vibration transmitted to the human hand-arm system from hand-held power tools, vibrating machines, or hand-held vibrating workpieces. The biodynamic response of the human hand and arm to hand transmitted vibration (HTV) forms an essential basis for effective evaluations of exposures, vibration-attenuation mechanisms, and potential injury mechanisms. The biodynamic response to HTV and its relationship to HAVS are critically reviewed and discussed to highlight the advances and the need for further research. In view of its strong dependence on the nature of HTV and the lack of general agreement on the characteristics of HTV, the reported studies are first reviewed to enhance an understanding of HTV and related issues. The characteristics of HTV and relevant unresolved issues are discussed on the basis of measured data, proposed standards, and measurement methods, while the need for further developments in measurement systems is emphasized. The studies on biodynamic response and their findings are grouped into four categories based on the methodology used and the objective. These include studies on (1) through-the-hand-arm response, expressed in terms of vibration transmissibility; (2) to-the-hand response, expressed in terms of the force-motion relationship of the hand-arm system; (3) to-the-hand biodynamic response function, expressed in terms of vibration energy absorption; and (4) computer modeling of the biodynamic response characteristics.

Arm↗

Relation of hand performance and preference in male and female left-handers to familial sinistrality and writing hand.

The relations of hand performance to the degree of left-hand preference, and left- minus right-hand performance were studied in left-handed male and female subjects considering familial sinistrality and writing hand. Hand performance was assessed by a dot-filling test; hand preference was assessed by the Edinburgh Handedness Inventory. It was established that there were fundamental differences in relationships between performance and preference measures to sex, familial sinistrality, and writing hand, which also created different patterns in the relationships between hand performance and the difference in performance between hands.

Adult↗

[Cognitive performance of right-handed and left-handed persons on the Wechsler Adult Intelligence Scale (WAIS-III)].

AIM: To contribute to the knowledge of the cognitive differences existent between right-handed and left-handed evaluating the cognitive outcome in a group of adults right-handed and another group of left-handed of similar characteristic (age, gender, cultural level) by means of the Wechsler Adult Intelligence Scale (WAIS-III). SUBJECTS AND METHODS: Two groups were studied: one formed by 25 right-handed (RHG) and another formed by 25 left-handed (LHG). None of those subject of the study presented mental deficiency neither neurological dysfunctions. The age stocking was of 24.28 years, with a range between 20 and 28 years. RESULTS: There are not differences in the intellectual quotient (verbal and performance), among the two groups. The LHG obtains worse results that the right-handed in speed of prosecution and in the subtests of arithmetic and key, while the RHG has obtained better results in the subtest of incomplete figures. CONCLUSIONS: The LHG has a cognitive yield similar to that of the RHG, with slight deficiencies in activities of visoperceptual component. It becomes necessary to continue deepening in the neuropsychological and cognitive differences between right-handed and left-handed, since the cognitive outcome of the left-handed ones continues being a topic in discussion.

Adult↗

Skin reactions related to hand hygiene and selection of hand hygiene products.

BACKGROUND: In October 2004, The World Health Organization (WHO) launched the World Alliance for Patient Safety. Within the alliance, the first priority of the Global Patient Safety Challenge is to reduce health care-associated infection. A key action within the challenge is to promote hand hygiene in health care globally as well as at the country level through the campaign "Clean Care is Safer Care." As a result, the WHO is developing Guidelines on Hand Hygiene in Health Care, designed to be applicable throughout the world. METHODS: This paper summarizes one component of the global WHO guidelines related to the impact of hand hygiene on the skin of health care personnel, including a discussion of types of skin reactions associated with hand hygiene, methods to reduce adverse reactions, and factors to consider when selecting hand hygiene products. RESULTS: Health care professionals have a higher prevalence of skin irritation than seen in the general population because of the necessity for frequent hand hygiene during patient care. CONCLUSION: Ways to minimize adverse effects of hand hygiene include selecting less irritating products, using skin moisturizers, and modifying certain hand hygiene practices such as unnecessary washing. Institutions need to consider several factors when selecting hand hygiene products: dermal tolerance and aesthetic preferences of users as well as practical considerations such as convenience, storage, and costs.

Anti-Infective Agents, Local↗

Effectiveness of liquid soap vs. chlorhexidine gluconate for the removal of Clostridium difficile from bare hands and gloved hands.

OBJECTIVE: To compare liquid soap versus 4% chlorhexidine gluconate in 4% alcohol for the decontamination of bare or gloved hands inoculated with an epidemic strain of Clostridium difficile. DESIGN: C difficile (6.7 log10 colony-forming units [CFU], 47% spores), was seeded onto bare or latex gloved hands of ten volunteers and allowed to dry. Half the volunteers initially washed with soap and half with chlorhexidine, followed by the other agent 1 week later. Cultures were done with Rodac plates at three sites on the hand: finger/thumbtips, the palmar surfaces of the fingers, and the palm. Statistical comparison was by paired Student's t test. RESULTS: On bare hands, soap and chlorhexidine did not differ in residual bacterial counts on the finger/thumbtips (log10 CFU, 2.0 and 2.1, P = NS) and fingers (log10 CFU, 2.4 and 2.5, P = NS). Counts were too high on bare palms to quantitate. On gloved hands, soap was more effective than chlorhexidine on fingers (log10 CFU 1.3 and 1.7, P < .01) and palms (log10 CFU 1.5 and 2.0, P < .01), but not finger/thumbtips (log10 CFU 1.6 with each, P = NS). Residual C difficile counts were lower on gloved hands than bare hands (P < 0.01 to < 0.0001). CONCLUSIONS: The two agents did not differ significantly in residual counts of C difficile on bare hands, but on gloved hands residual counts were lower following soap wash than following chlorhexidine wash. These observations support the use of either soap or chlorhexidine as a handwash for removal of C difficile, but efficacy in the prevention of C difficile transmission must be determined by prospective clinical trials.

Aerosols↗

Viewing the hand prior to movement improves accuracy of pointing performed toward the unseen contralateral hand.

It is now well established that the accuracy of pointing movements to visual targets is worse in the full open loop condition (FOL; the hand is never visible) than in the static closed loop condition (SCL; the hand is only visible in static position prior to movement onset). In order to account for this result, it is generally admitted that viewing the hand in static position (SCL) improves the movement planning process by allowing a better encoding of the initial state of the motor apparatus. Interestingly, this wide-spread interpretation has recently been challenged by several studies suggesting that the effect of viewing the upper limb at rest might be explained in terms of the simultaneous vision of the hand and target. This result is supported by recent studies showing that goal-directed movements involve different types of planning (egocentric versus allocentric) depending on whether the hand and target are seen simultaneously or not before movement onset. The main aim of the present study was to test whether or not the accuracy improvement observed when the hand is visible before movement onset is related, at least partially, to a better encoding of the initial state of the upper limb. To address this question, we studied experimental conditions in which subjects were instructed to point with their right index finger toward their unseen left index finger. In that situation (proprioceptive pointing), the hand and target are never visible simultaneously and an improvement of movement accuracy in SCL, with respect to FOL, may only be explained by a better encoding of the initial state of the moving limb when vision is present. The results of this experiment showed that both the systematic and the variable errors were significantly lower in the SCL than in the FOL condition. This suggests: (1) that the effect of viewing the static hand prior to motion does not only depend on the simultaneous vision of the goal and the effector during movement planning; (2) that knowledge of the initial upper limb configuration or position is necessary to accurately plan goal-directed movements; (3) that static proprioceptive receptors are partially ineffective in providing an accurate estimate of the limb posture, and/or hand location relative to the body; and (4) that static visual information significantly improves the representation provided by the static proprioceptive channel.

Fingers↗

Alcohol-based hand disinfection: a more robust hand-hygiene method in an intensive care unit.

This study involved observation of hand-hygiene behaviour and evaluation of the effect of alcohol-based hand disinfection and handwashing with plain liquid soap on microbial flora. The study was performed in a combined medical and surgical intensive care unit. We demonstrated a crude compliance of hand hygiene of 50.4%, which was only performed adequately in 20.8% of cases. Of this group, handwashing and hand-disinfection procedures were performed properly 34.0% and 71.6% of the time, respectively. Hand samples for bacteriological examinations with the glove juice method demonstrated that whilst handwashing was sensitive to the way in which hand hygiene was performed, alcohol-based hand disinfection was less sensitive to such performance. Our study demonstrated that alcohol-based hand disinfection is a robust hand-hygiene method with many advantages in a practical setting. It is very feasible for use in hospital wards.

Adult↗

Development of hand surgery: education of hand surgeons.

An organized experience in the care of hand injuries and infections was not available until World War II, when military hand centers were established. Dr Sterling Bunnell was designated as a special civilian consultant to the Secretary of War. The surgeons in the military services during World War II became the nucleus of the American Society for Surgery of the Hand (ASSH). Following World War II and the Korean War there was a major shift toward medical subspecialization, and the growth of surgery of the hand as a subspecialty parallels that trend. The ASSH initiated a coordinated effort to improve the educational experience, and in 1967 the ASSH Resident Training Committee was evaluating hand training programs. The ASSH developed a comprehensive program in continuing medical education, and received full accreditation from the American Medical Association Council on Medical Education. The American Medical Association has included hand surgery on its list of designated specialties since 1975. In 1973, the bylaws of the American Board of Medical Specialties were revised to provide special certification. The ASSH developed a proposal for a certificate of added qualification in surgery of the hand that was presented to the three primary boards (orthopaedic, plastic, surgery) and the ad hoc joint Committee on Surgery of the Hand was organized in 1982. An application for a certificate of added qualification in surgery was developed by the Joint Committee on Surgery of the Hand and approved by all three boards in 1985 and the ABMS in 1986. The first examination for the certificate of added qualification in surgery was held in 1989.

American Medical Association↗

Effectiveness of rheumatoid hand surgery: contrasting perceptions of hand surgeons and rheumatologists.

PURPOSE: Surgical management of rheumatoid hand diseases is controversial with large variation in practice pattern in the U.S. The purpose of this study is to evaluate the attitudes of hand surgeons and rheumatologists toward the effectiveness of rheumatoid hand surgery. METHODS: We designed a survey instrument to examine physicians' opinions about the effectiveness of different surgical treatments for rheumatoid hand deformities. The self-administered survey was mailed to a national random sample of 500 members of the American Society for Surgery of the Hand and 500 members of the American College of Rheumatology. RESULTS: Of survey responders, 82.5% of hand surgeons versus 34.1% of rheumatologists believe metacarpophalangeal joint arthroplasty improves hand function; 93.2% and 54.6%, respectively, believe prophylactic extensor tenosynovectomy prevents tendon rupture; and 52.5% and 12.6%, respectively, believe small joint synovectomy delays joint destruction. CONCLUSIONS: Rheumatologists view rheumatoid hand surgery as significantly less effective than do hand surgeons, which highlights the disagreements between the 2 specialties about the management of this clinical problem.

Arthritis, Rheumatoid↗

Reliability, validity, and sensitivity to change of the Cochin hand functional disability scale in hand osteoarthritis.

OBJECTIVE: To assess the reliability, validity and sensitivity to change of the Cochin hand functional scale in hand osteoarthritis (OA). BACKGROUND: The Cochin hand functional disability scale has been validated in rheumatoid arthritis. DESIGN: Patients with hand OA according to Altman's criteria were included. Impairment outcome measures (VAS of pain, hand score of tenderness, clinical hand score of impairment, Kallman's radiographic scale), functional disability measures [Cochin scale, Revel's functional index (RFI), Dreiser's functional index (DFI)] and patients' perceived handicap (VAS) were recorded twice, at baseline and at a 6-month follow-up visit. Interobserver reliability was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct (convergent and divergent) validity was investigated using the Spearman rank correlation coefficient and a factor analysis was performed. Sensitivity to change was assessed using the effect size (ES) and the standardized response mean (SRM), and the non-parametric Spearman rank correlation coefficient (r) was used to assess the correlation between quantitative variable changes and patient's overall opinion. RESULTS: 89 patients (8 males, mean age 63 years) were included. Interobserver reliability was excellent (ICC=0.96). The Bland and Altman method showed no systematic trend. Correlations of the Cochin scale score with RFI (r=0.86), DFI (r=0.87), VAS of handicap (r=0.67), VAS of pain (r=0.54), tenderness (r=0.51), clinical impairment (r=0.32), and Kallman's radiographic scale (r=0.13) indicated a good construct validity. Factor analysis extracted four main factors, accounting for 65% of the total variance. 51 patients were evaluated at the 6-month visit. The Cochin scale score had worsened with SRM and ES values of -0.26 and -0.17 respectively. Changes in the score had one of the highest correlation (r=0.47) with the patient's overall opinion. CONCLUSION: The Cochin hand functional disability scale which was first developed to assess the rheumatoid hand can be used to evaluate functional disability in hand OA.

Adult↗