Effect of thumb anaesthesia on weight perception, muscle activity and the stretch reflex in man.

PubMed Central

Marsden, C D; Rothwell, J C; Traub, M M

1979-01-01

1. We have confirmed the results of Gandevia & McCloskey (1977) on the effect of thumb anaesthesia on perception of weights lifted by the thumb. Weights lifted by flexion feel heavier and weights lifted by extension feel lighter. 2. The change in size of the long-latency stretch reflex in flexor pollicis longus or extensor pollicis longus after thumb anaesthesia cannot explain the effect on weight perception by removal or augmentation of the background servo assistance to muscular contraction. 3. During smooth thumb flexion, thumb anaesthesia increases e.m.g. activity in flexor pollicis longus and extensor pollicis longus for any given opposing torque. 4. During smooth thumb extension the opposite occurs: e.m.g. activity in both extensor and flexor pollicis longus decreases. 5. Clamping the thumb at the proximal phalanx to limit movement solely to the interphalangeal joint reduces or abolishes the effect of anaesthesia on both weight perception and e.m.g. activity during both flexion or extension tasks. 6. Gandevia & McCloskey's findings on the distorting effects of thumb anaesthesia on weight perception cannot be used to support the hypothesis of an efferent monitoring system of the sense of effort. Our results emphasize the close functional relationship between cutaneous and joint afferent information and motor control. PMID:512948

Lack of Hypertonia in Thumb Muscles After Stroke

PubMed Central

Kamper, Derek G.; Rymer, William Z.

2010-01-01

Despite the importance of the thumb to hand function, little is known about the origins of thumb impairment poststroke. Accordingly, the primary purpose of this study was to assess whether thumb flexors have heightened stretch reflexes (SRs) following stroke-induced hand impairment. The secondary purpose was to compare SR characteristics of thumb flexors in relation to those of finger flexors since it is unclear whether SR properties of both muscle groups are similarly affected poststroke. Stretch reflexes in thumb and finger flexors were assessed at rest on the paretic side in each of 12 individuals with chronic, severe, stroke-induced hand impairment and in the dominant thumb in each of eight control subjects also at rest. Muscle activity and passive joint flexion torques were measured during imposed slow (SS) and fast stretches (FS) of the flexors that span the metacarpophalangeal joints. Putative spasticity was then quantified in terms of the peak difference between FS and SS joint torques and electromyographic changes. For both the hemiparetic and control groups, the mean normalized peak torque differences (PTDs) measured in thumb flexors were statistically indistinguishable (P = 0.57). In both groups, flexor muscles were primarily unresponsive to rapid stretching. For 10 of 12 hemiparetic subjects, PTDs in thumb flexors were less than those in finger flexors (P = 0.03). Paretic finger flexor muscle reflex activity was consistently elicited during rapid stretching. These results may reflect an important difference between thumb and finger flexors relating to properties of the involved muscle afferents and spinal motoneurons. PMID:20668270

Anatomy is important, but need not be destiny: novel uses of the thumb in aye-ayes compared to other lemurs.

PubMed

Pellis, Sergio M; Pellis, Vivien C

2012-06-01

Aye-ayes (Daubentonia madagascerensis) have highly specialized hands with long digits, especially the thin middle one (D3), which is used for extracting food, such as beetle larvae, under bark. Due to the elongation of their fingers, including the thumb, it is presumed that aye-ayes have a rather limited capacity for delicate manipulation of objects. However, studies have reported independent movement of digits D3 and D4, and one report noted a seemingly independent thumb (D1) movement in holding food. Sixteen captive adult aye-ayes were videotaped feeding on a diverse range of foods so as to document how the thumb is used during food holding. To determine if the patterns observed were unique to aye-ayes, 24 individuals from 9 other species of lemurs were also videotaped. Two patterns of thumb use idiosyncratic to aye-ayes and one other lemur, the sifaka (Propithecus verreauxi), were identified: (1) when holding a food item in one hand, the thumb was used to secure the food, with the other digits playing a secondary role; (2) when holding a food item with both hands, the thumbs once again took a predominant role in securing the food. In the majority of these cases, whether held by one or two thumbs, the thumbs curled around the item, but some descriptive evidence is provided that suggests that aye-ayes exaggerate the role of the thumbs by shifting the hold to the outer edge. The novel uses of the thumbs in aye-ayes demonstrate that brain mechanisms can sometimes override the behavioral (or motor) limitations imposed by the morphology of the body. Copyright © 2011 Elsevier B.V. All rights reserved.

3D Printing Technology in Planning Thumb Reconstructions with Second Toe Transplant.

PubMed

Zang, Cheng-Wu; Zhang, Jian-Lei; Meng, Ze-Zu; Liu, Lin-Feng; Zhang, Wen-Zhi; Chen, Yong-Xiang; Cong, Rui

2017-05-01

To report preoperative planning using 3D printing to plan thumb reconstructions with second toe transplant. Between December 2013 and October 2015, the thumbs of five patients with grade 3 thumb defects were reconstructed using a wrap-around flap and second toe transplant aided by 3D printing technology. CT scans of hands and feet were analyzed using Boholo surgical simulator software (www.boholo.com). This allowed for the creation of a mirror image of the healthy thumb using the uninjured thumb. Using 3D images of the reconstructed thumb, a model of the big toe and the second toe was created to understand the dimensions of the donor site. This model was also used to repair the donor site defect by designing appropriate iliac bone and superficial circumflex iliac artery flaps. The polylactic acid model of the donor toes and reconstructed thumb was produced using 3D printing. Surgically, the wrap-around flap of the first dorsal metatarsal artery and vein combined with the joint and bone of the second toe was based upon the model donor site. Sensation was reconstructed by anastomosing the dorsal nerve of the foot and the plantar digital nerve of the great toe. Patients commenced exercises 2 weeks after surgery. All reconstructed thumbs survived, although partial flap necrosis occurred in one case. This was managed with regular dressing changes. Patients were followed up for 3-15 months. The lengths of the reconstructed thumbs are 34-49 mm. The widths of the thumb nail beds are 16-19 mm, and the thickness of the digital pulp is 16-20 mm. The thumb opposition function was 0-1.5 cm; the extension angle was 5°-20° (mean, 16°), and the angle of flexion was 38°-55° (mean, 47°). Two-point discrimination was 9-11 mm (mean, 9.6 mm). The reconstructed thumbs had good appearance, function and sensation. Based on the criteria set forth by the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of the Chinese Medical Association, the results were considered excellent for four cases and good for one case. The success rate was 100%. When planning a wrap-around flap and second toe transplant to reconstruct a thumb, both the donor and recipient sites can be modeled using 3D printing. This can shorten the operative time by supplying digital and accurate schematics for the operation. It can also optimize the function and appearance of the reconstructed thumb while minimizing damage to the donor site. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Posttraumatic thumb reconstruction.

PubMed

Muzaffar, Arshad R; Chao, James J; Friedrich, Jeffrey B; Freidrich, Jeffrey B

2005-10-01

After reading this article, the reader should be able to: 1. Discuss the critical anatomic features of the thumb as they affect on reconstructive decision making. 2. Define the goals of reconstruction. 3. Discuss an algorithm for thumb reconstruction according to the level of amputation. 4. Understand the role of prosthetics in thumb reconstruction. The function of the thumb is critical to overall hand function. Uniquely endowed with anatomic features that allow circumduction and opposition, the thumb enables activities of pinch, grasp, and fine manipulation that are essential in daily life. Destruction of the thumb secondary to trauma represents a much more significant loss than would result from loss of any other digit. Therefore, significant effort has been focused on thumb reconstruction. Numerous techniques have been described, ranging from simple osteoplastic techniques to complex microsurgical procedures. With an appreciation of the unique anatomic properties of the thumb, the hand surgeon is better able to understand the goals of thumb reconstruction and to develop an algorithm for thumb reconstruction. With such an understanding, an individualized reconstructive plan can be developed for each patient. A great many options are available for posttraumatic thumb reconstruction. Optimal results are obtained by pursuing an organized and logical approach to reconstruction based upon the level of tissue loss. Reconstruction methods depend on the location of the amputation and range from homodigital and heterodigital flaps to partial-toe transfer or a great-toe wrap-around flap to first-web-space deepening using Z-plasties, a dorsal rotation flap, or a distant flap, to distraction osteogenesis, lengthening of the thumb ray, spare parts from another injured digit in the acute setting for pollicization or heterotopic replantation, and microvascular toe transfer. Amputations in the distal third of the thumb are generally well-tolerated. The primary reconstructive issues are the restoration of a padded and sensate soft-tissue cover, as well as aesthetic considerations. First-web-space deepening will generally provide excellent results for amputations at the distal half of the middle third. In the proximal half of the middle third, lengthening of the thumb ray is generally required. Distraction lengthening of the first metacarpal is a useful and reliable technique that provides up to 3 cm of length without requiring complex microsurgical methods. Spare parts from another injured digit may be used in the acute setting for pollicization or heterotopic replantation. Microvascular toe transfer is an excellent option for elective reconstruction. However, other options also are available and may be more appropriate in some cases. Less ideal options include the various types of osteoplastic reconstruction. The reconstruction of posttraumatic thumb defects is a challenging and rewarding surgical endeavor. The value of a functioning thumb is immense, and its reconstruction is worthy of considerable effort. Despite the elegant reconstructive options available, the best results are obtained with replantation or revascularization whenever possible. Finally, the treatment plan always must be derived from a careful assessment of each patient's posttraumatic function and specific reconstructive needs.

Rules of Thumb from the Literature on Research and Evaluation.

ERIC Educational Resources Information Center

Lai, Morris K.

Practical advice on frequently asked questions dealing with research and evaluation methodology is presented as rules of thumb, with citations to the author's sources. A statement in the literature is considered a rule of thumb if it meets one of the following criteria: (1) it is specifically called a rule of thumb; (2) it contains numbers in…

[The biphalangy of the thumb. General review of the literature].

PubMed

Guillem, P; Demondion, X; Drizenko, A; Fontaine, C

1999-09-01

The thumb has only two phalanges whereas the other fingers present three. For two millennia, many anatomists tried to solve this riddle. Four different theories can be found in the review of literature, to explain what element misses in the radial column. In the first theory (Galen), the first metacarpal should be the proximal phalanx of the thumb. The particular ossification of the first metacarpal advocates for this theory. In the second theory (Sappey), the first metacarpal should result from the fusion between the true first metacarpal and the proximal phalanx of the thumb, and the proximal epiphysis should be constituted from both metacarpal and phalangeal parts. In the third theory (Paturet), the middle phalanx is thought to be missing. Apart morphological considerations, the main argument refers to symbrachydactyly, which consists in decreasing digital ray length (by reducing the middle phalanx), and usually affects digits excluding the thumb. In case the thumb is affected (in complex symbrachydactylies), the reduction concerns thus the first metacarpal, suggesting that the thumb middle phalanx has already disappeared. In the fourth theory (Pfitzner), the distal phalanx of the thumb should result from the fusion between the second and third phalanges of the thumb. This mechanism, named symphalangy, is well known in the foot, especially in the fifth toe, but also for the other toes, and even in the two ulnar fingers.

The use of the Artelon CMC Spacer for osteoarthritis of the basal joint of the thumb.

PubMed

Richard, Marc J; Lunich, Julie A; Correll, Gretchen R

2014-01-01

Favorable clinical outcomes have been reported with the Artelon CMC Spacer, however, several studies have documented complications with the device. The purpose of this study is to review a single surgeon's experience with the Artelon CMC Spacer for the treatment of basal joint arthritis of the thumb. Five thumbs in 6 patients with symptomatic osteoarthritis of the thumb carpometacarpal (CMC) joint were treated with the Artelon CMC Spacer. The mean age of the patients was 60.8 years old. Patients were followed for a mean of 39.3 months (6-63) post-operatively. Complications occurred in 4 of the 6 thumbs and half of the thumbs required at least one secondary operative procedure. A documented foreign-body reaction was present in 2 of the 6 thumbs. The Artelon CMC Spacer is an interposition material that acts as a biologic spacer for arthritic joints while maintaining mechanical strength. Due to an unacceptably high complication rate, we no longer use the Artelon CMC Spacer for the management of basal joint arthritis of the thumb. 4. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Improvement in pinch function after surgical treatment for thumb in the plane of the hand.

PubMed

Iba, K; Wada, T; Aoki, M; Yamashita, T

2012-02-01

Thumb in the plane of the hand (TPH) is a congenital deformity in which the nail plane of the radial-most digit is parallel to that of other digits, but structurally the digit retains the characteristics of a thumb. Four hands from four patients were retrospectively diagnosed as having TPH, with the underlying congenital conditions being symbrachydactyly, cleft hand and constriction band syndrome. Thumb web-plasty was carried out in all hands; one required additional rotation osteotomy of the metacarpal. Postoperative hand function was markedly improved and pinch function was possible in all cases. In most cases of TPH, the thumb has the potential to act in opposition, indicating that a thumb web-plasty is worth considering as an initial procedure.

Robotic Thumb Assembly

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Bridgwater, Lyndon (Inventor); Platt, Robert (Inventor); Wampler, II, Charles W. (Inventor); Goza, S. Michael (Inventor)

2013-01-01

An improved robotic thumb for a robotic hand assembly is provided. According to one aspect of the disclosure, improved tendon routing in the robotic thumb provides control of four degrees of freedom with only five tendons. According to another aspect of the disclosure, one of the five degrees of freedom of a human thumb is replaced in the robotic thumb with a permanent twist in the shape of a phalange. According to yet another aspect of the disclosure, a position sensor includes a magnet having two portions shaped as circle segments with different center points. The magnet provides a linearized output from a Hall effect sensor.

Arterial supply of the thumb: Systemic review.

PubMed

Miletin, J; Sukop, A; Baca, V; Kachlik, D

2017-10-01

We offer a complete systemic review of the anatomy of arteries of the thumb, including their sources in the first web space. Eleven studies were selected from the PubMed, Medline, Embase, Scopus and Ovid databases. Data about each artery of the thumb were obtained; in particular, the incidence and dominance of each of these arteries were calculated. The ulnopalmar digital artery of the thumb (UPDAT) was found in 99.63%, the radiopalmar digital artery of the thumb (RPDAT) in 99.26%, the ulnodorsal digital artery of the thumb (UDDAT) in 83.39%, and the radiodorsal digital artery of the thumb (RDDAT) in 70.38%. The sources for the thumb arteries are the first palmar metacarpal artery (for UPDAT in 63.15%, for RPDAT in 78.88%, for UDDAT in 56.95% and for RDDAT in 41.48%), the first dorsal metacarpal artery (for UPDAT in 20.54%, for RPDAT 2.53%, for UDDAT in 20.62%, and for RDDAT in 4.81%) and the superficial palmar arch, either complete or incomplete (for UPDAT in 25.57%, for RPDAT in 23.04%, for UDDAT in 0%, and for RDDAT in 5.19%). The dominant source could be identified in 88.2% of cases: the first palmar metacarpal artery (66.2%), the first dorsal metacarpal artery (15.5%) and the superficial palmar arch, complete or incomplete (8.2%). Four arteries usually supply the thumb. Any artery in the first web space can be a source for the thumb arteries. We propose a new classification of the arteries of the hand, dividing them into three systems (superficial palmar, deep palmar and dorsal system), and suggest that the term "princeps pollicis artery" be reconsidered and systemic anatomical terms of the thumb arteries preferred. Clin. Anat. 30:963-973, 2017. ©2017 Wiley-Liss, Inc. © 2017 Wiley Periodicals, Inc.

Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR.

PubMed

Udassi, Sharda; Udassi, Jai P; Lamb, Melissa A; Theriaque, Douglas W; Shuster, Jonathan J; Zaritsky, Arno L; Haque, Ikram U

2010-06-01

Infant CPR guidelines recommend two-finger chest compression with a lone rescuer and two-thumb with two rescuers. Two-thumb provides better chest compression but is perceived to be associated with increased ventilation hands-off time. We hypothesized that lone rescuer two-thumb CPR is associated with increased ventilation cycle time, decreased ventilation quality and fewer chest compressions compared to two-finger CPR in an infant manikin model. Crossover observational study randomizing 34 healthcare providers to perform 2 min CPR at a compression rate of 100 min(-1) using a 30:2 compression:ventilation ratio comparing two-thumb vs. two-finger techniques. A Laerdal Baby ALS Trainer manikin was modified to digitally record compression rate, compression depth and compression pressure and ventilation cycle time (two mouth-to-mouth breaths). Manikin chest rise with breaths was video recorded and later reviewed by two blinded CPR instructors for percent effective breaths. Data (mean+/-SD) were analyzed using a two-tailed paired t-test. Significance was defined qualitatively as p< or =0.05. Mean % effective breaths were 90+/-18.6% in two-thumb and 88.9+/-21.1% in two-finger, p=0.65. Mean time (s) to deliver two mouth-to-mouth breaths was 7.6+/-1.6 in two-thumb and 7.0+/-1.5 in two-finger, p<0.0001. Mean delivered compressions per minute were 87+/-11 in two-thumb and 92+/-12 in two-finger, p=0.0005. Two-thumb resulted in significantly higher compression depth and compression pressure compared to the two-finger technique. Healthcare providers required 0.6s longer time to deliver two breaths during two-thumb lone rescuer infant CPR, but there was no significant difference in percent effective breaths delivered between the two techniques. Two-thumb CPR had 4 fewer delivered compressions per minute, which may be offset by far more effective compression depth and compression pressure compared to two-finger technique. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

The Analysis of Risk Factors in No Thumb Test in Total Knee Arthroplasty

PubMed Central

Kim, Jee Hyoung; Ko, Dong Oh; Yoo, Chang Wook; Chun, Tae Hwan; Lee, Jung Soo

2011-01-01

Background We would like to analyze the risk factors of no thumb test among knee alignment tests during total knee arthroplasty surgery. Methods The 156 cases of total knee arthroplasty by an operator from October 2009 to April 2010 were analyzed according to preoperative indicators including body weight, height, degree of varus deformity, and patella subluxation and surgical indicators such as pre-osteotomy patella thickness, degree of patella degeneration, no thumb test which was evaluated after medial prepatella incision and before bone resection (1st test), no thumb test which was evaluated with corrective valgus stress (2nd test, J test), and the kind of prosthesis. We comparatively analyzed indicators affecting no thumb test (3rd test). Results There was no relation between age, sex, and body weight and no thumb test (3rd test). Patellar sulcus angle (p = 0.795), patellar congruence angle (p = 0.276) and preoperative mechanical axis showed no relationship. The 1st no thumb test (p = 0.007) and 2nd test (p = 0.002) showed significant relation with the 3rd no thumb test. Among surgical indicators, pre-osteotomy patella thickness (p = 0.275) and degeneration of patella (p = 0.320) were not relevant but post-osteotomy patellar thickness (p = 0.002) was relevant to no thumb test (3rd test). According to prosthesis, there was no significance with Nexgen (p = 0.575). However, there was significant correlation between Scorpio (p = 0.011), Vanguard (p = 0.049) and no thumb test (3rd test). Especially, Scorpio had a tendency to dislocate the patella, but Vanguard to stabilize the patella. Conclusions No thumb test (3rd test) is correlated positively with 1st test, 2nd test, and post-osteotomy patella thickness. Therefore, the more patella osteotomy and the prosthesis with high affinity to patellofemoral alignment would be required for correct patella alignment. PMID:22162789

ULNAR NERVE COMPONENT TO INNERVATION OF THUMB CARPOMETACARPAL JOINT

PubMed Central

Miki, Roberto Augusto; Kam, Check C; Gennis, Elisabeth R; Barkin, Jodie A; Riel, Ryan U; Robinson, Philip G; Owens, Patrick W

2011-01-01

Purpose Thumb carpometacarpal (CMC) joint arthritis is one of the most common problems addressed by hand surgeons. The gold standard of treatment for thumb CMC joint arthritis is trapeziectomy, ligament reconstruction and tendon interposition. Denervation of the thumb CMC joint is not currently used to treat arthritis in this joint due to the failure of the procedure to yield significant symptomatic relief. The failure of denervation is puzzling, given that past anatomic studies show the radial nerve is the major innervation of the thumb CMC joint with the lateral antebrachial nerve and the median nerve also innervating this joint. Although no anatomic study has ever shown that the ulnar nerve innervates the CMC joint, due to both the failure of denervation and the success of arthroscopic thermal ablation, we suspect that previous anatomic studies may have overlooked innervation of the thumb CMC joint via the ulnar nerve. Methods We dissected 19 formalin-preserved cadaveric hand-to-mid-forearm specimens. The radial, median and ulnar nerves were identified in the proximal forearm and then followed distally. Any branch heading toward the radial side of the hand were followed to see if they innervated the thumb CMC joint. Results Eleven specimens (58%) had superficial radial nerve innervation to the thumb CMC joint. Nine specimens (47%) had median nerve innervation from the motor branch. Nine specimens (47%) had ulnar nerve innervation from the motor branch. Conclusions We believe this is the first study to demonstrate that the ulnar nerve innervates the thumb CMC joint This finding may explain the poor results seen in earlier attempts at denervation of the thumb CMC, but the more favorable results with techniques such as arthroscopy with thermal ablation. PMID:22096446

Accuracy and feasibility of using an electrogoniometer for measuring simple thumb movements.

PubMed

Jonsson, Per; Johnson, Peter W; Hagberg, Mats

2007-05-01

The aim of this study was to determine the accuracy and feasibility of using an electrogoniometer (Model SG 110; Biometrics, Gwent, UK) for measuring simple thumb movements. Thumb disorders have been associated with the use of hand held devices such as mobile phones and these devices have become an integral part of modern life. In 15 young subjects, the measurements of eight flexion/extension (Flex/Ext) and adduction/abduction (Ad/Ab) thumb positions were compared between a thumb-mounted electrogoniometer and manual goniometer (which was taken as the benchmark). Group mean electrogoniometric measurement errors were below 4 degrees and 5 degrees for Ad/Ab and Flex/Ext measurements, respectively. During mobile phone use, the electrogoniometers measured differences in maximal joint angle postures, which appeared to be related to differences in mobile phone size. High movement velocities may increase the risk of musculoskeletal injury and the results indicated that Ad/Ab movements were twice the speed of Flex/Ext movements during mobile phone use. Electrogoniometers have utility for studying thumb movements during mobile phone use and may be used to evaluate other thumb-based input devices.

Students Learn by Doing: Teaching about Rules of Thumb.

ERIC Educational Resources Information Center

Cude, Brenda J.

1990-01-01

Identifies situation in which consumers are likely to substitute rules of thumb for research, reviews rules of thumb often used as substitutes, and identifies teaching activities to help students learn when substitution is appropriate. (JOW)

Extensor Pollicis Longus Injury in Addition to De Quervain’s with Text Messaging on Mobile Phones

PubMed Central

Kumar, Bhaskaranand; Bhat, Anil K; Venugopal, Anand

2014-01-01

Objective: To do a clinical and ultrasonic evaluation of subjects with thumb pain with text messaging. Background: Thumbs are commonly used for text messaging, which are not as well designed for fine manipulative or dexterous work. Repetitive use as in text messaging can lead to the injury to the tendons of the thumb. Materials and Methods: Ninety eight students with symptoms of Repetitive Strain Type of injuries of the thumb were selected from a survey and evaluated both clinically and by ultrasound analysis of the musculotendinous unit of the thumb to note changes due to excessive use of the mobile phone. Age and sex matched controls were also subjected to ultrasound evaluation. Results: Clinical examination showed positive Finkelstein test in 40% of the cases, significant reduction in the lateral and tip pinch strengths in the cases. Ultrasound detected changes in the first and the third compartments in 19% of the cases. Conclusion: Isolated cases of pain in the thumb have been reported but this study noted changes both clinically and by ultrasound in the tendons of the thumb. These changes should be taken as warning signs of possible subclinical changes taking place in the soft tissues of the thumb in these subjects due to repetitive use of mobile phones and thus, making them prone for developing painful Musculoskeletal Disorders. Application: Repetitive use of mobile phones for text messaging can lead to the damage of Extensor pollicis longus of the thumb in addition to the tendons of the first compartment of the wrist. PMID:25584249

Involuntary Neuromuscular Coupling between the Thumb and Finger of Stroke Survivors during Dynamic Movement.

PubMed

Jones, Christopher L; Kamper, Derek G

2018-01-01

Finger-thumb coordination is crucial to manual dexterity but remains incompletely understood, particularly following neurological injury such as stroke. While being controlled independently, the index finger and thumb especially must work in concert to perform a variety of tasks requiring lateral or palmar pinch. The impact of stroke on this functionally critical sensorimotor control during dynamic tasks has been largely unexplored. In this study, we explored finger-thumb coupling during close-open pinching motions in stroke survivors with chronic hemiparesis. Two types of perturbations were applied randomly to the index with a novel Cable-Actuated Finger Exoskeleton: a sudden joint acceleration stretching muscle groups of the index finger and a sudden increase in impedance in selected index finger joint(s). Electromyographic signals for specific thumb and index finger muscles, thumb tip trajectory, and index finger joint angles were recorded during each trial. Joint angle perturbations invoked reflex responses in the flexor digitorum superficialis (FDS), first dorsal interossei (FDI), and extensor digitorum communis muscles of the index finger and heteronymous reflex responses in flexor pollicis brevis of the thumb ( p  < 0.017). Phase of movement played a role as a faster peak reflex response was observed in FDI during opening than during closing ( p  < 0.002) and direction of perturbations resulted in shorter reflex times for FDS and FDI ( p  < 0.012) for extension perturbations. Surprisingly, when index finger joint impedance was suddenly increased, thumb tip movement was substantially increased, from 2 to 10 cm ( p  < 0.001). A greater effect was seen during the opening phase ( p  < 0.044). Thus, involuntary finger-thumb coupling was present during dynamic movement, with perturbation of the index finger impacting thumb activity. The degree of coupling modulated with the phase of motion. These findings reveal a potential mechanism for direct intervention to improve poststroke hand mobility and provide insight on prospective neurologically oriented therapies.

Involuntary Neuromuscular Coupling between the Thumb and Finger of Stroke Survivors during Dynamic Movement

PubMed Central

Jones, Christopher L.; Kamper, Derek G.

2018-01-01

Finger–thumb coordination is crucial to manual dexterity but remains incompletely understood, particularly following neurological injury such as stroke. While being controlled independently, the index finger and thumb especially must work in concert to perform a variety of tasks requiring lateral or palmar pinch. The impact of stroke on this functionally critical sensorimotor control during dynamic tasks has been largely unexplored. In this study, we explored finger–thumb coupling during close–open pinching motions in stroke survivors with chronic hemiparesis. Two types of perturbations were applied randomly to the index with a novel Cable-Actuated Finger Exoskeleton: a sudden joint acceleration stretching muscle groups of the index finger and a sudden increase in impedance in selected index finger joint(s). Electromyographic signals for specific thumb and index finger muscles, thumb tip trajectory, and index finger joint angles were recorded during each trial. Joint angle perturbations invoked reflex responses in the flexor digitorum superficialis (FDS), first dorsal interossei (FDI), and extensor digitorum communis muscles of the index finger and heteronymous reflex responses in flexor pollicis brevis of the thumb (p < 0.017). Phase of movement played a role as a faster peak reflex response was observed in FDI during opening than during closing (p < 0.002) and direction of perturbations resulted in shorter reflex times for FDS and FDI (p < 0.012) for extension perturbations. Surprisingly, when index finger joint impedance was suddenly increased, thumb tip movement was substantially increased, from 2 to 10 cm (p < 0.001). A greater effect was seen during the opening phase (p < 0.044). Thus, involuntary finger–thumb coupling was present during dynamic movement, with perturbation of the index finger impacting thumb activity. The degree of coupling modulated with the phase of motion. These findings reveal a potential mechanism for direct intervention to improve poststroke hand mobility and provide insight on prospective neurologically oriented therapies. PMID:29545767

Aniseikonia quantification: error rate of rule of thumb estimation.

PubMed

Lubkin, V; Shippman, S; Bennett, G; Meininger, D; Kramer, P; Poppinga, P

1999-01-01

To find the error rate in quantifying aniseikonia by using "Rule of Thumb" estimation in comparison with proven space eikonometry. Study 1: 24 adult pseudophakic individuals were measured for anisometropia, and astigmatic interocular difference. Rule of Thumb quantification for prescription was calculated and compared with aniseikonia measurement by the classical Essilor Projection Space Eikonometer. Study 2: parallel analysis was performed on 62 consecutive phakic patients from our strabismus clinic group. Frequency of error: For Group 1 (24 cases): 5 ( or 21 %) were equal (i.e., 1% or less difference); 16 (or 67% ) were greater (more than 1% different); and 3 (13%) were less by Rule of Thumb calculation in comparison to aniseikonia determined on the Essilor eikonometer. For Group 2 (62 cases): 45 (or 73%) were equal (1% or less); 10 (or 16%) were greater; and 7 (or 11%) were lower in the Rule of Thumb calculations in comparison to Essilor eikonometry. Magnitude of error: In Group 1, in 10/24 (29%) aniseikonia by Rule of Thumb estimation was 100% or more greater than by space eikonometry, and in 6 of those ten by 200% or more. In Group 2, in 4/62 (6%) aniseikonia by Rule of Thumb estimation was 200% or more greater than by space eikonometry. The frequency and magnitude of apparent clinical errors of Rule of Thumb estimation is disturbingly large. This problem is greatly magnified by the time and effort and cost of prescribing and executing an aniseikonic correction for a patient. The higher the refractive error, the greater the anisometropia, and the worse the errors in Rule of Thumb estimation of aniseikonia. Accurate eikonometric methods and devices should be employed in all cases where such measurements can be made. Rule of thumb estimations should be limited to cases where such subjective testing and measurement cannot be performed, as in infants after unilateral cataract surgery.

The thumb of Miocene apes: new insights from Castell de Barberà (Catalonia, Spain).

PubMed

Almécija, Sergio; Alba, David M; Moyà-Solà, Salvador

2012-07-01

Primate hands display a major selective compromise between locomotion and manipulation. The thumb may or may not participate in locomotion, but it plays a central role in most manipulative activities. Understanding whether or not the last common ancestor of humans and Pan displayed extant-ape-like hand proportions (i.e., relatively long fingers and a short thumb) can be clarified by the analysis of Miocene ape hand remains. Here we describe new pollical remains-a complete proximal phalanx and a partial distal phalanx-from the middle/late Miocene site of Castell de Barberà (ca., 11.2-10.5 Ma, Vallès-Penedès Basin), and provide morphometric and qualitative comparisons with other available Miocene specimens as well as extant catarrhines (including humans). Our results show that all available Miocene taxa (Proconsul, Nacholapithecus, Afropithecus, Sivapithecus, Hispanopithecus, Oreopithecus, and the hominoid from Castell de Barberà) share a similar phalangeal thumb morphology: the phalanges are relatively long, and the proximal phalanges have a high degree of curvature, marked insertions for the flexor muscles, a palmarly bent trochlea and a low basal height. All these features suggest that these Miocene apes used their thumb with an emphasis on flexion, most of them to powerfully assist the fingers during above-branch, grasping arboreal locomotion. Moreover, in terms of relative proximal phalangeal length, the thumb of Miocene taxa is intermediate between the long-thumbed humans and the short-thumbed extant apes. Together with previous evidence, this suggests that a moderate-length hand with relatively long thumb-involved in locomotion-is the original hand morphotype for the Hominidae. Copyright © 2012 Wiley Periodicals, Inc.

Complete annular and partial oblique pulley release for pediatric locked trigger thumb

PubMed Central

Kuo, Meiying

2010-01-01

Purpose To report the surgical treatment outcome of pediatric locked trigger thumb by sequential release of the annular pulley and partial release of the oblique pulley. Materials and Methods A retrospective review was undertaken on 28 operative thumbs in 24 patients with an average follow-up of 79 months. Intraoperative observations focused on the pathology of the pulley system. Surgical technique involved complete release of the annular pulley, which alone was insufficient in relieving the deformity, along with release of the proximal 50% of the oblique pulley in all patients. Postoperative parameters of bowstringing, resolution of Notta's node, thumb interphalangeal motion, and patient/parent satisfaction were assessed. Results The oblique pulley appeared stenotic, whereas the annular pulley was observed to be membranous and nearly indistinguishable from the tendon sheath. No patients had recurrence of thumb locking or triggering. No bowstringing was detected, and Notta’s node resolved fully in 19 of 20 thumbs. Five thumbs had an average of 12o less active IP joint motion without flexion contracture (i.e., less flexion). All patients or families expressed overall satisfaction with the procedure. Conclusion The annular pulley was attenuated in the majority of cases and the proximal half of the oblique pulley was stenotic in all patients. Releasing 50% of the oblique pulley after complete annular pulley release was necessary in all thumbs to achieve full FPL excursion. Mistaking the constricted proximal oblique pulley for an annular pulley may encourage releasing the entire oblique pulley, leading to an adverse result. Satisfactory outcome was achieved after surgical treatment of pediatric locked trigger thumbs. Type of Study/Level of Evidence Therapeutic IV. PMID:22131924

An anthropometric study to evaluate the correlation between the occlusal vertical dimension and length of the thumb.

PubMed

Basnet, Bishal Babu; Parajuli, Prakash Kumar; Singh, Raj Kumar; Suwal, Pramita; Shrestha, Pragya; Baral, Dharanidhar

2015-01-01

Establishment of proper occlusal vertical dimension (OVD) is one of the important tasks for successful prosthodontic therapy. An ideal method for determining OVD in terms of cost, time, and instrument requirements has been sought in prosthodontics by various investigators. However, no such single method has been formulated. In the current anthropometric study, the relationship of the length of the thumb to the OVD was tested in two ethnic groups of Nepal, Aryans, and Mongoloids. The result of this study can be useful in determining proper OVD in edentulous patients. The primary aim of the present study was to evaluate the correlation between the length of the thumb and OVD in Aryan and Mongoloid ethnic groups. The secondary aim was to compare the correlation between OVD and other anatomic measurements (eye-ear distance and pupil-to-rima oris distance) in these ethnicities. The OVD, thumb length, eye-ear distance and distance between pupil of eye and rima oris were measured in a total of 500 adult dentulous volunteers. The correlation between OVD and thumb length as well as other anatomic measurements was checked with Pearson's product moment correlation coefficient. Linear regression analysis was performed to determine the relationship of OVD to the length of the thumb. The thumb length was significantly (P≤0.05) correlated with strong and positive values (Pearson's coefficient =0.874 in the whole population, 0.826 in Aryans, and 0.944 in Mongoloids). Regression analysis showed that thumb length was significantly related to OVD in both ethnic groups. Within the limitations of the present study, the result implies that thumb length can be used as an adjunct for establishing OVD in the edentulous patients.

Radiographic hand osteoarthritis: patterns and associations with hand pain and function in a community-dwelling sample.

PubMed

Marshall, M; van der Windt, D; Nicholls, E; Myers, H; Hay, E; Dziedzic, K

2009-11-01

Patterns of radiographic osteoarthritis (ROA) of the hand are often examined by row, with the four joints of the thumb studied inconsistently. The objectives of this study were to determine relationships of ROA at different hand joints, use the findings to define radiographic sub-groups and investigate their associations with pain and function. Sixteen joints in each hand were scored for the presence of ROA in a community-dwelling cohort of adults, 50-years-and-over, with self-reported hand pain or problems. Principal components analysis (PCA) with varimax rotation was used to study patterns of ROA in the hand joints and identify distinct sub-groups. Differences in pain and function between these sub-groups were assessed using Australian/Canadian Osteoarthritis Index (AUSCAN), Grip Ability Test (GAT) and grip and pinch strength. PCA was undertaken on data from 592 participants and identified four components: distal interphalangeal joints (DIPs), proximal interphalangeal joints (PIPs), metacarpophalangeal joints (MCPs), thumb joints. However, the left thumb interphalangeal (IP) joint cross-loaded with the PIP and thumb groups. On this basis, participants were categorised into four radiographic sub-groups: no osteoarthritis (OA), finger only OA, thumb only OA and combined thumb and finger OA. Statistically significant differences were found between the sub-groups for AUSCAN function, and in women alone for grip and pinch strength. Participants with combined thumb and finger OA had the worst scores. Individual thumb joints can be clustered together as a joint group in ROA. Four radiographic sub-groups of hand OA can be distinguished. Pain and functional difficulties were highest in participants with both thumb and finger OA.

Getting a grip: different actions and visual guidance of the thumb and finger in precision grasping.

PubMed

Melmoth, Dean R; Grant, Simon

2012-10-01

We manipulated the visual information available for grasping to examine what is visually guided when subjects get a precision grip on a common class of object (upright cylinders). In Experiment 1, objects (2 sizes) were placed at different eccentricities to vary the relative proximity to the participant's (n = 6) body of their thumb and finger contact positions in the final grip orientations, with vision available throughout or only for movement programming. Thumb trajectories were straighter and less variable than finger paths, and the thumb normally made initial contact with the objects at a relatively invariant landing site, but consistent thumb first-contacts were disrupted without visual guidance. Finger deviations were more affected by the object's properties and increased when vision was unavailable after movement onset. In Experiment 2, participants (n = 12) grasped 'glow-in-the-dark' objects wearing different luminous gloves in which the whole hand was visible or the thumb or the index finger was selectively occluded. Grip closure times were prolonged and thumb first-contacts disrupted when subjects could not see their thumb, whereas occluding the finger resulted in wider grips at contact because this digit remained distant from the object. Results were together consistent with visual feedback guiding the thumb in the period just prior to contacting the object, with the finger more involved in opening the grip and avoiding collision with the opposite contact surface. As people can overtly fixate only one object contact point at a time, we suggest that selecting one digit for online guidance represents an optimal strategy for initial grip placement. Other grasping tasks, in which the finger appears to be used for this purpose, are discussed.

One-stage thumb lengthening with use of an osteocutaneous 2nd metacarpal flap.

PubMed

Givissis, Panagiotis; Stavridis, Stavros I; Ditsios, Konstantinos; Christodoulou, Anastasios

2009-12-01

Traumatic thumb amputation represents an extremely disabling entity, thus rendering its reconstruction a procedure of paramount importance. A case of a patient, who sustained a traumatic amputation of his left index finger at the metacarpophalangeal joint and of his left thumb in the middle of the proximal phalanx 4 months ago and was initially treated elsewhere, is described. For the thumb reconstruction, an osteocutaneous flap of the radial side of the 2nd metacarpal, which consisted of a 3, 5-cm bony segment with the overlying skin and its blood and nerve supply was used. The flap was transferred and fixed with a plate and screws to the palmar-medial side of the stump of the thumb, while the 1st web space was deepened by removing the rest of the second metacarpal, while a partial skin graft was used to cover a remaining gap. Thumb functionality was restored immediately postoperatively, and the overall result was satisfactory.

Motion deficit of the thumb in CMC joint arthritis.

PubMed

Gehrmann, Sebastian V; Tang, Jie; Li, Zong Ming; Goitz, Robert J; Windolf, Joachim; Kaufmann, Robert A

2010-09-01

Idiopathic osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint is a common disabling disease that often causes pain and motion loss. The aims of this study were to characterize the multidimensional motion capability of the thumb CMC joint in a group with severe CMC OA and to compare it with a control group. We included 15 subjects with stage III/IV CMC OA according to the Eaton/Littler classification, and 15 control subjects. A motion analysis system using surface markers was employed to quantify the maximum boundary of the thumb circumduction envelope during repetitive thumb movements. We measured the area enclosed by the angular circumduction envelope and the ranges of motion (ROM) in multiple directions for the thumb CMC joint. Thumb osteoarthritis of the CMC joint stage III/IV resulted in a significantly smaller ROM in flexion/extension (45 degrees +/- 11 degrees for the CMC OA group, 59 degrees +/- 10 degrees for the controls), abduction-adduction (37 degrees +/- 6 degrees for the CMC OA group, 63 degrees +/- 13 degrees for the controls), and pronation-supination (49 degrees +/- 10 degrees for the CMC OA group, 62 degrees +/- 11 degrees for the controls) (p < .01). When analyzing the motion directions in flexion-extension and abduction-adduction separately, there was only a loss of extension and adduction (p < .01). Severe stages of thumb CMC OA cause an asymmetrical motion deficit with decreased ROM in extension and adduction, leading to decreased capability of counteropposition. Copyright 2010. Published by Elsevier Inc.

Approximating optimal behavioural strategies down to rules-of-thumb: energy reserve changes in pairs of social foragers.

PubMed

Rands, Sean A

2011-01-01

Functional explanations of behaviour often propose optimal strategies for organisms to follow. These 'best' strategies could be difficult to perform given biological constraints such as neural architecture and physiological constraints. Instead, simple heuristics or 'rules-of-thumb' that approximate these optimal strategies may instead be performed. From a modelling perspective, rules-of-thumb are also useful tools for considering how group behaviour is shaped by the behaviours of individuals. Using simple rules-of-thumb reduces the complexity of these models, but care needs to be taken to use rules that are biologically relevant. Here, we investigate the similarity between the outputs of a two-player dynamic foraging game (which generated optimal but complex solutions) and a computational simulation of the behaviours of the two members of a foraging pair, who instead followed a rule-of-thumb approximation of the game's output. The original game generated complex results, and we demonstrate here that the simulations following the much-simplified rules-of-thumb also generate complex results, suggesting that the rule-of-thumb was sufficient to make some of the model outcomes unpredictable. There was some agreement between both modelling techniques, but some differences arose - particularly when pair members were not identical in how they gained and lost energy. We argue that exploring how rules-of-thumb perform in comparison to their optimal counterparts is an important exercise for biologically validating the output of agent-based models of group behaviour.

Selecting Pesticides and Nonchemical Alternatives: Green Thumbs' Rules of Thumb Decision Tools.

ERIC Educational Resources Information Center

Grieshop, James I.; And Others

1992-01-01

A sample of 78 (of 320) home gardeners use rules of thumb (heuristics) to choose between chemical pesticides and nonchemical alternatives. Pesticides rank low in 24 choice attributes where alternatives rank high, and vice versa. Gender, age, and years of pesticide use correlate with pesticide selection. (SK)

Reconstruction of closed rupture of thumb flexor tendon pulleys with a single free palmaris longus tendon graft: a case report and review of literature.

PubMed

Fazilleau, F; Cheval, D; Richou, J; Le Nen, D

2014-02-01

Closed rupture of thumb flexor tendon pulleys is extremely rare. Several techniques have already been described for finger pulley reconstruction. Various techniques based on prior anatomic and biomedical studies have been proposed for thumb pulley reconstruction, in which one or two of the three pulleys are replaced. In the present study, we describe an original technique using a single, free palmaris longus (PL) autograft for thumb pulley reconstruction. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Design and Evaluation of an Actuated Exoskeleton for Examining Motor Control in Stroke Thumb

PubMed Central

Wang, Furui; Jones, Christopher L.; Shastri, Milind; Qian, Kai; Kamper, Derek G.; Sarkar, Nilanjan

2016-01-01

Chronic hand impairment is common following stroke. This paper presents an actuated thumb exoskeleton (ATX) to facilitate research in examining motor control and hand rehabilitation. The ATX presented in this work aims to provide independent bi-directional actuation in each of the 5 degrees-of-freedom (DOF) of the thumb using a novel flexible shaft based mechanism that has 5 active DOF and 3 passive DOF. A prototype has been built and experiments have been conducted to measure the allowable workspace at the thumb and evaluate the kinematic and kinetic performance of the ATX. The experimental results show that the ATX is able to provide individual actuation at all 5 thumb joints with high joint velocity and torque capacities. Further improvement and future work are discussed. PMID:27672232

A Technique for the Management of Concomitant Scaphotrapezoid Arthritis in Patients With Thumb Metacarpotrapezial Arthritis: Interposition Arthroplasty With a Capitate Suture Anchor.

PubMed

Warganich, Tibor; Shin, Alexander Y

2017-06-01

Scaphotrapezoid (ST) arthritis is a common source of pain and disability that typically presents with concomitant basilar thumb arthritis. ST arthritis is often under recognized and under diagnosed as a source of continued pain after successful basilar thumb arthroplasty. Untreated, symptomatic ST arthritis can cause failure of an otherwise successfully executed thumb carpometacarpal arthroplasty due to persistent pain, which is frustrating to the patient and surgeon. Although multiple surgical treatment options have been described for basilar thumb carpometacarpal joint arthritis, there is no gold standard for the treatment of ST arthritis. We describe a surgical technique with a minimal trapezoid excision and interpositional arthroplasty using an acellular allograft secured with a suture anchor in the capitate.

[Clinical effect of distally-based dorsal thumb neurocutaneous vascular flap on repair of soft tissue defect in thumb].

PubMed

Huang, Yixiong; Shen, Zunli; Wang, Yongchun; Zhang, Shimin

2009-10-01

To investigate the surgical methods and clinical results of repairing soft tissue defects in the thumb with distally-based dorsal thumb neurocutaneous vascular flap. From January 2006 to October 2007, 23 patients with soft tissue defect in the thumb were treated, including 20 males and 3 females aged 19-46 years old (average 27.5 years old). The defect was caused by crush injury in 1 case, electric planer accident in 6 cases, incised injury in 8 cases, and avulsion injury in 8 cases. The defect was located on the palmar aspect of the thumb distal phalanx in 3 cases, the dorsal-radial aspect of the thumb distal phalanx in 3 cases, and ulnar or dorsal aspect in 17 cases. The defect size ranged from 3.3 cm x 1.2 cm to 4.2 cm x 1.2 cm. Among them, 18 cases were complicated with distal 1/2 nail bed defect or injury. The time between injury and hospital admission was 1-72 hours (average 22 hours). During operation, the defect was repaired with distally-based dorsal-radial neurovenocutaneous vascular flap of the thumb in 3 cases and distally-based dorsal-ulnar neurovenocutaneous vascular flap of the thumb in 20 cases. The size of those flaps was 4.0 cm x 1.6 cm-5.0 cm x 3.0 cm. The donor site underwent direct suture or split thickness skin graft repair. At 10 days after operation, 3 cases suffered from the epidermal necrosis in the distal part of the flap, 2 of them experienced the exfoliation of dark scab 14 days later and the flap survived, and the flap of the rest one survived after dressing change. The other flaps and the skin graft at the donor site all survived uneventfully. The wounds healed by first intention. All the patients were followed up for 10-16 months (average 12.6 months). The flaps were soft in texture and full in appearance. The two-point discrimination value 6 months after operation was 8-10 mm. At 12 months after operation, the growth of the residual fingernail was evident in 18 cases, including 4 cases of curved or hook fingernail. Active flexion and extension of the thumb were normal. The abduction of the first web space reached or surpassed 80 percent of the normal side in 20 cases and was below 80 percent of the normal side in 3 cases. The clinical outcomes were satisfactory in 11 cases, approximately satisfactory in 8 cases, and unsatisfactory in 4 cases according to self-designed evaluation system. The operative method of repairing the soft tissue defects in the thumb with the distally-based dorsal thumb neurocutaneous vascular flap is simple, stable in anatomy, in line with the principle of proximity, and suitable for repairing thumb tip defect 3 cm in size. It can bring a good postoperative appearance of the thumb and little influence on the hand function.

Prevalence of sesamoid bones in the interphalangeal joint of the thumb and fingers: a radiographic study.

PubMed

Seki, Yasuhiro; Hoshino, Yuko; Kuroda, Hiroshi

2013-10-01

The prevalence of sesamoid bones in the hands has been reported in some previous articles. Most of them, however, have reported sesamoid bones of the metacarpophalangeal joint of the hand and of the interphalangeal (IP) joint of the thumb. The present study investigates the prevalence of sesamoid bones of the IP joint of the thumb and fingers. A retrospective review of radiologic views of the IP joints in the thumb or fingers was performed, including a total of 650 patients (1,096 thumbs or fingers). Sesamoid bones were found in the IP joint of the thumb at 67% (212 of 318), while the index, middle, ring, little fingers had sesamoid bones in the proximal interphlangeal (PIP) joint at 0% (0 of 172), 0.4% (1 of 244), 0.5% (1 of 183), and 1% (2 of 179), respectively. None of the four fingers had sesamoid bones in the distal IP joint. Previous articles have described the similar prevalence to the present study, of sesamoid bones of the IP joint of the thumb, while some others reported the different prevalence. About the PIP joint, no previous articles have found a sesamoid bone. Because the lateral X-ray view is more accurate and suitable to evaluate sesamoid bones, we used the lateral one for the present study. The knowledge that sesamoid bones occurs at these rates in the thumb IP joint and finger PIP joints is helpful to differentiate chip fractures from sesamoid bones near the IP joint, including the PIP joint. Copyright © 2012 Wiley Periodicals, Inc.

The added value of measuring thumb and finger strength when comparing strength measurements in hypoplastic thumb patients.

PubMed

Molenaar, H M Ties; Selles, Ruud W; de Kraker, Marjolein; Stam, Henk J; Hovius, Steven E R

2013-10-01

When interventions to the hand are aimed at improving function of specific fingers or the thumb, the RIHM (Rotterdam Intrinsic Hand Myometer) is a validated tool and offers more detailed information to assess strength of the involved joints besides grip and pinch measurements. In this study, strength was measured in 65 thumbs in 40 patients diagnosed with thumb hypoplasia. These 65 thumbs were classified according to Blauth. Longitudinal radial deficiencies were also classified. The strength measurements comprised of grip, tip, tripod and key pinch. Furthermore palmar abduction and opposition of the thumb as well as abduction of the index and little finger were measured with the RIHM. For all longitudinal radial deficiency patients, grip and pinch strength as well as palmar abduction and thumb opposition were significantly lower than reference values (P<0.001). However, strength in the index finger abduction and the little finger abduction was maintained or decreased to a lesser extent according to the degree of longitudinal radial deficiency. All strength values decreased with increasing Blauth-type. Blauth-type II hands (n=15) with flexor digitorum superficialis 4 opposition transfer including stabilization of the metacarpophalangeal joint showed a trend toward a higher opposition strength without reaching statistical significance (P=0.094),however compared to non-operated Blauth-type II hands (n=6) they showed a lower grip strength (P=0.019). The RIHM is comparable in accuracy to other strength dynamometers. Using the RIHM, we were able to illustrate strength patterns on finger-specific level, showing added value when evaluating outcome in patients with hand related problems. © 2013.

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

Fuel Standard Volumes by Year Generated_thumb20150904-8240-13hgnxh Last update August 2012 View Graph product or destination Last update August 2015 View Graph Graph Download Data Custom_thumb U.S. Ethanol , from 1866-2014 Last update August 2015 View Graph Graph Download Data Generated_thumb20160920-21993

Salvage reconstruction of failed interposition arthroplasty at the base of the thumb.

PubMed

Braun, Richard M; Rechnic, Mark; Shah, Kalpit N

2012-12-01

We present an operative procedure designed to revise a failed arthroplasty at the base of the thumb. This report describes a reliable operation that corrects residual instability and malignment which results in thumbs that are weak and painful despite a previous procedure. The operation has also been used as a primary procedure for arthritis of the trapeziometacarpal joint where instability and subluxation was a major component of the problem requiring joint reconstruction. The unique features of this procedure include a reinforced double-thickness tendon graft, a unique tendon anchor, and a fascia lata allograft spacer. Significant functional improvement is anticipated when joint reconstruction provides increased proximal stability. Pinch and grip measurements improve. Pain scores also diminish after the operation. Hand function and patient satisfaction can be substantially improved with revision arthroplasty when the initial operation has failed to provide a thumb that is mobile, stable, and pain free. The technical features of the procedure address reduction of malignment, restoring of anatomic balance, and secure fixation of the proximal apex of the thumb metacarpal which restores thumb reduction position and digital balance.

Electronic door locking mechanism

DOEpatents

Williams, Gary Lin; Kirby, Patrick Gerald

1997-01-01

The invention is a motorized linkage for engaging a thumb piece in a door mechanism. The device has an exterior lock assembly with a small battery cell and combination lock. Proper entry by a user of a security code allows the battery to operate a small motor within the exterior lock assembly. The small motor manipulates a cam-plunger which moves an actuator pin into a thumb piece. The user applies a force on to the thumb piece. This force is transmitted by the thumb piece to a latch engagement mechanism by the actuator pin. The latch engagement mechanism operates the door latch.

Electronic door locking mechanism

DOEpatents

Williams, G.L.; Kirby, P.G.

1997-10-21

The invention is a motorized linkage for engaging a thumb piece in a door mechanism. The device has an exterior lock assembly with a small battery cell and combination lock. Proper entry by a user of a security code allows the battery to operate a small motor within the exterior lock assembly. The small motor manipulates a cam-plunger which moves an actuator pin into a thumb piece. The user applies a force on to the thumb piece. This force is transmitted by the thumb piece to a latch engagement mechanism by the actuator pin. The latch engagement mechanism operates the door latch. 6 figs.

Evidence of a false thumb in a fossil carnivore clarifies the evolution of pandas.

PubMed

Salesa, Manuel J; Antón, Mauricio; Peigné, Stéphane; Morales, Jorge

2006-01-10

The "false thumb" of pandas is a carpal bone, the radial sesamoid, which has been enlarged and functions as an opposable thumb. If the giant panda (Ailuropoda melanoleuca) and the red panda (Ailurus fulgens) are not closely related, their sharing of this adaptation implies a remarkable convergence. The discovery of previously unknown postcranial remains of a Miocene red panda relative, Simocyon batalleri, from the Spanish site of Batallones-1 (Madrid), now shows that this animal had a false thumb. The radial sesamoid of S. batalleri shows similarities with that of the red panda, which supports a sister-group relationship and indicates independent evolution in both pandas. The fossils from Batallones-1 reveal S. batalleri as a puma-sized, semiarboreal carnivore with a moderately hypercarnivore diet. These data suggest that the false thumbs of S. batalleri and Ailurus fulgens were probably inherited from a primitive member of the red panda family (Ailuridae), which lacked the red panda's specializations for herbivory but shared its arboreal adaptations. Thus, it seems that, whereas the false thumb of the giant panda probably evolved for manipulating bamboo, the false thumbs of the red panda and of S. batalleri more likely evolved as an aid for arboreal locomotion, with the red panda secondarily developing its ability for item manipulation and thus producing one of the most dramatic cases of convergence among vertebrates.

[One-stage toenail lengthening: a report of 9 cases].

PubMed

Zhang, Gong-Lin; Guo, Ao; Zhang, Ming; Xu, Zhao-Yao; Zhang, Ling-Zhi; Wang, Shun-Bing; Li, Jun; Wu, Fa-Lin; Yu, Hui

2008-01-01

To summarize clinical application of one-stage toenail lengthening in free second toe transfer for reconstruction of the thumb (finger). Nine patients (male 7, female 2) underwent thumb (finger) reconstruction with second toe transfer were treated by one-stage toenail lengthening technique. Eight were the thumb and 1 was the index finger. Patients aged from 18 to 46 years,with an average of 25 years. A rectangle skin was resected at 0.5 cm away from the eponychium, which was 0.2 cm high and as wide as the toenail. Then stripped U shape flap gently towards proximal end and sutured it. During the operation, the injury of the subcutaneous vascular network should be avoided. Superficial infection at donor area happened in 1 case and was healed by changing dressings. All the reconstruction thumbs (fingers) had survived completely. 2 to 3 mm extending of toenail length was obtained and the appearance of thumb (finger) was improved. There was no growth deformation of toenail. After 7 to 24 months follow up (the average time 13 months), the appearance of the nail was good. One-stage toenail lengthening in free second toe transfer for reconstruction of the thumb (finger), which can obtain a satisfactory appearance of the nail and have no influence on the motion of the reconstruction thumb (finger), is a simple and an effective operative procedure.

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

View Graph Graph Download Data Generated_thumb20140811-21276-p5mcbz Average Fuel Economy at Different Road Grades Generated_thumb20140811-21276-p5mcbz Trend of Fuel Economy and Consumption at different at Various Driving Speeds Generated_thumb20170119-11720-1o8tesk Trend of fuel efficiency at different

Thumb carpometacarpal osteoarthritis: arthrodesis compared with ligament reconstruction and tendon interposition.

PubMed

Hartigan, B J; Stern, P J; Kiefhaber, T R

2001-10-01

There has been considerable controversy regarding the procedure of choice for treatment of any given stage of osteoarthritis of the thumb carpometacarpal joint. This study was designed to directly compare the clinical results of two common surgical procedures for this condition, trapeziometacarpal arthrodesis and trapezial excision with ligament reconstruction and tendon interposition, in similar patient populations. Between 1988 and 1998, 109 patients (141 thumbs) who were less than sixty years old were treated with one of the two procedures. In a retrospective review, forty-two patients (fifty-eight thumbs) treated with arthrodesis completed an outcome questionnaire and twenty-nine patients (forty-four thumbs) treated with arthrodesis completed the questionnaire and were examined. In the group treated with trapezial excision with ligament reconstruction and tendon interposition, thirty-nine patients (forty-nine thumbs) completed the questionnaire and thirty patients (thirty-eight thumbs) completed the questionnaire and were examined. The average duration of follow-up was sixty-nine months. The groups were similar with regard to age, gender, hand dominance, and duration of follow-up. Subjective evaluation of pain, function, and satisfaction demonstrated no significant difference between the two groups, with >90% of patients satisfied following either procedure. Although grip strength did not differ between the groups, the arthrodesis group had significantly stronger lateral pinch (p < 0.001) and chuck pinch (p < 0.01). The group treated with ligament reconstruction and tendon interposition had a better range of motion with regard to opposition (p < 0.05) and the ability to flatten the hand (p < 0.0001). There was a higher complication rate in the arthrodesis group, with nonunion of the fusion site accounting for the majority of the complications. However, despite a persistent nonunion in six thumbs, those thumbs and the thumbs in which union was obtained did not differ with regard to pain; all of the patients with nonunion had improvement in their pain status compared with preoperatively, and all were very satisfied with the outcome. Peritrapezial arthritis developed in nine patients (fourteen thumbs). This finding was not related to age and did not affect overall pain, function, or satisfaction. Although traditionally arthrodesis and ligament reconstruction and tendon interposition have been indicated in two different patient populations, we compared them in a homogeneous group and found that the two procedures had similar results with regard to pain, function, and satisfaction despite minimal differences in strength and motion. Although complications were more frequent following arthrodesis, most did not affect the overall outcome.

Arthroscopic Synovectomy Combined with Autologous Fat Grafting in Early Stages of CMC Osteoarthritis of the Thumb.

PubMed

Kemper, Robert; Wirth, Johanna; Baur, Eva-Maria

2018-04-01

Background  Minimal invasive treatments such as arthroscopic techniques may be adequate to restore the anatomy and functional integrity of the thumb CMC (carpometacarpal) joint. In this paper, we reported the interposition of autologous fat tissue in combination with arthroscopic synovectomy/debridement for early stage of the thumb CMC joint osteoarthritis. Patients and Methods  Twelve patients with a mean age of 46 years with early radiological stages of thumb CMC joint osteoarthritis were included. Evaluation of outcome was measured prior and 3, 12, and 24 months after surgery including, Visual Analog Scale (VAS), QuickDASH, grip and pinch strength, range of motion (ROM), and patient satisfaction. Results  Pain at rest (or with load) was reduced from preoperative 4,7 (8,7) to 2 (5,9) at 3 to 6 months; 1,4 (4,3) at 12 months; and 0,75 (2,7) at 2 years after the surgery. Initial preoperative QuickDASH value of 52 points reduced to 33 (17-65) at 6 months, 23 (2-70) at 12 months, and 20 (11-29) at 24 months after the surgery. Grip strength and thumb pinch with respect to the contralateral untreated thumb was reduced in the first 12 months but recovered subsequently. ROM was equal to the contralateral thumb. Three patients suffered from tendinitis and required surgical treatment. One patient indicated prolonged pain symptoms. No infections were noted and no donor-site morbidity or side effects were detected. Conclusion  Arthroscopic synovectomy combined with autologous fat graft is a reliable surgical option for early thumb CMC joint osteoarthritis and that effect continues for more than 24 months.

Anatomical analysis of thumb opponency movement in the capuchin monkey (Sapajus sp).

PubMed

Aversi-Ferreira, Roqueline A G M F; Souto Maior, Rafael; Aziz, Ashraf; Ziermann, Janine M; Nishijo, Hisao; Tomaz, Carlos; Tavares, Maria Clotilde H; Aversi-Ferreira, Tales Alexandre

2014-01-01

Capuchin monkeys present a wide variety of manipulatory skills and make routine use of tools both in captivity and in the wild. Efficient handling of objects in this genus has led several investigators to assume near-human thumb movements despite the lack of anatomical studies. Here we perform an anatomical analysis of muscles and bones in the capuchin hand. Trapezo-metacarpal joint surfaces observed in capuchins indicate that medial rotation of metacarpal I is either absent or very limited. Overall, bone structural arrangement and thumb position relative to the other digits and the hand's palm suggest that capuchins are unable to perform any kind of thumb opponency, but rather a 'lateral pinch' movement. Although the capuchin hand apparatus bears other features necessary for complex tool use, the lack thumb opposition movements suggests that a developed cognitive and motor nervous system may be even more important for high manipulatory skills than traditionally held.

[Tendovaginitis stenosans of the thumb in small children (pollex flexus congenitus). The authors' results and review of the literature].

PubMed

Hierner, R; Berger, A

1997-11-01

Our personal treatment concept for trigger thumb in children is presented. The guiding symptoms are fixed flexion deformity, (painful) restriction of motion (with a click phenomenon) or persistent extension deformity. Although it is a simple pathology, careful diagnosis is mandatory to rule out other reasons with the same symptoms as trigger thumb, as some of these will lead to severe aesthetic and functional impairment. In 26 patients with persistent symptoms, the A1 ring ligament of the thumb was cut. Free active and passive joint motion was comparable to the opposite side in 92.7% of patients. In 2 cases a secondary operation was necessary because of incomplete A1 ring ligament release. If it is diagnosed and operated on early with a careful operative technique, nowadays no aesthetic or functional impairment should occur in children because of trigger thumb.

Apparent Covariation between Child Habit Disorders: Effects of Successful Treatment for Thumb Sucking on Untargeted Chronic Hair Pulling.

ERIC Educational Resources Information Center

Friman, Patrick C.; Hove, Gayleen

1987-01-01

The study examined effects of aversive taste treatment of thumb sucking on untreated habitual hair pulling by two young males (ages 2 and 5). Concomitant with successful treatment of thumb sucking, hair pulling was also eliminated. Results suggest an efficient method for changing behaviors that are difficult to treat directly. (Author/JW)

Single Degree-of-Freedom Exoskeleton Mechanism Design for Thumb Rehabilitation*

PubMed Central

Yihun, Yimesker; Miklos, Robert; Perez-Gracia, Alba; Reinkensmeyer, David J.; Denney, Keith; Wolbrecht, Eric T.

2014-01-01

This paper presents the kinematic design of a spatial, 1-degree-of-freedom closed linkage to be used as an exoskeleton for thumb motion. Together with an already-designed finger mechanism, it forms a robotic device for hand therapy. The goal for the exoskeleton is to generate the desired grasping and pinching path of the thumb with one degree of freedom, rather than using a system actuating all its joints independently. In addition to the path of the thumb, additional constraints are added in order to control the position and size of the exoskeleton, reducing physical and sensory interference with the user. PMID:23366289

Ergonomics study on mobile phones for thumb physiology discomfort

NASA Astrophysics Data System (ADS)

Bendero, J. M. S.; Doon, M. E. R.; Quiogue, K. C. A.; Soneja, L. C.; Ong, N. R.; Sauli, Z.; Vairavan, R.

2017-09-01

The study was conducted on Filipino undergraduate college students and aimed to find out about the significant factors associated with mobile phone usage and its effect on thumb pain.A correlation-prediction analysisand Multiple Linear Regression was adopted and used as the main tool in determining the significant factors and coming up with predictive models on thumb related pain. With the use of the software Statistical Package for the Social Sciences or SPSS in conducting linear regression, 2 significant factors on thumb-related pain (percentage of time using portrait as screen orientation when text messaging, amount of time playing games using one hand in a day) were found.

Autologous Fat Transfer for Thumb Carpometacarpal Joint Osteoarthritis: A Prospective Study.

PubMed

Herold, Christian; Rennekampff, Hans-Oliver; Groddeck, Robert; Allert, Sixtus

2017-08-01

Most operations for carpometacarpal joint osteoarthritis of the thumb irreversibly alter or destroy the anatomy. There is a high demand for minimally invasive alternatives. The authors report the results of autologous fat transfer for treatment of thumb carpometacarpal joint osteoarthritis. In a prospective study, 50 patients with thumb carpometacarpal joint osteoarthritis were observed for 1 year after autologous fat transfer. Manual liposuction and centrifugation were performed. Pain rating according to visual analogue pain scale; objective force of pinch grip and fist closure; and Disabilities of the Arm, Shoulder, and Hand questionnaire scores before and after treatment were analyzed. The average pain in stage 2 patients preoperatively was 7.7 ± 1.3; it was 1.8 ± 1.9 after 6 months and 2.4 ± 3.1 after 12 months. Patients with stage 2 osteoarthritis demonstrated a superior benefit from this treatment compared with patients with either stage 3 or stage 4 thumb carpometacarpal joint osteoarthritis. There were similar improvements for the parameters strength and Disabilities of the Arm, Shoulder, and Hand questionnaire score. No serious adverse events were observed. Autologous fat transplantation is an appealing alternative, especially in early-stage basal joint osteoarthritis of the thumb. The low invasiveness of the procedure and early recovery of patients compared with classical procedures such as trapeziectomy, and the superior long-term results compared with classical injection therapy, make this approach feasible as a first-line therapy in early-stage basal joint osteoarthritis of the thumb. Therapeutic, IV.

Approximating Optimal Behavioural Strategies Down to Rules-of-Thumb: Energy Reserve Changes in Pairs of Social Foragers

PubMed Central

Rands, Sean A.

2011-01-01

Functional explanations of behaviour often propose optimal strategies for organisms to follow. These ‘best’ strategies could be difficult to perform given biological constraints such as neural architecture and physiological constraints. Instead, simple heuristics or ‘rules-of-thumb’ that approximate these optimal strategies may instead be performed. From a modelling perspective, rules-of-thumb are also useful tools for considering how group behaviour is shaped by the behaviours of individuals. Using simple rules-of-thumb reduces the complexity of these models, but care needs to be taken to use rules that are biologically relevant. Here, we investigate the similarity between the outputs of a two-player dynamic foraging game (which generated optimal but complex solutions) and a computational simulation of the behaviours of the two members of a foraging pair, who instead followed a rule-of-thumb approximation of the game's output. The original game generated complex results, and we demonstrate here that the simulations following the much-simplified rules-of-thumb also generate complex results, suggesting that the rule-of-thumb was sufficient to make some of the model outcomes unpredictable. There was some agreement between both modelling techniques, but some differences arose – particularly when pair members were not identical in how they gained and lost energy. We argue that exploring how rules-of-thumb perform in comparison to their optimal counterparts is an important exercise for biologically validating the output of agent-based models of group behaviour. PMID:21765938

Distraction lengthening of the proximal phalanx in distal thumb amputations.

PubMed

Cansü, Eren; Ünal, Mehmet Bekir; Parmaksızoğlu, Fatih; Gürcan, Serkan

2015-01-01

Thumb amputation is a major cause of hand dysfunction, and the treatment for distal thumb amputations remains controversial. Although finger reconstruction methods using distraction lengthening are known to restore finger length and function, we found no reports in the literature regarding phalangeal lengthening in thumb amputations. We aimed to evaluate proximal phalangeal lengthening in thumb amputations at or near the interphalangeal (IP) joint. We retrospectively evaluated patients who had undergone distraction lengthening of the proximal phalanx of the thumb. All patients underwent osteotomy, either during the initial procedure or as a second-stage procedure. Distraction began 10 days after osteotomy with the use of an external fixator that remained in place until ossification of the gap occurred without bone grafting. Patients were evaluated using the QuickDASH score. Fourteen patients with a mean age of 27 years and a mean follow-up period of 7 years were enrolled. The mean phalangeal lengthening achieved was 20 mm. Ossification occurred at all distraction sites, and the fixators were maintained for a mean of 85 days. The mean healing index was 42.5 days/cm. All 14 patients achieved the desired amount of phalangeal lengthening without major complications such as nonunion, premature union, or gross infection. For reconstruction in cases of distal thumb amputations, distraction lengthening of the proximal phalanx can be used to improve absolute length, web space, and grip distance. The technique is safe and effective, improves functionality/cosmesis, and offers a low complication risk.

Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture.

PubMed

Bai, Rong-Jie; Zhang, Hui-Bo; Zhan, Hui-Li; Qian, Zhan-Hua; Wang, Nai-Li; Liu, Yue; Li, Wen-Ting; Yin, Yu-Ming

2018-05-05

Hand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities. Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed. The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons. Sports injury-related fingers and thumb deformity are relatively common. MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the fingers and thumb. It is a useful tool for accurate diagnosis of the sports-related ligaments and tendons injuries in hand.

Congenital radial and thumb aplasia in a neonatal owl monkey (Aotus nancymaae).

PubMed

Schuler, Anne Michele; Gibson, Susan V; Brady, Alan G; Abee, Christian R; Scammell, Jonathan G

2007-09-01

This report describes congenital radial and thumb aplasia in a neonatal owl monkey. Congenital limb deformities in human neonates and Old World primate species have been well characterized. The many probable causes of these congenital defects in skeletal structure include fetal exposure to environmental toxins and genetic influences. In nonhuman primates, the cause frequently remains undetermined. In the case we present, the neonate presented for examination because of inability to cling to the dam. The forelimbs were contracted distally, and thumbs were absent. Radiographs indicated complete radial aplasia and other skeletal abnormalities. This description is the fi rst case study of congenital radial and thumb aplasia in a New World primate species.

Development of a parametric kinematic model of the human hand and a novel robotic exoskeleton.

PubMed

Burton, T M W; Vaidyanathan, R; Burgess, S C; Turton, A J; Melhuish, C

2011-01-01

This paper reports the integration of a kinematic model of the human hand during cylindrical grasping, with specific focus on the accurate mapping of thumb movement during grasping motions, and a novel, multi-degree-of-freedom assistive exoskeleton mechanism based on this model. The model includes thumb maximum hyper-extension for grasping large objects (~> 50 mm). The exoskeleton includes a novel four-bar mechanism designed to reproduce natural thumb opposition and a novel synchro-motion pulley mechanism for coordinated finger motion. A computer aided design environment is used to allow the exoskeleton to be rapidly customized to the hand dimensions of a specific patient. Trials comparing the kinematic model to observed data of hand movement show the model to be capable of mapping thumb and finger joint flexion angles during grasping motions. Simulations show the exoskeleton to be capable of reproducing the complex motion of the thumb to oppose the fingers during cylindrical and pinch grip motions. © 2011 IEEE

Treatment alternatives of congenital hand differences with thumb hypoplasia involvement.

PubMed

Papadogeorgou, Ellada V; Soucacos, Panayotis N

2008-01-01

Congenital thumb hypoplasia is a complex and heterogeneous congenital difference that is detrimental to hand function. Apart from its' classic form, which is now considered to be part of radial dysplasia, it can occur as part of other congenital anomalies including, syndactyly, symbrachydactyly, atypical cleft hand, bifid thumb, triphalangeal thumb, mirror hand, constriction band syndrome, as well as generalized anomalies and syndromes. Management is aimed primarily at restoring basic hand function, specifically, power grasp and precision pinch, and secondarily to improve cosmoses, which inevitably is going to be impaired. Several treatment alternatives have been proposed to manage the specific disabling condition and include, 1st web space reconstruction and opponensplasty, pollicization, toe-to-hand transfer, distraction lengthening, free toe phalangeal transfer or the use of allograft, stabilization of the metacarpophalangeal joint, and surgery of "spare parts." The purpose of this study is to evaluate the various alternatives available today and propose an algorithm applicable for the appropriate management of thumb deficiency, based on their specific characteristics. Copyright 2008 Wiley-Liss, Inc. Microsurgery, 2008.

The Engineer's Thumb or Sherlock Holmes on the trail of 'the uncanny'.

PubMed

Batail, J

1997-08-01

Freud identified 'primal phantasies' (life in the womb, 'primal scene', seduction, castration). It is argued that 'The Engineer's Thumb', a short story from 'The Adventures of Sherlock Holmes', draws its uncanniness from the fact that it is underpinned by all the primal phantasies described by Freud. 'The Engineer's Thumb' therefore illustrates what analytical interpretation can contribute to the understanding of certain literary works. 'The Engineer's Thumb' may also serve as an introduction to a broader study of the Freudian concept of 'the uncanny'. This study seems to confirm what Freud said when he pointed out that 'an uncanny experience occurs either when infantile complexes which have been repressed are once more revived by some impression, or when primitive beliefs which have been surmounted seem once more to be confirmed' (1919, p. 249). 'The Engineer's Thumb' has another interesting feature: in this short story. Conan Doyle, by setting up a 'talking cure', anticipates the creation of psychoanalysis and highlights in a striking way certain aspects of what was to become psychoanalytical treatment.

Anatomical Analysis of Thumb Opponency Movement in the Capuchin Monkey (Sapajus sp)

PubMed Central

Aversi-Ferreira, Roqueline A. G. M. F.; Maior, Rafael Souto; Aziz, Ashraf; Ziermann, Janine M.; Nishijo, Hisao; Tomaz, Carlos; Tavares, Maria Clotilde H.; Aversi-Ferreira, Tales Alexandre

2014-01-01

Capuchin monkeys present a wide variety of manipulatory skills and make routine use of tools both in captivity and in the wild. Efficient handling of objects in this genus has led several investigators to assume near-human thumb movements despite the lack of anatomical studies. Here we perform an anatomical analysis of muscles and bones in the capuchin hand. Trapezo-metacarpal joint surfaces observed in capuchins indicate that medial rotation of metacarpal I is either absent or very limited. Overall, bone structural arrangement and thumb position relative to the other digits and the hand’s palm suggest that capuchins are unable to perform any kind of thumb opponency, but rather a ‘lateral pinch’ movement. Although the capuchin hand apparatus bears other features necessary for complex tool use, the lack thumb opposition movements suggests that a developed cognitive and motor nervous system may be even more important for high manipulatory skills than traditionally held. PMID:24498307

[The artery of the thumb metacarpophalangeal joint].

PubMed

Schmidt, V H; Fischer, G

1994-07-01

As a rule, a small artery passing through the palmar plate runs into the thumb metacarpophalangeal joint. Frequently, the joint vessel arises from the arteria princeps pollicis, and rarely from the arteria metacarpalis dorsalis I or from muscle branches of the arteria princeps pollicis. In 30% of our specimens we could find a third larger palmar thumb artery. To our knowledge, this vessel was not described up to now precisely. Frequently arising from the arteria princeps pollicis, it passes the whole region of the metacarpophalangeal joint of the thumb. Distally, the artery runs within the floor of the flexor pollicis longus tendon sheath. After a mean distance of 19.7 mm, the vessel passes through the wall of the tendon sheath between the A 1-pulley and the oblique pulley. This vessel anastomoses with the arteria radiopalmaris pollicis proximal to the junction of the digitopalmar arch. According to the nomenclature of anatomic variations in the forearm, we suggest to name the additional thumb vessel "Arteria mediana pollicis".

Foucher first dorsal metacarpal artery flap versus littler heterodigital neurovascular flap in resurfacing thumb pulp loss defects.

PubMed

Delikonstantinou, Iraklis P; Gravvanis, Andreas I; Dimitriou, Vasilios; Zogogiannis, Ioannis; Douma, Amalia; Tsoutsos, Dimosthenis A

2011-08-01

Our study aims to illustrate the advantages and disadvantages of Foucher's first dorsal metacarpal artery flap and Littler's heterodigital neurovascular flap in thumb pulp reconstruction, by assessing wound healing of donor and recipient sites, sensibility, and functional outcome of the reconstructed thumb. Fourteen male patients were reconstructed either with Foucher (n = 8) or Littler flap (n = 6). Dissection of Foucher's flap was faster than that of Littler's flap. All Littler flaps survived completely, but we experienced 1 partial Foucher flap necrosis. Thumb motility and stability was optimal in all patients. Wound healing of donor sites was achieved in both groups. Two patients reconstructed with Littler flap developed scar contractures and presented a reduced range of motion of donor finger and first webspace, respectively. Although Littler flap resulted in better sensibility and tactile gnosis of the reconstructed thumb-pulp, Foucher flap ensured negligible donor site morbidity, complete cortical reorientation, and better overall hand function.

Ontogenetic trends in gnostic hand function in 3- to 12-yr-old children.

PubMed

van Grunsven, W; Njiokiktjien, C; Vranken, M; Vuylsteke-Wauters, M

2003-06-01

The intimate relation between the sensory and motor functions of the hands during object manipulation and exploratory touch, the well-known improvement in object handling and constructive performance in ontogenesis and the emergent laterality thereof, assume changes in morphognostic capabilities in children. In this study we tried to corroborate the hypothesis of Mesker that mature and lateralized finger-thumb opposition is preceded by a stage of two-sided manual form agnosia in preschool children, followed by acquisition of morphognosis of the fingers and, finally, the thumbs. This study examined the development of gnostic hand function in 290 children from 3 to 11 years of age who drew the outlines of a meaningless wooden object passively felt with each hand without visual control. Analysis showed a clear ontogenetic change across the two age groups of increasing morphognostic function: 48% of the 6-yr.-olds drew correctly what the fingers of both left and right hands had perceived (thumbs, 14%). Of the 11-yr.-olds 91% and 61% performed perfectly with the right and left hands, respectively. The fingers preceded the thumbs in reproduction by most children, and the correct reproduction by the left thumb precedes that of the right thumb. The ontogenesis of bimanual sensorimotor functioning is discussed in the light of cortical and callosal development.

Thumb carpometacarpal joint resurfacing with autologous ear cartilage.

PubMed

Nickell, William B

2014-05-01

A study was designed to ascertain the long-term effectiveness of using autologous full-thickness ear cartilage to resurface the arthritic face of the trapezium, leaving the body of the trapezium intact. The value of injection of the involved carpometacarpal (CMC) joint with local anesthetic in predicting improvement from the surgery was also studied. An operation was used to enter the CMC joint of the thumb between the thenar muscles and the abductor tendon. The articular surface of the trapezium was resected and resurfaced with full-thickness ear cartilage from the patient's ear. Patients were selected based on constant, unremitting pain. All patients also had x-ray evidence of severe arthritis at the CMC joint of the thumb. Both thumbs were evaluated for pain, range of motion, key and palmar pinch, and grip strength before the surgery and followed up for a minimum of 30 months to be included in the study. Fifty-nine patients had ear cartilage arthroplasty from 1997 to 2007 by the same surgeon with a total of 67 operations (8 patients, all women, had both thumbs operated). Forty-nine of these patients, 4 men and 45 women (53 hands), were available for follow-up and constitute the study group. Eight procedures were done on the left hand, and 45, on the right. There were no ear complications and no cartilage extrusions. All patients had improved range of motion and greatly decreased pain. Strength was equaled or exceeded the unoperated thumb. Preoperative joint injection was a good predictor of postoperative pain relief. All patients were pleased with the result and said that they would have the surgery again. Thumb CMC joint arthroplasty with autologous ear cartilage and preservation of the body of the trapezium is an effective alternative to existing procedures.There is no morbidity to the ear, and predictable long-term improvement in thumb pain and strength can be obtained. Injection of the CMC joint before surgery with local anesthetic is a reliable predictor of improvement from surgery.

[Internal fixation with one-hole microplate for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture].

PubMed

Wang, Xi-Xun; Sun, De-Tao; Chen, Xu-Hui; Li, Jun; Cui, Yan; Hu, Ji-Chao; Shu, Zheng-Hua; He, Jian; Ding, Chao-Qi; Chen, Bo

2015-03-01

To study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture. Twenty-two patients (16 males, 6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months, and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries (< 2 weeks) and 4 had old injuries (> 2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture, 6 patients had radial collateral ligament injuries of the thumb combined with fracture, 4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm x 4.0 mm to 6.0 mm x 7.0 mm. The incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria, and 20 patients got an excellent result and 2 good. The application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.

Grip Preference, Dermatoglyphics, and Hand Use in Captive Chimpanzees (Pan troglodytes)

PubMed Central

Hopkins, William D.; Russell, Jamie L.; Hostetter, Autumn; Pilcher, Dawn; Dahl, Jeremy F.

2007-01-01

This paper examined the association between grip type, hand use, and fingerprint patterns in a sample of captive chimpanzees. Grip type for simple reaching was assessed for the left and right hand and classified as thumb-index, middle-index, or single-digit responses. Fingerprint patterns were characterized as whorls, loops, or arches on each finger. The results indicated that chimpanzees exhibit significantly more thumb-index responses for the right compared to the left hand. In addition, thumb-index responses were more prevalent for subjects that had a whorl compared to a loop or arch on their thumb. The results suggest that fingerprint patterns are associated with individual differences in grasping type in chimpanzees as well as some variation in hand use. PMID:15761856

Correction of a Hyperextension Deformity at the Metacarpophalangeal Joint by Arthroplasty for Osteoarthritis of the Thumb Carpometacarpal Joint Followed by External Fixator: A Case Series: Modified Ilizarov Method for Correction of a Collapsed Thumb Deformity Due to Carpometacarpal Osteoarthritis.

PubMed

Hamada, Yoshitaka; Kobayashi, Anna; Sairyo, Koichi; Sato, Ryosuke; Hibino, Naohito

2015-06-01

A hyperextension deformity in the advanced stages of carpometacarpal (CMC) arthritis of the thumb could affect the outcomes of thumb CMC joint arthroplasty. We introduce the interesting approach for treating severely collapsed thumb deformities with gradual distraction and coordinated correction of the MCP and CMC joints by means of external fixators. We divided 8 cases into 3 groups according to the angle of passive flexion of the hyperextended MCP joint: group 1, 10-20°, group 2a, 20-40°, and group 2b, >40°, retrospectively. We first performed CMC arthroplasty with trapezium excision. In group 1, we corrected the MCP hyperextension deformity by manual passive flexion and fixed the joint with an extension block Kirshner wire (K-wire) for 2 months. However, deformities recurred in 2 of 5 cases after removing the K-wire. These patients received corrective percutaneous osteotomy with external fixators at the metacarpal neck. In groups 2a and 2b, we performed CMC arthroplasty and set external fixators at the same time. All cases in groups 1 and 2a have been without recurrence for more than 2 years, while a deformity recurred in group 2b. The results of this small case series encouraged us to propose an interesting approach for collapsed zigzag thumb deformity. Good outcomes with excellent maintenance of active MCP movement and no recurrence are highly anticipated if the hyperextended thumb has no obvious degenerative changes and can be corrected by <40° of passive flexion. Our results also indicate a risk of recurrence associated with extension block by K-wire.

Collagenase Treatment for Dupuytren Disease of the Thumb and First Web.

PubMed

Dreise, Marieke M; Stenekes, Martin W; Werker, Paul M N

2016-03-01

To evaluate the short-term effectiveness of collagenase Clostridium histolyticum to treat thumb and first web contractures in Dupuytren disease. We prospectively included 14 thumbs in 12 patients with a contracture at the metacarpophalangeal or interphalangeal joint of at least 20° with a palpable cord in the thumb (n = 8) or an adduction contracture of the thumb with palpable cords in the first web (n = 6). They received an injection containing 0.58 mg of collagenase Clostridium histolyticum in the fibrous cord divided over 3 spots. The contracture was released by carefully manipulating the thumb under local anesthesia 1 day later. The extension and abduction deficits were measured before and after the intervention (follow-up at 7 and 30 days and 6 months). Wilcoxon signed rank test was used to analyze the data. In the total sample, postintervention extension deficits were statistically significantly lower than preintervention deficits except in one patient who had a recurrence at 6 months compared with the 30-day posttreatment result. Intermetacarpophalangeal head distance (IMD) also improved significantly. In an analysis of subgroups, we compared the separate contributions of treatment of a pretendinous cord and a first web cord on both extension deficit and IMD. Treatment of pretendinous cords significantly affected both extension deficit and IMD. However, treatment of first web contractures did not significantly improve extension or IMD. Collagenase Clostridium histolyticum is a good treatment option for pretendinous cords in thumbs affected with Dupuytren disease because it provides good results, is minimally invasive, and has minor adverse events. Therapeutic IV. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Examination of the torque required to passively palmar abduct the thumb CMC joint in a pediatric population with hemiplegia and stroke.

PubMed

Stirling, Leia; Ahmad, Mona Qureshi; Kelty-Stephen, Damian; Correia, Annette

2015-12-16

Many activities of daily living involve precision grasping and bimanual manipulation, such as putting toothpaste on a toothbrush or feeding oneself. However, children afflicted by stroke, cerebral palsy, or traumatic brain injury may have lost or never had the ability to actively and accurately control the thumb. To translate insights from adult rehabilitation robotics to innovative therapies for hand rehabilitation in pediatric care, specifically for thumb deformities, an understanding of the torque needed to abduct the thumb to assist grasping tasks is required. Participants (n=16, 10 female, 13.2±3.1 years) had an upper extremity evaluation and measures were made of their passive range of motion, anthropometrics, and torques to abduct the thumb for both their affected and non-affected sides. Torque measures were made using a custom wrist orthosis that was adjusted for each participant. The torque to achieve maximum abduction was 1.47±0.61inlb for the non-affected side and 1.51±0.68inlb for the affected side, with a maximum recorded value of 4.87inlb. The overall maximum applied torque was observed during adduction and was 5.10inlb. We saw variation in the applied torque, which could have been due to the applied torques by the Occupational Therapist or the participant actively assisting or resisting the motion rather than remaining passive. We expect similar muscle and participant variation to exist with an assistive device. Thus, the data presented here can be used to inform the specifications for the development of an assistive thumb orthosis for children with "thumb-in-palm" deformity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Implementing Filters to Identify and Prioritize Industrial Base Risk: Rules of Thumb to Reduce Cognitive Overload

DTIC Science & Technology

2015-04-30

Thumb to Reduce Cognitive Overload Sally Sleeper, ODASD[M&IBP] John F. Starns, Northrop Grumman Published April 30, 2015 Disclaimer: The views...Prioritize Industrial Base Risk: Rules of Thumb to Reduce Cognitive Overload 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6... Cognitive Overload Sally Sleeper—joined the Office of the Deputy Assistant Secretary of Defense for Manufacturing and Industrial Base Policy as Senior

Effective Operational Assessment: A Return to the Basics

DTIC Science & Technology

2010-10-27

white. Second, they concentrated on what should have been measured (an FM 5-0 rule of thumb ), such as the numbers (and names) of remaining insurgents...12 was manageable, vice ―excessive,‖ another rule of thumb . They cut right to the heart of what mattered in determining whether the insurgents...mentioned, FM 5-0 provides three excellent rules of thumb for the basics of operational assessment: ―avoid excessive analyses,‖ ―avoid … overly

Evidence of a false thumb in a fossil carnivore clarifies the evolution of pandas

PubMed Central

Salesa, Manuel J.; Antón, Mauricio; Peigné, Stéphane; Morales, Jorge

2006-01-01

The “false thumb” of pandas is a carpal bone, the radial sesamoid, which has been enlarged and functions as an opposable thumb. If the giant panda (Ailuropoda melanoleuca) and the red panda (Ailurus fulgens) are not closely related, their sharing of this adaptation implies a remarkable convergence. The discovery of previously unknown postcranial remains of a Miocene red panda relative, Simocyon batalleri, from the Spanish site of Batallones-1 (Madrid), now shows that this animal had a false thumb. The radial sesamoid of S. batalleri shows similarities with that of the red panda, which supports a sister-group relationship and indicates independent evolution in both pandas. The fossils from Batallones-1 reveal S. batalleri as a puma-sized, semiarboreal carnivore with a moderately hypercarnivore diet. These data suggest that the false thumbs of S. batalleri and Ailurus fulgens were probably inherited from a primitive member of the red panda family (Ailuridae), which lacked the red panda's specializations for herbivory but shared its arboreal adaptations. Thus, it seems that, whereas the false thumb of the giant panda probably evolved for manipulating bamboo, the false thumbs of the red panda and of S. batalleri more likely evolved as an aid for arboreal locomotion, with the red panda secondarily developing its ability for item manipulation and thus producing one of the most dramatic cases of convergence among vertebrates. PMID:16387860

Big drinkers: how BMI, gender and rules of thumb influence the free pouring of wine.

PubMed

Smarandescu, Laura; Walker, Doug; Wansink, Brian

2014-11-01

This research examines free pouring behavior and provides an account of how Body Mass Index (BMI) and gender might lead to the overpouring, and consequently the overconsumption of wine. An observational study with young adults investigated how BMI and gender affect free-pouring of wine over a variety of pouring scenarios, and how rules-of-thumb in pouring affect the quantities of alcohol poured by men and women across BMI categories. For men, the amount poured was positively related to BMI. However, BMI did not affect pours by women. The use of the "half glass" rule-of-thumb in pouring reduced the volume of wine poured by over 20% for both men and women. Importantly, this rule-of-thumb substantially attenuated the pours by men at high BMI levels. Increasing awareness of pouring biases represents an early and effective step toward curbing alcohol consumption among men, and especially those who are overweight. Additionally, using a simple "half glass" rule-of-thumb may be an effective way to curb overpouring, despite non-standard glass sizes. Copyright © 2014. Published by Elsevier B.V.

Study of non-syndromic thumb aplasia in six independent cases

PubMed Central

Riaz, Hafiza Fizzah; Lal, Karmoon; Ahmad, Bashir; Shuaib, Muhammad; Naqvi, Syeda Farwa; Malik, Sajid

2014-01-01

Objectives: To report on six independent and isolated cases demonstrating thumb aplasia as an essentially limb-specific phenotype. Methods: The subjects were ascertained during 2011-2013 from six different geographic regions of Pakistan, and underwent detailed clinical and phenotypic examination. Results: The affected arms of patients had complete absence of first digital rays, medial inclinations of second and fifth fingers, narrowing of palms, missing carpals, and shortening of zeugopod. All the subjects were presented with isolated and sporadic limb deficiencies, and five had no family history of limb or any other malformation. Parental consanguinity was denied in majority of the cases. We present detailed phenotypic manifestation of thumb apalsia in these subjects. Conclusion: Thumb aplasia markedly impairs the normal function of affected hand. Surgical procedures like pollicisation of the index finger should be employed to improve the quality of life of these subjects. There is so far no specific genetic factor known for isolated thumb aplasia, compromising an accurate genetic counseling. Collection of patients with similar phenotypic presentations could be useful in further molecular genetic investigations. PMID:24949004

Thumb Arthritis

MedlinePlus

... and Recovery Find a hand surgeon near you. Videos Thumb Arthritis Close Popup Figures Figure 1 - Basal ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...

Thumb Sprains

MedlinePlus

... Thumb Sprains Find a hand surgeon near you. Videos Figures Figure 1: The ulnar collateral ligament (UCL) ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...

Grip preference, dermatoglyphics, and hand use in captive chimpanzees (Pan troglodytes).

PubMed

Hopkins, William D; Russell, Jamie L; Hostetter, Autumn; Pilcher, Dawn; Dahl, Jeremy F

2005-09-01

This paper examined the association between grip type, hand use, and fingerprint patterns in a sample of captive chimpanzees. Grip type for simple reaching was assessed for the left and right hand and classified as thumb-index, middle-index, or single-digit responses. Fingerprint patterns were characterized as whorls, loops, or arches on each finger. The results indicated that chimpanzees exhibit significantly more thumb-index responses for the right compared to the left hand. In addition, thumb-index responses were more prevalent for subjects that had a whorl compared to a loop or arch on their thumb. The results suggest that fingerprint patterns are associated with individual differences in grasping type in chimpanzees as well as some variation in hand use. (c) 2005 Wiley-Liss, Inc.

A rare case of idiopathic thumb CMC joint neuropathic arthropathy complicated by blunt trauma.

PubMed

Singh, Manavdeep; Butala, R R; Khedekar, R G; Tripati, Manish

2016-01-01

Neuropathic arthropathy (Charcot joints), which most frequently affects the weight-bearing joints of the body, is commonly associated with a variety of medical and neurological conditions, and is notoriously difficult to treat due to the nature of the underlying pathology. We present a case of idiopathic neuropathic arthropathy of the thumb CMC joint of an elderly female complicated by blunt trauma to the thumb. To our knowledge, this is the first reported case in the literature of this rare association.

Occupational exposure decisions: can limited data interpretation training help improve accuracy?

PubMed

Logan, Perry; Ramachandran, Gurumurthy; Mulhausen, John; Hewett, Paul

2009-06-01

Accurate exposure assessments are critical for ensuring that potentially hazardous exposures are properly identified and controlled. The availability and accuracy of exposure assessments can determine whether resources are appropriately allocated to engineering and administrative controls, medical surveillance, personal protective equipment and other programs designed to protect workers. A desktop study was performed using videos, task information and sampling data to evaluate the accuracy and potential bias of participants' exposure judgments. Desktop exposure judgments were obtained from occupational hygienists for material handling jobs with small air sampling data sets (0-8 samples) and without the aid of computers. In addition, data interpretation tests (DITs) were administered to participants where they were asked to estimate the 95th percentile of an underlying log-normal exposure distribution from small data sets. Participants were presented with an exposure data interpretation or rule of thumb training which included a simple set of rules for estimating 95th percentiles for small data sets from a log-normal population. DIT was given to each participant before and after the rule of thumb training. Results of each DIT and qualitative and quantitative exposure judgments were compared with a reference judgment obtained through a Bayesian probabilistic analysis of the sampling data to investigate overall judgment accuracy and bias. There were a total of 4386 participant-task-chemical judgments for all data collections: 552 qualitative judgments made without sampling data and 3834 quantitative judgments with sampling data. The DITs and quantitative judgments were significantly better than random chance and much improved by the rule of thumb training. In addition, the rule of thumb training reduced the amount of bias in the DITs and quantitative judgments. The mean DIT % correct scores increased from 47 to 64% after the rule of thumb training (P < 0.001). The accuracy for quantitative desktop judgments increased from 43 to 63% correct after the rule of thumb training (P < 0.001). The rule of thumb training did not significantly impact accuracy for qualitative desktop judgments. The finding that even some simple statistical rules of thumb improve judgment accuracy significantly suggests that hygienists need to routinely use statistical tools while making exposure judgments using monitoring data.

Control of thumb force using surface functional electrical stimulation and muscle load sharing

PubMed Central

2013-01-01

Background Stroke survivors often have difficulties in manipulating objects with their affected hand. Thumb control plays an important role in object manipulation. Surface functional electrical stimulation (FES) can assist movement. We aim to control the 2D thumb force by predicting the sum of individual muscle forces, described by a sigmoidal muscle recruitment curve and a single force direction. Methods Five able bodied subjects and five stroke subjects were strapped in a custom built setup. The forces perpendicular to the thumb in response to FES applied to three thumb muscles were measured. We evaluated the feasibility of using recruitment curve based force vector maps in predicting output forces. In addition, we developed a closed loop force controller. Load sharing between the three muscles was used to solve the redundancy problem having three actuators to control forces in two dimensions. The thumb force was controlled towards target forces of 0.5 N and 1.0 N in multiple directions within the individual’s thumb work space. Hereby, the possibilities to use these force vector maps and the load sharing approach in feed forward and feedback force control were explored. Results The force vector prediction of the obtained model had small RMS errors with respect to the actual measured force vectors (0.22±0.17 N for the healthy subjects; 0.17±0.13 N for the stroke subjects). The stroke subjects showed a limited work range due to limited force production of the individual muscles. Performance of feed forward control without feedback, was better in healthy subjects than in stroke subjects. However, when feedback control was added performances were similar between the two groups. Feedback force control lead, especially for the stroke subjects, to a reduction in stationary errors, which improved performance. Conclusions Thumb muscle responses to FES can be described by a single force direction and a sigmoidal recruitment curve. Force in desired direction can be generated through load sharing among redundant muscles. The force vector maps are subject specific and also suitable in feedforward and feedback control taking the individual’s available workspace into account. With feedback, more accurate control of muscle force can be achieved. PMID:24103414

Thumb carpometacarpal joint congruence during functional tasks and thumb range-of-motion activities

PubMed Central

Halilaj, Eni; Moore, Douglas C; Patel, Tarpit K; Laidlaw, David H; Ladd, Amy L; Weiss, Arnold-Peter C; Crisco, Joseph J

2017-01-01

Joint incongruity is often cited as a possible etiological factor for the high incidence of thumb carpometacarpal (CMC) joint osteoarthritis (OA) in older women. There is evidence suggesting that biomechanics plays a role in CMC OA progression, but little is known about how CMC joint congruence, specifically, differs among different cohorts. The purpose of this in vivo study was to determine if CMC joint congruence differs with sex, age, and early stage OA for different thumb positions. Using CT data from 155 subjects and a congruence metric that is based on both articular morphology and joint posture, we did not find any differences in CMC joint congruence with sex or age group, but found that patients in the early stages of OA exhibit lower congruence than healthy subjects of the same age group. PMID:25570956

Thumb carpometacarpal joint congruence during functional tasks and thumb range-of-motion activities.

PubMed

Halilaj, Eni; Moore, Douglas C; Patel, Tarpit K; Laidlaw, David H; Ladd, Amy L; Weiss, Arnold-Peter C; Crisco, Joseph J

2014-01-01

Joint incongruity is often cited as a possible etiological factor for the high incidence of thumb carpometacarpal (CMC) joint osteoarthritis (OA) in older women. There is evidence suggesting that biomechanics plays a role in CMC OA progression, but little is known about how CMC joint congruence, specifically, differs among different cohorts. The purpose of this in vivo study was to determine if CMC joint congruence differs with sex, age, and early stage OA for different thumb positions. Using CT data from 155 subjects and a congruence metric that is based on both articular morphology and joint posture, we did not find any differences in CMC joint congruence with sex or age group, but found that patients in the early stages of OA exhibit lower congruence than healthy subjects of the same age group.

On-top and side-to-side plasties for thumb polydactyly.

PubMed

Al-Qattan, Noha M; Al-Qattan, Mohammad M

2017-01-01

"On-top" and "side-to-side" plasties are techniques used for treating thumb duplications in which one thumb is adequate proximally and the other thumb contains a better pulp and nail distally. The detailed functional results of these techniques have not been reported in the literature. We report on two cases. The first case had Wassel type VI duplication. The ulnar duplicate had a functioning interphalangeal joint and the radial duplicate had a functioning carpometacarpal joint. "On-top" plasty was done by putting the distal part of the ulnar duplicate on top of the proximal part of the radial duplicate. At 10 years after surgery, the outcome was excellent both cosmetically and functionally. In the second case (Wassel type VII with a zigzag deformity), the radial duplicate had a hypoplastic distal phalanx with no nail. The ulnar duplicate had a functioning interphalangeal joint and the radial duplicate had a functioning carpometacarpal joint. "Side-to-side" plasty was done by joining both thumbs side-to-side at the level of the proximal phalanx. At 3 years after surgery, the outcome we considered acceptable cosmetically and excellent functionally. We could not find similar cases in the literature with detailed long-term postoperative results. "On-top" and "side-to-side" plasties in the management of specific cases of thumb polydactyly obtain excellent functional results with excellent or acceptable cosmetic outcome. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Prevention of Thumb Web Space Contracture With Multiplanar External Fixation.

PubMed

Harper, Carl M; Iorio, Matthew L

2016-09-01

Thumb web space contracture following hand trauma can be disabling with numerous reconstructive procedures existing to correct the resultant deformity. Following marked soft tissue injury to the hand we utilized the Stryker Hoffmann II Micro External Fixator System to link the first and second metacarpals by a multiplanar system using 1.6 or 2.0 mm self-drilling half-pins and 3 mm carbon fiber connecting rods. This facilitated placement of the thumb in maximal palmar abduction as well as allowed adjustment of thumb position throughout the postoperative period. This technique was performed on 5 patients. Two patients were treated with a first web space external fixator for table saw injuries to the radial aspect of the hand. An additional 2 patients were treated with a first web space external fixator following metacarpophalangeal joint capsular release in the setting of thermal burns. A fifth patient underwent second ray amputation, trapeziectomy and trapezoidectomy for squamous cell carcinoma with subsequent stabilization with the external fixator. The external fixator was left in place until soft tissues were healed (average 5.5 wk). The patients were allowed to mobilize their hand in as much as the external fixator allowed, and no device-associated complications were noted. Thumb web space was preserved with passive and supple thumb circumduction and web space abduction/adduction in all patients at an average follow-up of 5 months. The average Quick Dash Score was 35±5 and the average Modern Activity Subjective Survey of 2007 was 30±8.

The proportion of the face in younger adults using the thumb rule of Leonardo da Vinci.

PubMed

Oguz, O

1996-01-01

The present study was conducted to examine whether the thumb rule of Leonardo da Vinci could be an objective method in the determination of the natural and artistic proportions of human face. In this study, a sample of 400 subjects (200 male and 200 female, 22-25 years old) was used. Measurements were made of the length of thumb, the length of ear, the approximate distances between the hair line and the glabella or eyebrows, between the glabella or eyebrows and the tip of the nose and the distance between the nose and the chin, and the distance between the ear and the lateral aspect of the eye. The results obtained in the males and females showed significant (p < 0.01) correlations between the length of thumb and the proportions of the face examined in the study. Additionally, the height of the face was found to be almost three times the length of the thumb. However, the measurements obtained from female subjects were on average smaller than those taken from males. The results obtained in this experiment could be of value in understanding of the evaluation of the face for the people working in plastic surgery or art.

The inheritance of fingerprint patterns.

PubMed

Slatis, H M; Katznelson, M B; Bonné-Tamir, B

1976-05-01

Analysis of the fingerprints of 571 members of the Habbanite isolate suggest inherited patterns and pattern sequences. A genetic theory has been developed; it assumes that the basic fingerprint pattern sequence is all ulnar loops and that a variety of genes cause deviations from this pattern sequence. Genes that have been proposed include: (1) a semidominant gene for whorls on the thumbs (one homozygote has whorls on both thumbs, the other has ulnar loops on both thumbs and the heterozygote usually has two ulnar loops or one ulnar loop and one whorl); (2) a semidominant gene for whorls on the ring fingers which acts like the gene for whorls on the thumbs; (3) a dominant gene for arches on the thumbs and often on other fingers; (4) one or more dominant genes for arches on the fingers; (5) a dominant gene for whorls on all fingers except for an ulnar loop on the middle finger; (6) a dominant gene for radial loops on the index fingers, frequently associated with an arch on the middle fingers; and (7) a recessive gene for radial loops on the ring and little fingers. These genes may act independently or may show epistasis.

The inheritance of fingerprint patterns.

PubMed Central

Slatis, H M; Katznelson, M B; Bonné-Tamir, B

1976-01-01

Analysis of the fingerprints of 571 members of the Habbanite isolate suggest inherited patterns and pattern sequences. A genetic theory has been developed; it assumes that the basic fingerprint pattern sequence is all ulnar loops and that a variety of genes cause deviations from this pattern sequence. Genes that have been proposed include: (1) a semidominant gene for whorls on the thumbs (one homozygote has whorls on both thumbs, the other has ulnar loops on both thumbs and the heterozygote usually has two ulnar loops or one ulnar loop and one whorl); (2) a semidominant gene for whorls on the ring fingers which acts like the gene for whorls on the thumbs; (3) a dominant gene for arches on the thumbs and often on other fingers; (4) one or more dominant genes for arches on the fingers; (5) a dominant gene for whorls on all fingers except for an ulnar loop on the middle finger; (6) a dominant gene for radial loops on the index fingers, frequently associated with an arch on the middle fingers; and (7) a recessive gene for radial loops on the ring and little fingers. These genes may act independently or may show epistasis. PMID:1266855

Augmented Central Pain Processing in Vulvodynia

PubMed Central

Hampson, Johnson P.; Reed, Barbara D.; Clauw, Daniel J.; Bhavsar, Rupal; Gracely, Richard H.; Haefner, Hope K.; Harris, Richard E.

2013-01-01

Vulvodynia (VVD) is a chronic pain disorder, wherein women display sensitivity to evoked stimuli at the vulva and/or spontaneous vulvar pain. Our previous work suggests generalized hyperalgesia in this population, however little is known about central neurobiological factors that may influence pain in VVD. Here we investigated local (vulvar) and remote (thumb) pressure evoked pain processing in 24 VVD patients compared to 13 age-matched, pain-free healthy controls (HC). As a positive control we also examined thumb pressure pain in 24 fibromyalgia (FM) patients. The VVD and FM patients displayed overlapping insular brain activations that were greater than HC, in response to thumb stimulation (P<0.005 corrected). Compared to HC, VVD participants displayed greater levels of activation during thumb stimulation within the insula, dorsal mid-cingulate, posterior cingulate and thalamus (P<0.005 corrected). Significant differences between VVD subgroups (primary versus secondary and provoked versus unprovoked) were seen within the posterior cingulate with thumb stimulation, and within the precuneus region with vulvar stimulation (provoked versus unprovoked only). The augmented brain activation in VVD patients in response to a stimulus remote from the vulva suggests central neural pathology in this disorder. Moreover, differing central activity between VVD subgroups suggests heterogeneous pathologies within this diagnosis. PMID:23578957

Improvisation in wrap-around toe-to-thumb transfer.

PubMed

Govila, A

1993-01-01

Wrap-around partial great toe transfer, a one time dream, is now a well established and universally accepted method of thumb reconstruction. In this technique, part of the soft tissue of the great toe are wrapped around and shaped to the size of the graft from iliac bone in such a manner that a thumb of normal dimensions and shape is produced. Instead of the iliac bone graft, we found great merit in using the second metacarpal from the traumatised hand to be reconstructed. In this paper its use and merits are elaborated.

Finite element validation of stress intensity factor calculation models for thru-thickness and thumb-nail cracks in double edge notch specimens

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beres, W.; Koul, A.K.

1994-09-01

Stress intensity factors for thru-thickness and thumb-nail cracks in the double edge notch specimens, containing two different notch radius (R) to specimen width (W) ratios (R/W = 1/8 and 1/16), are calculated through finite element analysis. The finite element results are compared with predictions based on existing empirical models for SIF calculations. The effects of a change in R/W ratio on SIF of thru-thickness and thumb-nail cracks are also discussed. 34 refs.

Application of robotic manipulability indices to evaluate thumb performance during smartphone touch operations.

PubMed

Endo, Hiroshi

2015-01-01

This study examined whether manipulability during smartphone thumb-based touch operations could be predicted by the following robotic manipulability indices: the volume and direction of the 'manipulability ellipsoid' (MEd), both of which evaluate the influence of kinematics on manipulability. Limits of the thumb's range of motion were considered in the MEd to improve predictability. Thumb postures at 25 key target locations were measured in 16 subjects. Though there was no correlation between subjective evaluation and the volume of the MEd, high correlation was obtained when motion range limits were taken into account. These limits changed the size of the MEd and improved the accuracy of the manipulability evaluation. Movement directions associated with higher performance could also be predicted. In conclusion, robotic manipulability indices with motion range limits were considered to be useful measures for quantitatively evaluating human hand operations.

One-Handed Thumb Use on Smart Phones by Semi-literate and Illiterate Users in India

NASA Astrophysics Data System (ADS)

Katre, Dinesh

There is a tremendous potential for developing mobile-based productivity tools and occupation specific applications for the semi-literate and illiterate users in India. One-handed thumb use on the touchscreen of smart phone or touch phone is considered as an effective alternative than the use of stylus or index finger, to free the other hand for supporting the occupational activity. In this context, usability research and experimental tests are conducted to understand the role of fine motor control, usability of thumb as the interaction apparatus and the ergonomic needs of users. The paper also touches upon cultural, racial and anthropometric aspects, which need due consideration while designing the mobile interface. Design recommendations are evolved to enhance the effectiveness of one-handed thumb use on smart phone, especially for the benefit of semi-literate and illiterate users.

Pain Experience is Somatotopically Organized and Overlaps with Pain Anticipation in the Human Cerebellum.

PubMed

Michelle Welman, F H S; Smit, Albertine E; Jongen, Joost L M; Tibboel, Dick; van der Geest, Jos N; Holstege, Jan C

2018-02-26

Many fMRI studies have shown activity in the cerebellum after peripheral nociceptive stimulation. We investigated whether the areas in the cerebellum that were activated after nociceptive thumb stimulation were separate from those after nociceptive toe stimulation. In an additional experiment, we investigated the same for the anticipation of a nociceptive stimulation on the thumb or toe. For his purpose, we used fMRI after an electrical stimulation of the thumb and toe in 19 adult healthy volunteers. Following nociceptive stimulation, different areas were activated by stimulation on the thumb (lobule VI ipsilaterally and Crus II mainly contralaterally) and toe (lobules VIII-IX and IV-V bilaterally and lobule VI contralaterally), i.e., were somatotopically organized. Cerebellar areas innervated non-somatotopically by both toe and thumb stimulation were the posterior vermis and Crus I, bilaterally. In the anticipation experiment, similar results were found. However, here, the somatotopically activated areas were relatively small for thumb and negligible for toe stimulation, while the largest area was innervated non-somatotopically and consisted mainly of Crus I and lobule VI bilaterally. These findings indicate that nociceptive stimulation and anticipation of nociceptive stimulation are at least partly processed by the same areas in the cerebellum. This was confirmed by an additional conjunction analysis. Based on our findings, we hypothesize that input that is organized in a somatotopical manner reflects direct input from the spinal cord, while non-somatotopically activated parts of the cerebellum receive their information indirectly through cortical and subcortical connections, possibly involved in processing contextual emotional states, like the expectation of pain.

Finger tapping impairments are highly sensitive for evaluating upper motor neuron lesions.

PubMed

Shirani, Afsaneh; Newton, Braeden D; Okuda, Darin T

2017-03-21

Identifying highly sensitive and reliable neurological exam components are crucial in recognizing clinical deficiencies. This study aimed to investigate finger tapping performance differences between patients with CNS demyelinating lesions and healthy control subjects. Twenty-three patients with multiple sclerosis or clinically isolated syndrome with infratentorial and/or cervical cord lesions on MRI, and 12 healthy controls were videotaped while tapping the tip of the index finger against the tip and distal crease of the thumb using both the dominant and non-dominant hand. Videos were assessed independently by 10 evaluators (three MS neurologists, four neurology residents, three advanced practice providers). Sensitivity and inter-evaluator reliability of finger tapping interpretations were calculated. A total of 1400 evaluations (four videos per each of the 35 subjects evaluated by 10 independent providers) were obtained. Impairments in finger tapping against the distal thumb crease of the non-dominant hand, identified by neurologists, had the greatest sensitivity (84%, p < 0.001) for detecting impairment. Finger tapping against the thumb crease was more sensitive than the thumb tip across all categories of providers. The best inter-evaluator reliability was associated with neurologists' evaluations for the thumb crease of the non-dominant hand (kappa = 0.83, p < 0.001). Impaired finger tapping against the distal thumb crease of the non-dominant hand was a more sensitive technique for detecting impairments related to CNS demyelinating lesions. Our findings highlight the importance of precise examinations of the non-dominant side where impaired fine motor control secondary to an upper motor injury might be detectable earlier than the dominant side.

Local subcutaneous and muscle pain impairs detection of passive movements at the human thumb

PubMed Central

Weerakkody, N S; Blouin, J S; Taylor, J L; Gandevia, S C

2008-01-01

Activity in both muscle spindle endings and cutaneous stretch receptors contributes to the sensation of joint movement. The present experiments assessed whether muscle pain and subcutaneous pain distort proprioception in humans. The ability to detect the direction of passive movements at the interphalangeal joint of the thumb was measured when pain was induced experimentally in four sites: the flexor pollicis longus (FPL), the subcutaneous tissue overlying this muscle, the flexor carpi radialis (FCR) muscle and the subcutaneous tissue distal to the metacarpophalangeal joint of thumb. Tests were conducted when pain was at a similar subjective intensity. There was no significant difference in the ability to detect flexion or extension under any painful or non-painful condition. The detection of movement was significantly impaired when pain was induced in the FPL muscle, but pain in the FCR, a nearby muscle that does not act on the thumb, had no effect. Subcutaneous pain also significantly impaired movement detection when initiated in skin overlying the thumb, but not in skin overlying the FPL muscle in the forearm. These findings suggest that while both muscle and skin pain can disturb the detection of the direction of movement, the impairment is site-specific and involves regions and tissues that have a proprioceptive role at the joint. Also, pain induced in FPL did not significantly increase the perceived size of the thumb. Proprioceptive mechanisms signalling perceived body size are less disturbed by a relevant muscle nociceptive input than those subserving movement detection. The results highlight the complex relationship between nociceptive inputs and their influence on proprioception and motor control. PMID:18467366

Sturckow gives the thumbs up in the Node 1

NASA Image and Video Library

2007-06-21

S117-E-09480 (17 June 2007) --- Astronaut Rick Sturckow, STS-117 commander, gives a "thumbs-up" signal after placing the STS-117 mission insignia along with others in the Unity node of the International Space Station.

Propagation of Significant Figures.

ERIC Educational Resources Information Center

Schwartz, Lowell M.

1985-01-01

Shows that the rules of thumb for propagating significant figures through arithmetic calculations frequently yield misleading results. Also describes two procedures for performing this propagation more reliably than the rules of thumb. However, both require considerably more calculational effort than do the rules. (JN)

Standards and reliability in evaluation: when rules of thumb don't apply.

PubMed

Norcini, J J

1999-10-01

The purpose of this paper is to identify situations in which two rules of thumb in evaluation do not apply. The first rule is that all standards should be absolute. When selection decisions are being made or when classroom tests are given, however, relative standards may be better. The second rule of thumb is that every test should have a reliability of .80 or better. Depending on the circumstances, though, the standard error of measurement, the consistency of pass/fail classifications, and the domain-referenced reliability coefficients may be better indicators of reproducibility.

A Review of Anthropometric Data of German Air Force and United States Air Force Flying Personnel 1967-1968

DTIC Science & Technology

1975-04-01

Circ. Level (r.) 9. Radialn (r.) 10. Lower Arm Circ. Level (r.) 11. Stylion (r.) 12. Base of Hand (r.) 13. -ase of Thumb (r.) 14. Glabella 15. Min...the skin ,rease at the proximal edge of the palm. BASE OF THUMB - the point at which the extended base of the hand line intersects the radial borter...BONE the small bone of the hand just distal to the bend of the wrist or the base of the thumb . NECK POINT the point marking the intersection of the

Anthropometric Survey of US Army Personnel (1988): Correlation Coefficients and Regression Equations. Part 5. Stepwise and Standard Multiple Regression Tables

DTIC Science & Technology

1990-05-01

0.759 0.744 0.768 0.753 106 (THUMBBR) THUMB BREADTH -0.652 -0.673 -0.539 -0.663 217 (LIPLGTHH) LIP LENGTH HEADBOARD 0.017 0.019 0.020 51 (FTBRHOR) FOOT...DEPENDENT VARIABLE: (106) THUMB BREADTH (THUBBR) MODEL INDEPENDENT VARIABLE 1 2 3 4 5 INTERCEPT 6.621 5.016 6.267 5.697 4.528 59 (HANDCIRC) HAND...95 (SLLSPEL) SLEEVE LENGTH: SPINE-ELBOW -0.020 -0.019 -C.018 9 (BLFTCIRC) BALL OF FOOT CIRCUMFERENCE -0.032 -0.039 106 (THUMBBR) THUMB BREADTH 0.228

Association between hyperflexibility of the thumb and an unexplained bleeding tendency: is it a rule of thumb?

PubMed

Kaplinsky, C; Kenet, G; Seligsohn, U; Rechavi, G

1998-05-01

A bleeding tendency manifested by petechiae and ecchymoses is one of the most common causes for referral of patients to haematology clinics. Vessel wall pathology is not usually considered to be a cause for deranged haemostasis, although coexistence of increased capillary fragility and joint hypermobility have been reported. We determined the frequency of thumb hyperextensibility and scored the findings in a series of 44 patients referred because of ecchymoses and petechiae, as well as 261 control children and their mothers. All 44 patients had normal coagulation studies. Thumb flexibility score was +4 in 30 patients, +3 in eight patients, +2 in five patients and +1 in one of the index patients. In the control group, only one of 261 had a +4, and three had a +3 score, and two of 260 mothers had a +4 score. Ecchymoses were not observed in any of these subjects, nor in the +1 patients. Based on clinical presentation and normal coagulation studies, we suggest that our patients had an underlying subtype of Ehlers-Danlos syndrome. In view of the dramatically high occurrence of thumb hyperextensibility in patients with unexplained mild bleeding tendency, costly haemostatic and coagulation studies on such patients may not be necessary.

"Rule of Thumb" and the Folklaw of the Husband's Stick.

ERIC Educational Resources Information Center

Kelly, Henry Ansgar

1994-01-01

The origin of the term "rule of thumb" is investigated, especially as it relates to legal issues and, in particular, in doctrine concerning the beating of wives. The term's supposed origin as a standard for determining spouse abuse is questioned. (MSE)

Orofacial and thumb-index finger ramp-and-hold isometric force dynamics in young neurotypical adults.

PubMed

Barlow, Steven M; Hozan, Mohsen; Lee, Jaehoon; Greenwood, Jake; Custead, Rebecca; Wardyn, Brianna; Tippin, Kaytlin

2018-04-27

The relation among several parameters of the ramp-and-hold isometric force contraction (peak force and dF/dt max during the initial phase of force recruitment, and the proportion of hold-phase at target) was quantified for the right and left thumb-index finger pinch, and lower lip midline compression in 40 neurotypical right-handed young adults (20 female/20 males) using wireless force sensors and data acquisition technology developed in our laboratory. In this visuomotor control task, participants produced ramp-and-hold isometric forces as 'rapidly and accurately' as possible to end-point target levels at 0.25, 0.5, 1 and 2 Newtons presented to a computer monitor in a randomized block design. Significant relations were found between the parameters of the ramp-and-hold lip force task and target force level, including the peak rate of force change (dF/dt max ), peak force, and the criterion percentage of force within ±5% of target during the contraction hold phase. A significant performance advantage was found among these force variables for the thumb-index finger over the lower lip. The maximum voluntary compression force (MVCF) task revealed highly significant differences in force output between the thumb-index fingers and lower lip (∼4.47-4.70 times greater for the digits versus lower lip), a significant advantage of the right thumb-index finger over the non-dominant left thumb-index finger (12% and 25% right hand advantage for males and females, respectively), and a significant sex difference (∼1.65-1.73 times greater among males). Copyright © 2018 Elsevier Ltd. All rights reserved.

Computed tomographic analysis of the internal structure of the metacarpals and its implications for hand use, pathology, and surgical intervention.

PubMed

Wong, Alison L; Meals, Clifton G; Ruff, Christopher B

2018-03-01

The variation of bone structure and biomechanics between the metacarpals is not well characterized. It was hypothesized that their structure would reflect their common patterns of use (i.e., patterns of hand grip), specifically that trabecular bone density would be greater on the volar aspect of all metacarpal bases, that this would be most pronounced in the thumb, and that the thumb diaphysis would have the greatest bending strength. Cross-sections at basal and mid-diaphyseal locations of 50 metacarpals from 10 human hands were obtained by peripheral quantitative computed tomography. The volar and dorsal trabecular densities of each base were measured and characterized using the volar/dorsal density ratio. The polar stress-strain index (SSIp), a surrogate measure of torsional/bending strength, was measured for each diaphysis and standardized for bone length and mass. Comparisons were made using mixed-model analyses of variance (ANOVAs) and post hoc tests. Volar/dorsal trabecular density ratios showed even distribution in all metacarpal bases except for the thumb, which showed greater values on the volar aspect. The thumb, second, and third metacarpals all had high bending strength (SSIp), but the thumb's SSIp relative to its length and trabecular mass was much higher than those of the other metacarpals. Trabecular density of the metacarpal bases was evenly distributed except in the thumb, which also showed higher bending strength relative to its length and mass. Understanding of how these indicators of strength differ across metacarpals may improve both fracture diagnosis and treatment and lays the groundwork for investigating changes with age, hand dominance, and occupation.

[Treatment of ulnar collateral ligament avulsion fracture of thumb metacarpophalangeal joint using a combination of Kirschner wire and silk tension band].

PubMed

Gao, Shunhong; Feng, Shiming; Jiao, Cheng

2012-12-01

To investigate the effectiveness of Kirschner wire combined with silk tension band in the treatment of ulnar collateral ligament avulsion fracture of the thumb metacarpophalangeal joint. Between September 2008 and October 2011, 14 patients with ulnar collateral ligament avulsion fracture of the thumb metacarpophalangeal joint were treated using a combination of Kirschner wire and silk tension band. There were 8 males and 6 females, aged 23-55 years (mean, 40.8 years). The causes of injury were machinery twist injury in 5 cases, manual twist injury in 4 cases, falling in 4 cases, sports injury in 1 case. The time from injury to operation was 2 hours-14 days. All the patients presented pain over the ulnar aspect of the metacarpophalangeal joint of the thumb, limitation of motion, and joint instability with pinch and grip. The lateral stress testing of the metacarpophalangeal joint was positive. Function training was given at 2 weeks after operation. All incisions healed by first intention. The lateral stress testing of the metacarpophalangeal joint was negative. All the patients were followed up 6-18 months (mean, 13.1 months). The X-ray films showed good fracture reduction and healing with an average time of 7 weeks (range, 4-10 weeks). At last follow-up, the thumbs had stable flexion and extension of the metacarpophalangeal joint, normal opposition function and grip and pinch strengths. According to Saetta et al. criteria for functional assessment, the results were excellent in 11 cases and good in 3 cases; the excellent and good rate was 100%. It is an easy and simple method to treat ulnar collateral ligament avulsion fracture of the thumb metacarpophalangeal joint using Kirschner wire combined with silk tension band, which can meet the good finger function.

The effectiveness of orthoses in the conservative management of thumb CMC joint osteoarthritis: An analysis of functional pinch strength.

PubMed

Grenier, Marie-Lyne; Mendonca, Rochelle; Dalley, Peter

2016-01-01

The study was a retrospective cohort analysis for a 19-month period from May 2013 to December 2014. Although the use of orthoses has long been a staple of conservative treatment measures for individuals with osteoarthritis of the thumb carpometacarpal (CMC) joint, there remains little evidence exploring its effectiveness in improving functional outcomes for this client population. The purpose of this study was to assess the effectiveness of 3 frequently used orthoses in improving the functional pinch strength of adults with a diagnosis of thumb CMC joint osteoarthritis. A retrospective cohort analysis was conducted to determine whether pinch strength improved after orthotic fabrication, and fitting in patients referred to a hand therapy clinic. Patients who received a Colditz design orthosis had a mean increase of 2.64 lb with regard to functional pinch strength after orthotic fabrication and fitting. Patients who received a Comfort Cool orthosis (North Coast Medical, Morgan Hill, CA) had a mean increase of 2.47 lb, whereas patients who received a Thumb Spica orthosis had a mean increase of 3.25 lb. There was no evidence of any statistically significant difference in the average improvements in pinch strength between the Colditz design orthosis and the Comfort Cool orthosis. Results from this study demonstrate that orthosis wear consistently increases the functional pinch strength of individuals with thumb CMC joint osteoarthritis. Large-scale multisite research studies comparing various orthotic designs are necessary to help therapists determine best practice interventions for the conservative management of thumb CMC joint osteoarthritis. 2(c). Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Transposition of branches of radial nerve innervating supinator to posterior interosseous nerve for functional reconstruction of finger and thumb extension in 4 patients with middle and lower trunk root avulsion injuries of brachial plexus.

PubMed

Wu, Xia; Cong, Xiao-Bing; Huang, Qi-Shun; Ai, Fang-Xin; Liu, Yu-Tian; Lu, Xiao-Cheng; Li, Jin; Weng, Yu-Xiong; Chen, Zhen-Bing

2017-12-01

This study aimed to investigate the reconstruction of the thumb and finger extension function in patients with middle and lower trunk root avulsion injuries of the brachial plexus. From April 2010 to January 2015, we enrolled in this study 4 patients diagnosed with middle and lower trunk root avulsion injuries of the brachial plexus via imaging tests, electrophysiological examinations, and clinical confirmation. Muscular branches of the radial nerve, which innervate the supinator in the forearm, were transposed to the posterior interosseous nerve to reconstruct the thumb and finger extension function. Electrophysiological findings and muscle strength of the extensor pollicis longus and extensor digitorum communis, as well as the distance between the thumb tip and index finger tip, were monitored. All patients were followed up for 24 to 30 months, with an average of 27.5 months. Motor unit potentials (MUP) of the extensor digitorum communis appeared at an average of 3.8 months, while MUP of the extensor pollicis longus appeared at an average of 7 months. Compound muscle action potential (CMAP) appeared at an average of 9 months in the extensor digitorum communis, and 12 months in the extensor pollicis longus. Furthermore, the muscle strength of the extensor pollicis longus and extensor digitorum communis both reached grade III at 21 months. Lastly, the average distance between the thumb tip and index finger tip was 8.8 cm at 21 months. In conclusion, for patients with middle and lower trunk injuries of the brachial plexus, transposition of the muscular branches of the radial nerve innervating the supinator to the posterior interosseous nerve for the reconstruction of thumb and finger extension function is practicable and feasible.

A Modified Rule of Thumb for Evaluating Scale Reproducibilities Determined by Electronic Computers

ERIC Educational Resources Information Center

Hofmann, Richard J.

1978-01-01

The Goodenough technique for determining scale error is compared to the Guttman technique and demonstrated to be more conservative than the Guttman technique. Implications with regard to Guttman's evaluative rule of thumb for evaluating a reproducibility are noted. (Author)

Tracing the origin of the panda's thumb

NASA Astrophysics Data System (ADS)

Abella, Juan; Pérez-Ramos, Alejandro; Valenciano, Alberto; Alba, David M.; Ercoli, Marcos D.; Hontecillas, Daniel; Montoya, Plinio; Morales, Jorge

2015-06-01

We investigate the relative development of the carnivoran radial sesamoids to untangle the evolution of this iconic structure. In the pandas (both giant and red), this `false thumb' is known to perform a grasping role during bamboo feeding in both the red and giant pandas. An original locomotor role has been inferred for ailurids, but this remains to be ascertained for ursids. A large sample of radial sesamoids of Indarctos arctoides from the Miocene of Batallones-3 (Spain) indicates that this early ailuropodine bear displayed a relatively hypertrophied radial sesamoid, with a configuration more similar to that of the red panda and other carnivorans than to that of giant pandas. This false thumb is the first evidence of this feature in the Ursidae, which can be linked to a more herbivorous diet. Moreover, in the two extant pandas, the false thumb should not be interpreted as an anatomical convergence, but as an exaptive convergence regarding its use during the bamboo feeding, which changes the evolutionary view of this singular structure.

Basal thumb arthritis

PubMed Central

Dias, Richard; Chandrasenan, Jeevan; Rajaratnam, Vaikunthan; Burke, Frank D

2007-01-01

Basal thumb arthritis is a common condition seen in hand clinics across the United Kingdom and is often associated with other pathological conditions such as carpal tunnel syndrome and scaphotrapezial arthritis. Typically, patients complain of pain localised to the base of the thumb. This pain is often activity related, particularly after excessive use involving forceful pinch. A detailed history and examination is normally all that is needed to make the diagnosis. Provocative manoeuvres may be helpful in localising symptoms to the basal joint with degenerative changes or synovitis. Radiographs are useful for confirming the diagnosis and staging the disease in order to plan for surgery. The mainstay of initial treatment of basal thumb arthritis of any stage is activity modifications, rest, nonsteroidal anti‐inflammatory drugs, exercises and splinting. A variety of surgical procedures are available to treat the condition when conservative measures have failed, in order to control symptoms and improve function. We review the current literature and discuss the clinical aspects of this condition, staging, and treatment options available, and the difficulties treating this group of patients. PMID:17267677

Left hand polydactyly: a case report.

PubMed

Mumoli, Nicola; Gandini, Daniele; Wamala, Edris Kalanzi; Cei, Marco

2008-11-24

Polydactyly is a congenital anomaly with a wide range of manifestations that occurs in many forms, ranging from varying degrees of mere splitting to completely duplicated thumb. When duplication occurs alone, it is usually unilateral and sporadic. In this case report we describe an otherwise healthy 19-year-old woman of Tibetan heritage with isolated left hand preaxial polydactyly. She experienced working related difficulties in her daily yak's milking. She subsequently underwent surgical correction, and the over number thumb was removed with associated meticulous skeletal and soft tissue reconstruction. Polydactyly is the most common congenital digital anomaly of the hand and foot. It can occur in isolation or as part of a syndrome. Surgery is necessary to create a single, functioning thumb and is indicated to improve cosmesis. Skin, nail, bone, ligament, and musculoskeletal elements must be combined to reconstruct an optimal digit. In this case (Tibetan society is almost exclusively a sheep-breeding one) surgery was necessary to leave a single, functioning thumb for her work as yak milkmaid.

Central line-associated bloodstream infections and catheter dwell-time: A theoretical foundation for a rule of thumb.

PubMed

Voets, Philip J G M

2018-05-14

Many clinicians know from experience and medical epidemiological literature that the risk of central line-associated bloodstream infections (CLABSI) increases rapidly with a prolonged catheter dwell-time, but how this infection risk increases over time remains obscure. In this manuscript, a clinically useful rule of thumb is derived, stating that the risk of CLABSI increases in a quadratic fashion with the increase in catheter dwell-time. The proposed rule of thumb could be considered a quick and effortless clinical tool to rationally predict the pattern of CLABSI risk with an increasing catheter dwell-time. Copyright © 2018. Published by Elsevier Ltd.

Rick Husband gives thumbs-up from flight deck during rendezvous

NASA Image and Video Library

2017-04-20

S96-E-5037 (29 May 1999) --- Astronaut Rick D. Husband, pilot, signals with thumbs up during Discovery's rendezvous operations with the International Space Station (ISS). The photo was taken with an electronic still camera (ESC) at 03:34:23 GMT, May 29, 1999.

Arthroscopic Hemitrapeziectomy for First Carpometacarpal Arthritis: Results at 7-year Follow-up

PubMed Central

Leak, Robert S.; Culp, Randall W.; Osterman, A. Lee

2008-01-01

The purpose of this study was to determine the outcome of arthroscopic hemitrapeziectomy combined with thermal capsular plication and temporary K-wire fixation in patients with painful thumb basal joint due to either osteoarthritis or posttraumatic arthritis. There were 18 thumbs that were evaluated in this retrospective study of arthroscopic hemitrapeziectomy of the distal trapezium in addition to a pancapsular thermal shrinkage at an average of 7.6-year follow-up. No patient has required further surgery. A subjective improvement in pain, pinch activities, strength, and range of motion (ROM) was noted in all patients, and no patient had further surgery on their thumb. On exam, no patient had a first carpal–metacarpal grind or laxity. Total ROM of the thumb axis decreased by 20%, but all patients could oppose to the fifth finger. Grip strength remained unchanged, key pinch improved from 8 to 11 lbs, and tip pinch improved from 4 to 5 lbs. Radiographs showed a metacarpal subsidence of 1.8 mm (0–4 mm). Four complications were noted: two cases of dorsal radial nerve neuritis, one rupture of the flexor pollicis longus, and one prolonged hematoma. Results demonstrate that arthroscopic hemitrapeziectomy and capsular shrinkage for first carpometacarpal arthritis is an effective technique that provides high patient satisfaction, a functional pain-free thumb, and a reliable rate of return to activity. PMID:18820976

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

3 results Generated_thumb20170118-11720-lxiuaf Clean Cities Alternative Fuel and Advanced Vehicle Inventory Generated_thumb20170118-11720-lxiuaf Advanced fuel and advanced vehicle inventory reported by Last update July 2017 View Image Graph Clean Cities Alternative Fuel and Advanced Vehicle Inventory

Guidelines, Criteria, and Rules of Thumb for Evaluating Normed and Standardized Assessment Instruments in Psychology.

ERIC Educational Resources Information Center

Cicchetti, Domenic V.

1994-01-01

In the context of developing assessment instruments in psychology, issues of standardization, norming procedures, and test reliability and validity are discussed. Criteria, guidelines, and rules of thumb are provided to help the clinician with instrument selection for a given psychological assessment. (SLD)

Statistical Rules-of-Thumb.

ERIC Educational Resources Information Center

Brewer, James K.

1988-01-01

Six best-selling introductory behavioral statistics textbooks that were published in 1982 and two well-known sampling theory textbooks were reviewed to determine the presence of rules-of-thumb--useful principles with wide application that are not intended to be strictly accurate. The relative frequency and type of rules are reported along with a…

Assessing Financial Education Methods: Principles vs. Rules-of-Thumb Approaches

ERIC Educational Resources Information Center

Skimmyhorn, William L.; Davies, Evan R.; Mun, David; Mitchell, Brian

2016-01-01

Despite thousands of programs and tremendous public and private interest in improving financial decision-making, little is known about how best to teach financial education. Using an experimental approach, the authors estimated the effects of two different education methodologies (principles-based and rules-of-thumb) on the knowledge,…

Capacity Value: Evaluation of WECC Rule of Thumb; NREL (National Renewable Energy Laboratory)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Milligan, Michael; Ibanez, Eduardo

2015-06-09

This presentation compares loss of load expectation and wind and solar capacity values to the rules of thumb used in the Western Interconnection planning and provides alternative recommendations to the modeling efforts of the Western Electricity Coordinating Council's Transmission Expansion Planning Policy Committee.

An overview of robotic/mechanical devices for post-stroke thumb rehabilitation.

PubMed

Suarez-Escobar, Marian; Rendon-Velez, Elizabeth

2018-01-15

This article aims to clarify the current state-of-the-art of robotic/mechanical devices for post-stroke thumb rehabilitation as well as the anatomical characteristics and motions of the thumb that are crucial for the development of any device that aims to support its motion. A systematic literature search was conducted to identify robotic/mechanical devices for post-stroke thumb rehabilitation. Specific electronic databases and well-defined search terms and inclusion/exclusion criteria were used for such purpose. A reasoning model was devised to support the structured abstraction of relevant data from the literature of interest. Following the main search and after removing duplicated and other non-relevant studies, 68 articles (corresponding to 32 devices) were left for further examination. These articles were analyzed to extract data relative to (i) the motions assisted/permitted - either actively or passively - by the device per anatomical joint of the thumb and (ii) mechanical-related aspects (i.e., architecture, connections to thumb, other fingers supported, adjustability to different hand sizes, actuators - type, quantity, location, power transmission and motion trajectory). Most articles describe preliminary design and testing of prototypes, rather than the thorough evaluation of commercially ready devices. Defining appropriate kinematic models of the thumb upon which to design such devices still remains a challenging and unresolved task. Further research is needed before these devices can actually be implemented in clinical environments to serve their intended purpose of complementing the labour of therapists by facilitating intensive treatment with precise and repeatable exercises. Implications for Rehabilitation Post-stroke functional disability of the hand, and particularly of the thumb, significantly affects the capability to perform activities of daily living, threatening the independence and quality of life of the stroke survivors. The latest studies show that a high-dose intensive therapy (in terms of frequency, duration and intensity/effort) is the key to effectively modify neural organization and recover the motor skills that were lost after a stroke. Conventional therapy based on manual interaction with physical therapists makes the procedure labour intensive and increases the costs. Robotic/mechanical devices hold promise for complementing conventional post-stroke therapy. Specifically, these devices can provide reliable and accurate therapy for long periods of time without the associated fatigue. Also, they can be used as a means to assess patients? performance and progress in an objective and consistent manner. The full potential of robot-assisted therapy is still to be unveiled. Further exploration will surely lead to devices that can be well accepted equally by therapists and patients and that can be useful both in clinical and home-based rehabilitation practice such that motor recovery of the hand becomes a common outcome in stroke survivors. This overview provides the reader, possibly a designer of such a device, with a complete overview of the state-of-the-art of robotic/mechanical devices consisting of or including features for the rehabilitation of the thumb. Also, we clarify the anatomical characteristics and motions of the thumb that are crucial for the development of any device that aims to support its motion. Hopefully, this?combined with the outlined opportunities for further research?leads to the improvement of current devices and the development of new technology and knowledge in the field.

An innovative approach to cessation of thumb-sucking in a child with epilepsy: a case report.

PubMed

Chhabra, Nidhi; Chhabra, Anuj; Bansal, Samriti

2012-01-01

The thumb-sucking habit is acquired in infancy, but if it persists beyond preschool age, it can have deleterious effects on facial growth, oral function, occlusal relationship, and aesthetics, leading to dental and skeletal deformities. This paper presents a clinical case history of using nonpunitive reminder therapy to intercept the thumb-sucking habits of an 8-year-old child with epilepsy. A modified Bluegrass appliance was used along with the positive reinforcement. The modified Bluegrass appliance utilized an acrylic roller and was very comfortable for the patient; it was also successful in eliminating the habit within a short period of time. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Users guide to finger, thumb, and triple axis real time experiment control programs. [Neutron scattering spectrometer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pinter, T.G.; Notis, E.M.

1977-04-01

This manual provides the user with instructions for using the real time control system for the neutron scattering spectrometers: finger, thumb, and triple axis. The input requirements of the various programs are described in detail. Logging on procedures, program loading, and data set organization are also discussed.

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

Data Generated_thumb20160404-15442-1rr9crl AFV and HEV Model Offerings, By Manufacturer traditional and bioenergy power, fuels, and resources. The tool also calculates the biofuels potential for a Graph Download Data Generated_thumb20160926-6025-heors6 Light-Duty AFV, HEV, and Diesel Model Offerings

What Is Strong Correlation?

ERIC Educational Resources Information Center

Kozak, Marcin

2009-01-01

Interpretation of correlation is often based on rules of thumb in which some boundary values are given to help decide whether correlation is non-important, weak, strong or very strong. This article shows that such rules of thumb may do more harm than good, and instead of supporting interpretation of correlation--which is their aim--they teach a…

Cutoff Criteria for Fit Indexes in Covariance Structure Analysis: Conventional Criteria versus New Alternatives.

ERIC Educational Resources Information Center

Hu, Li-tze; Bentler, Peter M.

1999-01-01

The adequacy of "rule of thumb" conventional cutoff criteria and several alternatives for fit indices in covariance structure analysis was evaluated through simulation. Analyses suggest that, for all recommended fit indexes except one, a cutoff criterion greater than (or sometimes smaller than) the conventional rule of thumb is required…

How Many Subjects Does It Take to Do a Regression Analysis?

ERIC Educational Resources Information Center

Green, Samuel B.

1991-01-01

An evaluation of the rules-of-thumb used to determine the minimum number of subjects required to conduct multiple regression analyses suggests that researchers who use a rule of thumb rather than power analyses trade simplicity of use for accuracy and specificity of response. Insufficient power is likely to result. (SLD)

Rules of Thumb for Up-and-Down Economics.

ERIC Educational Resources Information Center

Kennedy, Peter

1994-01-01

Reports that economist Paul Krugman identifies three types of economic writing. Asserts that the major principles of macroeconomics can be synthesized into "Five Rules of Thumb" which can help to interpret economic news. Presents and discusses these five rules and includes a survey summary of journalists and economists on this issue.…

An Atypical Metastasis of Follicular-Type Adenocarcinoma of the Thyroid Gland to Thumb

PubMed Central

Huri, Gazi

2011-01-01

Bone metastasis in the hand is rare. The etiology of metastatic hand cancers is different from other bones. Bronchogenic carcinoma is the most common primary tumor metastasis to hand. In this paper a rare case of thumb metastasis from “follicular-type carcinoma” of the thyroid is presented. PMID:23198224

Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting.

PubMed

Kietrys, David M; Gerg, Michael J; Dropkin, Jonathan; Gold, Judith E

2015-09-01

This study aimed to determine the effects of input device type, texting style, and screen size on upper extremity and trapezius muscle activity and cervical posture during a short texting task in college students. Users of a physical keypad produced greater thumb, finger flexor, and wrist extensor muscle activity than when texting with a touch screen device of similar dimensions. Texting on either device produced greater wrist extensor muscle activity when texting with 1 hand/thumb compared with both hands/thumbs. As touch screen size increased, more participants held the device on their lap, and chose to use both thumbs less. There was also a trend for greater finger flexor, wrist extensor, and trapezius muscle activity as touch screen size increased, and for greater cervical flexion, although mean differences for cervical flexion were small. Future research can help inform whether the ergonomic stressors observed during texting are associated with musculoskeletal disorder risk. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Thumb-loops up for catalysis: a structure/function investigation of a functional loop movement in a GH11 xylanase

PubMed Central

Paës, Gabriel; Cortés, Juan; Siméon, Thierry; O'Donohue, Michael J.; Tran, Vinh

2012-01-01

Dynamics is a key feature of enzyme catalysis. Unfortunately, current experimental and computational techniques do not yet provide a comprehensive understanding and description of functional macromolecular motions. In this work, we have extended a novel computational technique, which combines molecular modeling methods and robotics algorithms, to investigate functional motions of protein loops. This new approach has been applied to study the functional importance of the so-called thumb-loop in the glycoside hydrolase family 11 xylanase from Thermobacillus xylanilyticus (Tx-xyl). The results obtained provide new insight into the role of the loop in the glycosylation/deglycosylation catalytic cycle, and underline the key importance of the nature of the residue located at the tip of the thumb-loop. The effect of mutations predicted in silico has been validated by in vitro site-directed mutagenesis experiments. Overall, we propose a comprehensive model of Tx-xyl catalysis in terms of substrate and product dynamics by identifying the action of the thumb-loop motion during catalysis. PMID:24688637

Stability of INFIT and OUTFIT Compared to Simulated Estimates in Applied Setting.

PubMed

Hodge, Kari J; Morgan, Grant B

Residual-based fit statistics are commonly used as an indication of the extent to which the item response data fit the Rash model. Fit statistic estimates are influenced by sample size and rules-of thumb estimates may result in incorrect conclusions about the extent to which the model fits the data. Estimates obtained in this analysis were compared to 250 simulated data sets to examine the stability of the estimates. All INFIT estimates were within the rule-of-thumb range of 0.7 to 1.3. However, only 82% of the INFIT estimates fell within the 2.5th and 97.5th percentile of the simulated item's INFIT distributions using this 95% confidence-like interval. This is a 18 percentage point difference in items that were classified as acceptable. Fourty-eight percent of OUTFIT estimates fell within the 0.7 to 1.3 rule- of-thumb range. Whereas 34% of OUTFIT estimates fell within the 2.5th and 97.5th percentile of the simulated item's OUTFIT distributions. This is a 13 percentage point difference in items that were classified as acceptable. When using the rule-of- thumb ranges for fit estimates the magnitude of misfit was smaller than with the 95% confidence interval of the simulated distribution. The findings indicate that the use of confidence intervals as critical values for fit statistics leads to different model data fit conclusions than traditional rule of thumb critical values.

Power of performance of the thumb adductor muscles: effect of laterality and gender.

PubMed

Gutnik, Boris; Nash, Derek; Ricacho, Norberto; Hudson, Grant; Skirius, Jonas

2006-01-01

The aim of this work was to originally measure mechanical power output of the thumb adductor muscles during fast adduction of the thumb in the horizontal plane. This information will contribute to biomechanical guidelines to help clinicians, sport medicine and rehabilitation specialists in the objective functional evaluation of abnormalities of thumb adductors. Participants performed 20 fast adductions in response to audio signals. Maximum and average angular velocity and angular acceleration were measured. Tangential components of these parameters were then derived. The force of adduction was obtained from the tangential acceleration and the mass of the rotational system. The power was then calculated as the product of the force of adduction and average tangential velocity during the acceleration phase of adduction. All young and untrained males and females were strictly right handed. There was no significant difference in power between dominant and nondominant muscles for either males or females, but males developed significantly more power than females. Because adduction was performed at maximal speed, these data may be explained by the influence of parallel and series elastic elements in the muscle, as well as by influence of fast twitch fibers. Power may be used as a clinical index of the effectiveness of muscle contraction. The similarity of power outputs from dominant and nondominant thumb adductor muscles of right-handers can suggest a classical Bernstein approach. This theoretical approach purports that peripheral factors can distort central commands projected to dominant and nondominant extremities.

Radiographic Analysis of Simulated First Dorsal Interosseous and Opponens Pollicis Loading Upon Thumb CMC Joint Subluxation: A Cadaver Study.

PubMed

Adams, Julie E; O'Brien, Virginia; Magnusson, Erik; Rosenstein, Benjamin; Nuckley, David J

2018-01-01

Therapy programs to treat thumb carpometacarpal (CMC) arthritis may engage selective activation and reeducation of thenar muscles, particularly the first dorsal interosseous (FDI) and opponens pollicis (OP) to reduce subluxation of the joint. We describe the effect of simulated selective activation of the FDI and OP muscles upon radiographic subluxation of the thumb CMC joint. In a cadaver model of CMC subluxation, loads were applied to the FDI, the OP, and then concomitantly at 0%, 25%, 50%, 75%, and 100% maximal loads and radial subluxation of the joint and reduction in subluxation was measured. Selective activation of the OP, alone, improved the subluxation ratio (SR) in a dose-dependent manner. Selective activation of FDI, alone, demonstrated minimal effects on SR. Concomitant activation of OP and FDI improved the SR across all loading states, and activation of 75% and greater, when compared with FDI activation alone, resulted in a statistically significant improvement in SR to within 10% of the presubluxed joint. Concomitant activation of the FDI and OP acts to reduce subluxation of the thumb CMC joint in a dose-dependent fashion. The OP is likely the predominant reducing force. Hand therapy programs that focus on selective strengthening programs likely function in part to encourage patients to activate the easily palpable and easily understood FDI. Concomitant coactivation of the OP may be the major reducing force to elicit clinical and radiographic reduction of subluxation, improved thumb positioning, and reduction of pain and arthritic symptoms.

A variant in the sonic hedgehog regulatory sequence (ZRS) is associated with triphalangeal thumb and deregulates expression in the developing limb

PubMed Central

Furniss, Dominic; Lettice, Laura A.; Taylor, Indira B.; Critchley, Paul S.; Giele, Henk; Hill, Robert E.; Wilkie, Andrew O.M.

2008-01-01

A locus for triphalangeal thumb, variably associated with pre-axial polydactyly, was previously identified in the zone of polarizing activity regulatory sequence (ZRS), a long range limb-specific enhancer of the Sonic Hedgehog (SHH) gene at human chromosome 7q36.3. Here, we demonstrate that a 295T>C variant in the human ZRS, previously thought to represent a neutral polymorphism, acts as a dominant allele with reduced penetrance. We found this variant in three independently ascertained probands from southern England with triphalangeal thumb, demonstrated significant linkage of the phenotype to the variant (LOD = 4.1), and identified a shared microsatellite haplotype around the ZRS, suggesting that the probands share a common ancestor. An individual homozygous for the 295C allele presented with isolated bilateral triphalangeal thumb resembling the heterozygous phenotype, suggesting that the variant is largely dominant to the wild-type allele. As a functional test of the pathogenicity of the 295C allele, we utilized a mutated ZRS construct to demonstrate that it can drive ectopic anterior expression of a reporter gene in the developing mouse forelimb. We conclude that the 295T>C variant is in fact pathogenic and, in southern England, appears to be the most common cause of triphalangeal thumb. Depending on the dispersal of the founding mutation, it may play a wider role in the aetiology of this disorder. PMID:18463159

[Osteoarthritis of the trapeziometacarpal joint in men: different stakes. Results of three surgical techniques].

PubMed

Gallinet, D; Gasse, N; Blanchet, N; Tropet, Y; Obert, L

2011-02-01

Basal thumb arthritis is less common in men, but the functional implication is different in this manual worker or active retired population. The objective was to analyse the results of three surgical procedure in an exclusively men's population. Twenty-eight patients (19 partial trapeziectomy with interposition of a chondrocostal autograft, seven total trapeziectomy and two prosthesis), with a mean age of 69 years old, were reviewed at a mean follow-up of 71 months. Mobility and pain were similar in the three populations. But the strength and Dash scores were better in the cartilage group. Radiologically the length of the thumb ray was greater in the cartilage group and no signs of loosening were observed in the prosthesis group. The surgery of reference in this population is the arthrodesis of the trapeziometacarpal joint. But the lack of mobility is disabling, the strength is questionable and painlessness varies due to high rates of non-union. Only one study compared four surgical procedures in an exclusively male population and total trapeziectomy seemed to give the best results. But this technique carries risk of shortening of the thumb ray. Even if the comparison is difficult, the association of partial trapeziectomy with interposition of costal cartilage graft seems to give better stability to the thumb column by preserving length as well as greater strength compared to total trapeziectomy. We advocate this procedure for basal thumb arthritis in men. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Radiographic Assessment of the Robert and Lateral Views in Trapeziometacarpal Osteoarthrosis.

PubMed

Oheb, Jonathan; Lansinger, Yuri; Jansen, Joshua A; Nguyen, Jimmy Q; Porembski, Margaret A; Rayan, Ghazi M

2015-01-01

To evaluate the effectiveness of the Robert view in assessing trapeziometacarpal arthrosis and to compare the accuracy of the Robert and lateral views in staging trapeziometacarpal (TM) joint arthrosis. Patient demographics were obtained. Four participating raters reviewed 62 randomly selected thumb x-rays of patients presenting with thumb TM joint pain. Lateral and Robert-hyperpronation views were assessed using an analysis of 13 criteria. X-rays of 62 thumbs for 58 patients were evaluated. The average patients' age was 64 (47-87) and 51 (80%) were females. The majority of X-rays evaluated fell into stage 3. Stage 2 was the second most common level of arthritis encountered and the least was stage 1. More osteophytes were encountered in the trapezium than metacarpal on both the Robert and lateral views. The Robert view was superior in detecting osteophytes on the trapezium than the lateral view. Osteophyte size varied from 1.7 to 2 mm. The lateral view displayed 61 cases with dorsal metacarpal subluxation (98%). The Robert view displayed 48 cases (77%) with radial metacarpal subluxation and 9 cases (15%) with ulnar metacarpal subluxation. Thumb metacarpal adduction deformity was encountered on the lateral view in 20 cases (32%) whereas on the Robert view it was encountered in 14 cases (23%). Subchondral sclerosis was encountered on the Robert view in 56 thumbs (90%) while it was seen on the lateral view in 52 thumbs (84%). Pantrapezial arthritis involving the STT joint was encountered equally in 16 cases (26%) on the Robert view and the lateral views. The study found a moderate level of interrater reliability on both the lateral and Robert views. With the exception of osteophytes encountered on the trapezium versus the metacarpal, there were no other statistically significant findings. This study confirms that each of the Robert and lateral views offer unique information and combining both views enhances the ability to assess radiographic disease severity, and should be the recommended set of X-rays for assessing TM osteoarthrosis.

Ergonomics: The Study of Work

DTIC Science & Technology

2000-01-01

Disease Name thumbs pain at the base of the thumbs twisting and gripping butchers , house- keepers, packers, seam- stresses, cutters fingers De...Quervain’s disease difficulty moving finger; snapping and jerking movements repeatedly using the index fingers meatpackers, poultry workers, carpenters...line workers rotator cuff tendinitis hands, wrists pain, swelling repetitive or forceful hand and wrist motions core making, poultry process- ing

3D printed self-driven thumb-sized motors for in-situ underwater pollutant remediation

PubMed Central

Yu, Fen; Hu, Qipeng; Dong, Lina; Cui, Xiao; Chen, Tingtao; Xin, Hongbo; Liu, Miaoxing; Xue, Chaowen; Song, Xiangwei; Ai, Fanrong; Li, Ting; Wang, Xiaolei

2017-01-01

Green fuel-driven thumb sized motors (TSM) were designed and optimized by 3D printing to explore their in-situ remediation applications in rare studied underwater area. Combined with areogel processing and specialized bacteria domestication, each tiny TSM could realize large area pollutant treatment precisely in an impressive half-automatically manner. PMID:28205596

3D printed self-driven thumb-sized motors for in-situ underwater pollutant remediation

NASA Astrophysics Data System (ADS)

Yu, Fen; Hu, Qipeng; Dong, Lina; Cui, Xiao; Chen, Tingtao; Xin, Hongbo; Liu, Miaoxing; Xue, Chaowen; Song, Xiangwei; Ai, Fanrong; Li, Ting; Wang, Xiaolei

2017-02-01

Green fuel-driven thumb sized motors (TSM) were designed and optimized by 3D printing to explore their in-situ remediation applications in rare studied underwater area. Combined with areogel processing and specialized bacteria domestication, each tiny TSM could realize large area pollutant treatment precisely in an impressive half-automatically manner.

Simplified Habit Reversal Plus Adjunct Contingencies in the Treatment of Thumb Sucking and Hair Pulling in a Young Child.

ERIC Educational Resources Information Center

Long, Ethan S.; Miltenberger, Raymond G.; Rapp, John T.

1999-01-01

Using simplified reversal treatment consisting of awareness training, competing response training, and social support procedures, minimal results were initially obtained in thumb sucking and hair pulling behaviors. Additional treatment phases involving differential reinforcement and response cost resulted in near zero levels of the behavior when…

Ratio Tables to Promote Proportional Reasonings in the Primary Classroom

ERIC Educational Resources Information Center

Dole, Shelley

2008-01-01

There are many classroom activities that can be implemented with primary students that introduce and immerse them in ratio investigations. Some enjoyable tasks include finding the ratio of tongue rollers to non-tongue rollers in the classroom; left-hand dominant to right-hand dominant; right-thumb over left-thumb when clasping the hands to…

Toe-to-hand transfer: Evolving Indications and Relevant Outcomes

PubMed Central

Waljee, Jennifer F.; Chung, Kevin C.

2014-01-01

In the late 19th century, the first toe to hand transfer was performed in Vienna, Switzerland as a staged procedure by Nicolandi.(1) Since that time, the advent of microsurgery has revolutionized toe to hand transfers. In 1966, Buncke performed the first microvascular toe to thumb transfer in a rhesus monkey.(2) The first toe to thumb transfer using microsurgical techniques in humans was performed by Cobbett in 1969, followed shortly thereafter by the first transfer of a second toe to the thumb position.(3,4) Today, due to expanding microsurgical techniques and surgeon innovation, the indications and techniques for toe-to-hand transfer procedures continue to evolve and now encompass patients with a variety of acquired and congenital hand defects.(5) PMID:23790426

Evaluation of Health on the Net seal label and DISCERN as content quality indicators for patients seeking information about thumb sucking habit.

PubMed

Shital Kiran, D P; Bargale, Seema; Pandya, Parth; Bhatt, Kuntal; Barad, Nirav; Shah, Nilay; Venkataraghavan, Karthik; Ramesh, K

2015-08-01

The aim of this study was to evaluate the reliability of websites on the thumb sucking habit using DISCERN instrument and Health on the Net (HON) seal code at a single moment in time. An Internet search engine (www.google.com) was used to identify websites comprising information on "thumb sucking habit." Of over 204,000 links for thumb sucking habit, the first 100 were analyzed in detail. After excluding discussion groups, news and video feeds, and removing carbon copy sites, only 36 relevant websites remained, which were then assessed using the DISCERN instrument and HON seal code. Using the 16 questions of DISCERN for assessing the reliability and quality of the consumer information which were scored from 1 to 5, an appropriate index of the quality of the information was generated. All the assessed websites were also checked for presence or absence of HON seal code. The maximum score attainable for an outstanding website is 80. Of the 36 websites that were scored the highest score obtained by one of the websites according to the DISCERN tool was 55 of 80, and the lowest score achieved was 16 of 80. The websites achieving the maximum and minimum score were children.webmd.com and thebehaviorsolution.com, respectively. The HON seal was displayed only in three websites, which were medicinenet.com, righthealth.com, and children.webmd.com. By directing patients to validated websites on the thumb sucking habit, clinicians can ensure patients find appropriate information.

Examining the Rule of Thumb of Not Using Multilevel Modeling: The "Design Effect Smaller than Two" Rule

ERIC Educational Resources Information Center

Lai, Mark H. C.; Kwok, Oi-man

2015-01-01

Educational researchers commonly use the rule of thumb of "design effect smaller than 2" as the justification of not accounting for the multilevel or clustered structure in their data. The rule, however, has not yet been systematically studied in previous research. In the present study, we generated data from three different models…

Introducing a longitudinal study of community gardeners and gardens in New York City

Treesearch

Erika S. Svendsen; Lindsay K. Campbell; Nancy Falxa-Raymond; Jessica Northridge; Edie Stone

2012-01-01

For almost a decade, the NYC Department of Parks and Recreation GreenThumb program has collected data about hundreds of New York City community gardens citywide to understand how these gardens function. Building on a data set that includes surveys and interviews conducted periodically with garden representatives since 2003, GreenThumb and USDA Forest Service...

An Evaluation of a Computer-Based Videotext Information Delivery System for Farmers: The Green Thumb Project.

ERIC Educational Resources Information Center

Warner, Paul D.; Clearfield, Frank

The Green Thumb Project was designed to test the feasibility of operating a computerized system for disseminating weather, market, and other agricultural production and management information on a day-to-day basis; to develop a prototype software support system for the test; and to provide essential project information on conduct of the test to…

What's So Special about Plants? Inquiry in the Classroom

ERIC Educational Resources Information Center

Lightbody, Mary

2011-01-01

Students come to class with diverse experiences and backgrounds, and the author tries to take advantage of that diversity in the plant unit. Every year the author secures the help of the two or three green thumbs or green-thumb wannabes to help take care of the collection of plants she brings from home in the fall. The author also invites students…

Loss of Dermatan-4-Sulfotransferase 1 Function Results in Adducted Thumb-Clubfoot Syndrome

PubMed Central

Dündar, Munis; Müller, Thomas; Zhang, Qi; Pan, Jing; Steinmann, Beat; Vodopiutz, Julia; Gruber, Robert; Sonoda, Tohru; Krabichler, Birgit; Utermann, Gerd; Baenziger, Jacques U.; Zhang, Lijuan; Janecke, Andreas R.

2009-01-01

Adducted thumb-clubfoot syndrome is an autosomal-recessive disorder characterized by typical facial appearance, wasted build, thin and translucent skin, congenital contractures of thumbs and feet, joint instability, facial clefting, and coagulopathy, as well as heart, kidney, or intestinal defects. We elucidated the molecular basis of the disease by using a SNP array-based genome-wide linkage approach that identified distinct homozygous nonsense and missense mutations in CHST14 in each of four consanguineous families with this disease. The CHST14 gene encodes N-acetylgalactosamine 4-O-sulfotransferase 1 (D4ST1), which catalyzes 4-O sulfation of N-acetylgalactosamine in the repeating iduronic acid-α1,3-N-acetylgalactosamine disaccharide sequence to form dermatan sulfate. Mass spectrometry of glycosaminoglycans from a patient's fibroblasts revealed absence of dermatan sulfate and excess of chondroitin sulfate, showing that 4-O sulfation by CHST14 is essential for dermatan sulfate formation in vivo. Our results indicate that adducted thumb-clubfoot syndrome is a disorder resulting from a defect specific to dermatan sulfate biosynthesis and emphasize roles for dermatan sulfate in human development and extracellular-matrix maintenance. PMID:20004762

Single Degree-of-Freedom Exoskeleton Mechanism Design for Finger Rehabilitation

PubMed Central

Wolbrecht, Eric T.; Reinkensmeyer, David J.; Perez-Gracia, Alba

2014-01-01

This paper presents the kinematic design of a single degree-of-freedom exoskeleton mechanism: a planar eight-bar mechanism for finger curling. The mechanism is part of a finger-thumb robotic device for hand therapy that will allow users to practice key pinch grip and finger-thumb opposition, allowing discrete control inputs for playing notes on a musical gaming interface. This approach uses the mechanism to generate the desired grasping trajectory rather than actuating the joints of the fingers and thumb independently. In addition, the mechanism is confined to the back of the hand, so as to allow sensory input into the palm of the hand, minimal size and apparent inertia, and the possibility of placing multiple mechanisms side-by-side to allow control of individual fingers. PMID:22275628

Patients With Thumb Carpometacarpal Arthritis Have Quantifiable Characteristic Expectations That Can Be Measured With a Survey.

PubMed

Kang, Lana; Hashmi, Sohaib Z; Nguyen, Joseph; Lee, Steve K; Weiland, Andrew J; Mancuso, Carol A

2016-01-01

Although patient expectations associated with major orthopaedic conditions have shown clinically relevant and variable effects on outcomes, expectations associated with thumb carpometacarpal (CMC) arthritis have not been identified, described, or analyzed before, to our knowledge. We asked: (1) Do patients with thumb CMC arthritis express characteristic expectations that are quantifiable and have measurable frequency? (2) Can a survey on expectations developed from patient-derived data quantitate expectations in patients with thumb CMC arthritis? The study was a prospective cohort study. The first phase was a 12-month-period involving interviews of 42 patients with thumb CMC arthritis to define their expectations of treatment. The interview process used techniques and principles of qualitative methodology including open-ended interview questions, unrestricted time, and study size determined by data saturation. Verbatim responses provided content for the draft survey. The second phase was a 12-month period assessing the survey for test-retest reliability with the recruitment of 36 participants who completed the survey twice. The survey was finalized from clinically relevant content, frequency of endorsement, weighted kappa values for concordance of responses, and intraclass coefficient and Cronbach's alpha for interrater reliability and internal consistency. Thirty-two patients volunteered 256 characteristic expectations, which consisted of 21 discrete categories. Expectations with similar concepts were combined by eliminating redundancy while maintaining original terminology. These were reduced to 19 items that comprised a one-page survey. This survey showed high concordance, interrater reliability, and internal consistency, with weighted kappa values between 0.58 and 0.78 (95% CI, 0.39-0.78; p < 0.001); intraclass correlation coefficient of 0.94 (95% CI, 0.94-0.98; p < 0.001), and Cronbach's alpha values of 0.94 and 0.95 (95% CI, 0.91-0.96; p < 0.001). The thumb CMC arthritis expectations survey score is convertible to an overall score between 0 to 100 points calculated on the basis of the number of expectations and the degree of improvement expected, with higher scores indicating higher expectations. Patients with thumb CMC arthritis volunteer a characteristic and quantifiable set of expectations. Using responses recorded verbatim from patient interviews, a clinically relevant, valid, and reliable expectations survey was developed that measures the physical and psychosocial expectations of patients seeking treatment for CMC arthritis. The survey provides a calculable score that can record patients' expectations. Clinical application of this survey includes identification of factors that influence fulfilment of these expectations. Level II, prospective study.

[Results after distraction arthroplasty according to Bufalini and Perugia in early stages of trapeziometacarpal osteoarthritis].

PubMed

Fatzer, Lukas; Soleman, E; Sanchez, T

2015-02-01

A distraction arthroplasty of the trapeziometacarpal joint was introduced by Bufalini and Perugia for the treatment of the early stages of carpometacarpal osteoarthritis. Our retrospective study presents the results of this technique. Thereby, a tendon graft anchored to the distal second metacarpal is fixed at the base of the first metacarpal, keeping it in distraction. 10 distraction arthroplasties were performed in 9 patients with carpometacarpal osteoarthritis stage I and II of the thumb after unsuccessful conservative therapy. In 2 cases, which were excluded from our study, trapeziectomy had to be performed because of persisting pain. Patient satisfaction, pain measurement, range of motion, and tip, key and grip strength were evaluated at a follow-up of 46.5 (29-63) months in the remaining 7 patients (8 operations overall). Strengh measurement was taken in an absolute value and compared to the opposite side. Thumb range of motion was measured with the combined flexion-opposition of the thumb with the Kapandij index and also the angle of abduction of the metacarpal I to metacarpal II. Assessment included a DASH score evaluation and an X-ray control. All of the 7 evaluated patients were satisfied with the operation results. Compared to the opposite side, patients achieved 80.1% (5.9 kg±1.1 kg) of key pinch strength, 86.3% (4.8 kg±0.9 kg) of oppositional tip pinch strength, and 86.1% (23.1 kg±4.8 kg) of grip strength. In combined flexion and opposition a Kapandij index of 8.5 (94.4%) compared to 9 on the opposite side was achieved. Thumb radial abduction was 48.2°±2.8°, compared to 51.0°±2.9° on the contralateral hand. At follow-up, the mean DASH score was 17.8 (±10.0). Radiological control showed no progression of carpometacarpal osteoarthritis of the thumb. The collected data after distraction arthroplasty according to Bufalini and Perugia confirm the efficacy of the technique in the early stage of carpometacarpal osteoarthritis of the thumb. Even though a failure rate of 20% occurred, in our opinion the operation is justified in the early stages of carpometacarpal osteoarthritis of the thumb as the patients benefit from a pain-free interval, leaving the option for future trapeziectomy. © Georg Thieme Verlag KG Stuttgart · New York.

A Glove for Tapping and Discrete 1D/2D Input

NASA Technical Reports Server (NTRS)

Miller, Sam A.; Smith, Andy; Bahram, Sina; SaintAmant, Robert

2012-01-01

This paper describes a glove with which users enter input by tapping fingertips with the thumb or by rubbing the thumb over the palmar surfaces of the middle and index fingers. The glove has been informally tested as the controller for two semi-autonomous robots in a a 3D simulation environment. A preliminary evaluation of the glove s performance is presented.

Assisting People with Multiple Disabilities and Minimal Motor Behavior to Control Environmental Stimulation through a Mouse Wheel

ERIC Educational Resources Information Center

Shih, Ching-Hsiang; Shih, Ching-Tien; Lin, Kun-Tsan; Chiang, Ming-Shan

2009-01-01

This study assessed whether two people with profound multiple disabilities and minimal motor behavior would be able to control environmental stimulation using thumb poke ability with a mouse wheel and a newly developed mouse driver (i.e., a new mouse driver replacing standard mouse driver, and turning a mouse into a precise thumb poke detector).…

Biology Teachers Designing Context-Based Lessons for Their Classroom Practice--The Importance of Rules-of-Thumb

ERIC Educational Resources Information Center

Wieringa, Nienke; Janssen, Fred J. J. M.; Van Driel, Jan H.

2011-01-01

In science education in the Netherlands new, context-based, curricula are being developed. As in any innovation, the outcome will largely depend on the teachers who design and implement lessons. Central to the study presented here is the idea that teachers, when designing lessons, use rules-of-thumb: notions of what a lesson should look like if…

Efficacy of combined conservative therapies on clinical outcomes in patients with thumb base osteoarthritis: protocol for a randomised, controlled trial (COMBO).

PubMed

Deveza, Leticia A; Hunter, David J; Wajon, Anne; Bennell, Kim L; Vicenzino, Bill; Hodges, Paul; Eyles, Jillian P; Jongs, Ray; Riordan, Edward A; Duong, Vicky; Min Oo, Win; O'Connell, Rachel; Meneses, Sarah R F

2017-01-12

Management of thumb base osteoarthritis (OA) using a combination of therapies is common in clinical practice; however, evidence for the efficacy of this approach is lacking. The aim of this study is to determine the effect of a combination of conservative therapies for the treatment of thumb base OA compared with an education control group. This is a randomised, controlled, single-centre, two-arm superiority trial with 1:1 allocation ratio; with assessor and statistician blinded. Participants are blinded to the trial's hypothesis and to the interventions received by the opposite group. A total of 204 participants will be recruited from the community and randomised using a computer-generated schedule. The intervention group will receive education for joint protection and OA, a splint for the base of the thumb, hand exercises and topical diclofenac sodium 1% gel over 6 weeks. The control group will receive education for joint protection and OA alone. Main inclusion criteria are pain ≥40 mm (Visual Analogue Scale, 0-100) at the base of the thumb, impairment in hand function ≥6 (Functional Index for Hand Osteoarthritis, 0-30) and radiographic thumb base OA (Kellgren Lawrence grade ≥2). Participants currently receiving any of the intervention components will be excluded. Outcomes will be measured at 2, 6 and 12 weeks. The primary outcome is change in pain and hand function from baseline to 6 weeks. Other outcomes include changes in grip and pinch strength, quality of life, presence of joint swelling and tenderness, duration of joint stiffness, patient's global assessment and use of rescue medication. Analysis will be performed according to the intention-to-treat principle. Adverse events will be monitored throughout the study. This protocol is approved by the local ethics committee (HREC/15/HAWKE/479). Dissemination will occur through presentations at international conferences and publication in peer-reviewed journals. ACTRN12616000353493; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Stabilising Effect of the Anterior Oblique Ligament to Prevent Directional Subluxation at the Trapeziometacarpal Joint of the Thumb: A Biomechanical Cadaveric Study

PubMed Central

McCann, Mark R.; Rust, Philippa A.; Wallace, Robert

2018-01-01

Background: The trapeziometacarpal joint (TMCJ) is inherently unstable, relying on ligament restraint to prevent subluxation. Subluxation of the thumb in a dorsoradial direction is often observed in clinical practice, either after acute ligament injury or more commonly with osteoarthritis (OA). This subluxation follows loss of function of trapeziometacarpal ligaments that stabilise this joint, resisting the deforming force of abductor pollicis longus (APL). The exact ligaments that stabilise and prevent the thumb from the pull of APL causing dorsoradial subluxation remain unknown, although the anterior oblique ligament (AOL) has been implicated. The aim of this study was to measure the direction of subluxation resisted by the AOL. Methods: In this study we used cadaveric limbs and custom made biomechanical testing to measure the influence AOL has in stabilising the thumb against subluxation in three planes: radial, dorsal and dorsoradial. Three fresh frozen hands were dissected to expose the TMCJ, leaving all ligaments, capsule and APL attachment in place. The force required to create a displacement of 5mm between the first metacarpal and the trapezium in these three planes was measured before and after AOL division. Results: The average force to displace in the dorsoradial plane prior to division was 6.68N, and a statistically significant reduction to 1.15N (P<0.001) was found after division of the AOL. A statistically significant increase in force (P<0.001) from 2.89N to 4.04N was seen in the radial plane, while no change was seen dorsally (P=0.98), with average forces of 2.74N and 2.62N found pre and post division. Conclusion: There is clinical significance in reporting quantifiable data in this field, as subluxation of the thumb is often seen with OA. The results of our study provide support for surgical reconstruction of the AOL as the primary surgical stabilizer against dorsoradial subluxation of the thumb. Level of evidence: III PMID:29600262

Investigation of the effect of conservative interventions in thumb carpometacarpal osteoarthritis: systematic review and meta-analysis.

PubMed

Bertozzi, Lucia; Valdes, Kristin; Vanti, Carla; Negrini, Stefano; Pillastrini, Paolo; Villafañe, Jorge Hugo

2015-01-01

The purpose of this study was to conduct a current review of randomized controlled trials regarding the effect of conservative interventions on pain and function in people with thumb carpometacarpal (CMC) osteoarthritis (OA), perform a meta-analysis of the findings and summarize current knowledge. Data were obtained from MEDLINE, CINAHL, Embase, PEDro and CENTRAL databases from their inception to May 2014. Reference lists of relevant literature reviews were also searched. All published randomized trials without restrictions to time of publication or language were considered for inclusion. Study subjects were symptomatic adults with thumb CMC OA. Two reviewers independently selected studies, conducted quality assessment and extracted results. Data were pooled in a meta-analysis, when possible, using a random-effects model. Quality of the body evidence was assessed using GRADE approach. Sixteen RCTs involving 1145 participants met the inclusion criteria. Twelve were of high quality (PEDro score > 6). We found moderate quality evidence that manual therapy and therapeutic exercise combined with manual therapy improve pain in thumb CMC OA at short- and intermediate-term follow-up, and from low to moderate quality evidences that magneto therapy improves pain and function at short-term follow-up. Orthoses (splints) were found to improve function at long-term follow-up and pinch strength at short-term follow-up. Finally, we found from very low to low-quality evidence that other conservative interventions provide no significant improvement in pain and in function at short- and long-term follow-up. Some of the commonly performed conservative interventions performed in therapy have evidence to support their use to improve hand function and decrease hand pain. Additional research is required to determine the efficacy of other therapeutic interventions that are performed with patients with thumb CMC OA. Manual therapy and exercise are an effective means of improving pain and function at short-term follow-up by patients with thumb CMC OA. Magneto therapy, manual therapy, manual therapy and exercise and Orthoses (splints) were found to have clinically significant results. Very few of the included studies showed a clinically significant effect size in favor of treatment.

The effectiveness of physical therapies for patients with base of thumb osteoarthritis: Systematic review and meta-analysis.

PubMed

Ahern, Malene; Skyllas, Jason; Wajon, Anne; Hush, Julia

2018-06-01

Trapeziometacarpal osteoarthritis (known as base of thumb OA) is a common condition causing pain and disability worldwide. The purpose of this review was to evaluate the effectiveness of multimodal and unimodal physical therapies for base of thumb osteoarthritis (OA) compared with usual care, placebo or sham interventions. Systematic review and meta-analysis. We searched MEDLINE (PubMed), CINAHL, Embase, AMED, PEDro, Cochrane Database of Systematic Review, Cochrane Register of Controlled Trials (CENTRAL) from inception to May 2017. Randomized controlled trials involving adults comparing physical therapy treatment for base of thumb OA with an inactive control (placebo or sham treatment) and reported pain, strength or functional outcomes were included. Meta-analyses were performed where possible. Methodological risk of bias was assessed with the Cochrane Risk of Bias tool. Five papers with low risk of bias were included. Meta-analyses of mean differences (MD) with 95% confidence intervals (95% CI), were calculated for between-group differences in point estimates at 4 weeks post-intervention. Multimodal and unimodal physical therapies resulted in clinically worthwhile improvements in pain intensity (MD 2.9 [95% CI 2.8 to 3.0]; MD 3.1 [95% CI 2.5 to 3.8] on a 0-10 scale, respectively). Hand function improved following unimodal treatments (MD 6.8 points [95% CI 1.7 to 11.9)] on a 0-100 scale) and after a multimodal treatment (MD 20.5 (95%CI -0.7 to 41.7). High quality evidence shows unimodal and multimodal physical therapy treatments can result in clinically worthwhile improvements in pain and function for patients with base of thumb OA. Copyright © 2018 Elsevier Ltd. All rights reserved.

Dual-hemisphere transcranial direct current stimulation over primary motor cortex enhances consolidation of a ballistic thumb movement.

PubMed

Koyama, Soichiro; Tanaka, Satoshi; Tanabe, Shigeo; Sadato, Norihiro

2015-02-19

Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates motor performance and learning. Previous studies have shown that tDCS over the primary motor cortex (M1) can facilitate consolidation of various motor skills. However, the effect of tDCS on consolidation of newly learned ballistic movements remains unknown. The present study tested the hypothesis that tDCS over M1 enhances consolidation of ballistic thumb movements in healthy adults. Twenty-eight healthy subjects participated in an experiment with a single-blind, sham-controlled, between-group design. Fourteen subjects practiced a ballistic movement with their left thumb during dual-hemisphere tDCS. Subjects received 1mA anodal tDCS over the contralateral M1 and 1mA cathodal tDCS over the ipsilateral M1 for 25min during the training session. The remaining 14 subjects underwent identical training sessions, except that dual-hemisphere tDCS was applied for only the first 15s (sham group). All subjects performed the task again at 1h and 24h later. Primary measurements examined improvement in peak acceleration of the ballistic thumb movement at 1h and 24h after stimulation. Improved peak acceleration was significantly greater in the tDCS group (144.2±15.1%) than in the sham group (98.7±9.1%) (P<0.05) at 24h, but not 1h, after stimulation. Thus, dual-hemisphere tDCS over M1 enhanced consolidation of ballistic thumb movement in healthy adults. Dual-hemisphere tDCS over M1 may be useful to improve elemental motor behaviors, such as ballistic movements, in patients with subcortical strokes. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

"The Golden Rule": Only a starting point for quality care.

PubMed

Corazzini, Kirsten N; Lekan-Rutledge, Deborah; Utley-Smith, Queen; Piven, Mary L; Colón-Emeric, Cathleen S; Bailey, Donald; Ammarell, Natalie; Anderson, Ruth A

2005-01-01

The Golden Rule guides people to choose for others what they would choose for themselves. The Golden Rule is often described as 'putting yourself in someone else's shoes', or 'Do unto others as you would have them do unto you'(Baumrin 2004). The viewpoint held in the Golden Rule is noted in all the major world religions and cultures, suggesting that this may be an important moral truth (Cunningham 1998). The Golden Rule underlies acts of kindness, caring, and altruism that go above and beyond "business as usual" or "usual care" (Huang, 2005). As such, this heuristic or 'rule of thumb' has universal appeal and helps guide our behaviors toward the welfare of others. So why question the Golden Rule? Unless used mindfully, any heuristic can be overly-simplistic and lead to unintended, negative consequences.A heuristic is a rule of thumb that people use to simplify potentially overwhelming or complex events. These rules of thumb are largely unconscious, and occur irrespective of training and educational level (Gilovich, Griffin & Kahneman 2002). Rules of thumb, such as the Golden Rule, allow a person to reduce a complex situation to something manageable-e.g., 'when in doubt, do what I would want done'. Because it is a simplifying tool, however, the Golden Rule may lead to inappropriate actions because important factors may be overlooked.In this article we describe "The Golden Rule" as used by administrators, supervisors, charge nurses, and CNAs in case studies of four nursing homes. By describing use of this rule-of-thumb, we aim to challenge nurses in nursing homes to: 1) be mindful of their use of "The Golden Rule" and its impact on staff and residents; and 2) help staff members think through how and why "The Golden Rule" may impact their relationships with staff and residents.

Two-Thumb Encircling Technique Over the Head of Patients in the Setting of Lone Rescuer Infant CPR Occurred During Ambulance Transfer: A Crossover Simulation Study.

PubMed

Jo, Choong Hyun; Cho, Gyu Chong; Lee, Chang Hee

2017-07-01

The purpose of this study was to determine if the over-the-head 2-thumb encircling technique (OTTT) provides better overall quality of cardiopulmonary resuscitation compared with conventional 2-finger technique (TFT) for a lone rescuer in the setting of infant cardiac arrest in ambulance. Fifty medical emergency service students were voluntarily recruited to perform lone rescuer infant cardiopulmonary resuscitation for 2 minutes on a manikin simulating a 3-month-old baby in an ambulance. Participants who performed OTTT sat over the head of manikins to compress the chest using a 2-thumb encircling technique and provide bag-valve mask ventilations, whereas those who performed TFT sat at the side of the manikins to compress using 2-fingers and provide pocket-mask ventilations. Mean hands-off time was not significantly different between OTTT and TFT (7.6 ± 1.1 seconds vs 7.9 ± 1.3 seconds, P = 0.885). Over-the-head 2-thumb encircling technique resulted in greater depth of compression (42.6 ± 1.4 mm vs 41.0 ± 1.4 mm, P < 0.001) and faster rate of compressions (114.4 ± 8.0 per minute vs 112.2 ± 8.2 per minute, P = 0.019) than TFT. Over-the-head 2-thumb encircling technique resulted in a smaller fatigue score than TFT (1.7 ± 1.5 vs 2.5 ± 1.6, P < 0.001). In addition, subjects reported that compression, ventilation, and changing compression to ventilation were easier in OTTT than in TFT. The use of OTTT may be a suitable alternative to TFT in the setting of cardiac arrest of infants during ambulance transfer.

Changes in corticospinal excitability and the direction of evoked movements during motor preparation: A TMS study

PubMed Central

van Elswijk, Gijs; Schot, Willemijn D; Stegeman, Dick F; Overeem, Sebastiaan

2008-01-01

Background Preparation of the direction of a forthcoming movement has a particularly strong influence on both reaction times and neuronal activity in the primate motor cortex. Here, we aimed to find direct neurophysiologic evidence for the preparation of movement direction in humans. We used single-pulse transcranial magnetic stimulation (TMS) to evoke isolated thumb-movements, of which the direction can be modulated experimentally, for example by training or by motor tasks. Sixteen healthy subjects performed brisk concentric voluntary thumb movements during a reaction time task in which the required movement direction was precued. We assessed whether preparation for the thumb movement lead to changes in the direction of TMS-evoked movements and to changes in amplitudes of motor-evoked potentials (MEPs) from the hand muscles. Results When the required movement direction was precued early in the preparatory interval, reaction times were 50 ms faster than when precued at the end of the preparatory interval. Over time, the direction of the TMS-evoked thumb movements became increasingly variable, but it did not turn towards the precued direction. MEPs from the thumb muscle (agonist) were differentially modulated by the direction of the precue, but only in the late phase of the preparatory interval and thereafter. MEPs from the index finger muscle did not depend on the precued direction and progressively decreased during the preparatory interval. Conclusion Our data show that the human corticospinal movement representation undergoes progressive changes during motor preparation. These changes are accompanied by inhibitory changes in corticospinal excitability, which are muscle specific and depend on the prepared movement direction. This inhibition might indicate a corticospinal braking mechanism that counteracts any preparatory motor activation. PMID:18559096

Analysis of the Constraint Joint Loading in the Thumb During Pipetting.

PubMed

Wu, John Z; Sinsel, Erik W; Zhao, Kristin D; An, Kai-Nan; Buczek, Frank L

2015-08-01

Dynamic loading on articular joints is essential for the evaluation of the risk of the articulation degeneration associated with occupational activities. In the current study, we analyzed the dynamic constraint loading for the thumb during pipetting. The constraint loading is considered as the loading that has to be carried by the connective tissues of the joints (i.e., the cartilage layer and the ligaments) to maintain the kinematic constraints of the system. The joint loadings are solved using a classic free-body approach, using the external loading and muscle forces, which were obtained in an inverse dynamic approach combined with an optimization procedure in anybody. The constraint forces in the thumb joint obtained in the current study are compared with those obtained in the pinch and grasp tests in a previous study (Cooney and Chao, 1977, "Biomechanical Analysis of Static Forces in the Thumb During Hand Function," J. Bone Joint Surg. Am., 59(1), pp. 27-36). The maximal compression force during pipetting is approximately 83% and 60% greater than those obtained in the tip pinch and key pinch, respectively, while substantially smaller than that obtained during grasping. The maximal lateral shear force is approximately six times, 32 times, and 90% greater than those obtained in the tip pinch, key pinch, and grasp, respectively. The maximal dorsal shear force during pipetting is approximately 3.2 and 1.4 times greater than those obtained in the tip pinch and key pinch, respectively, while substantially smaller than that obtained during grasping. Our analysis indicated that the thumb joints are subjected to repetitive, intensive loading during pipetting, compared to other daily activities.

A Data-Driven Design Evaluation Tool for Handheld Device Soft Keyboards

PubMed Central

Trudeau, Matthieu B.; Sunderland, Elsie M.; Jindrich, Devin L.; Dennerlein, Jack T.

2014-01-01

Thumb interaction is a primary technique used to operate small handheld devices such as smartphones. Despite the different techniques involved in operating a handheld device compared to a personal computer, the keyboard layouts for both devices are similar. A handheld device keyboard that considers the physical capabilities of the thumb may improve user experience. We developed and applied a design evaluation tool for different geometries of the QWERTY keyboard using a performance evaluation model. The model utilizes previously collected data on thumb motor performance and posture for different tap locations and thumb movement directions. We calculated a performance index (PITOT, 0 is worst and 2 is best) for 663 designs consisting in different combinations of three variables: the keyboard's radius of curvature (R) (mm), orientation (O) (°), and vertical location on the screen (L). The current standard keyboard performed poorly (PITOT = 0.28) compared to other designs considered. Keyboard location (L) contributed to the greatest variability in performance out of the three design variables, suggesting that designers should modify this variable first. Performance was greatest for designs in the middle keyboard location. In addition, having a slightly upward curve (R = −20 mm) and orientated perpendicular to the thumb's long axis (O = −20°) improved performance to PITOT = 1.97. Poorest performances were associated with placement of the keyboard's spacebar in the bottom right corner of the screen (e.g., the worst was for R = 20 mm, O = 40°, L =  Bottom (PITOT = 0.09)). While this evaluation tool can be used in the design process as an ergonomic reference to promote user motor performance, other design variables such as visual access and usability still remain unexplored. PMID:25211465

Fingertip reconstruction with a palmar advancement flap and free dermal graft: a report of six cases.

PubMed

Arons, M S

1985-03-01

The palmar thumb advancement flap was first described by Moberg in 1964. It was further utilized for the thumb and defined by Posner and Smith in 1971. In 1980, Macht and Watson favorably reported their technique of palmar advancement that was applicable not only for the thumb, but also for all five digits with soft tissue tip losses. A further refinement of their technique is to augment the digital tip with an autogenous dermal graft. This dermal "padding" is placed directly over the bony tuft to act as a "shock absorber," add bulk and contour to the distal tip of the finger, increase soft tissue stability, eliminate direct percussive tenderness of the bone, and decrease disability for specific occupations such as those requiring typewriting. Six cases are reported.

Program Evaluation of Outcomes Based Orthotic and Prosthetic Education

DTIC Science & Technology

2006-12-01

Rheumatoid Arthritis; synovial joints ; tendon sheaths. b. Osteoarthritis; weight bearing joints ; loading areas. c. Osteoporosis; cancellous bone...flexion. 32. The desirable length of a thumb post is: a. to the thumb IP joint . b. proximal to the IP joint . c. to the nail bed. d. just...assist hyperextension of the thoracic spine. b. eliminate motion. c. prevent lumbar flexion. d. reduce axial load on lumbar vertebrae. 44

The compensatory motion of wrist immobilization on thumb and index finger performance--kinematic analysis and clinical implications.

PubMed

Liu, Chien-Hsiou; Chiang, Hsin-Yu; Chen, Kun-Hung

2015-01-01

Based on the high prevalence of people with problems in the wrist and hand simultaneously, it is of its importance to clarify whether hand joints exert extra motion to compensate for wrist motion while immobilized. This study aimed to measure the compensatory movement of the thumb and index finger when people perform daily activities with an immobilized wrist. Thirty healthy volunteers were recruited in this study. A wrist splint, the Jebsen-Taylor Hand Function Test, and the OptoTrak Certus motion tracking system were used. Seven inter-digit mean joint angles of the index finger and thumb were calculated. Paired sample t-test was used. (1) The compensatory motions were noted in the Metacarpophalangeal and Carpometacarpal joints of the thumb, and the proximal interphalangeal joints of the index finger; (2) The manifestation of compensatory motion was related to type of activity performed except when picking up light and heavy cans. The compensatory motions appeared while the wrist was immobilized and were found to be disadvantageous to the progression of disease. In the future, studies need to be done to understand how to select products with correct ergonomic design to enable people to reap greater benefits from wearing wrist splints.

Current practice patterns in conservative thumb CMC joint care: survey results.

PubMed

O'Brien, Virginia H; McGaha, Jamie L

2014-01-01

Cross-sectional descriptive survey Best practice for conservative clinical care pathways is not well outlined in the literature for patients with thumb carpometacarpal joint (CMCJ) pain. This self-report survey investigated the current practice patterns of assessments and conservative interventions for the painful thumb CMCJ among hand therapists. An online survey was distributed to members of the American Society of Hand Therapists (ASHT). Questions were included about evaluation measures and intervention techniques used for this population. A descriptive analysis was completed of the results. A total of 23.5% of the ASHT membership responded to the survey. Results were categorized using the International Classification of Functioning and Disability domains as a framework. The survey results report varying use of evaluation measures, therapeutic interventions, including orthotic fabrication, joint protection and patient education all therapeutic interventional techniques, and modalities. Therapists use a comprehensive array of evaluation measures and interventions for body functions and structures in the care of thumb CMC pain. In contrast, more consistent use is needed of psychometrically-sound functional outcome measures that show change in activities and participation. This survey highlights areas to employ current evidence, as well as, future research should address environmental factors and personal factors for this population Not applicable. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

[Measurement of motor strength of the hand using the Martin Vigorometer in evaluating the success of physical therapy in arthritis of the thumb].

PubMed

Culjak, M; Skreb-Rakijasić, N; Strizrep, T

1993-01-01

Motor strength of the fist was examined in 60 women with rhisarthrosis of the thumb before and after physical therapy with parafin compresses and magnetotherapy, as well as ultrasound through the water with VIGORIMETER "MARTIN". By measuring a better effect has been proved by using parafin compresses and magnetotherapy instead of the therapy with the ultrasound through the water.

The evolution of human and ape hand proportions.

PubMed

Almécija, Sergio; Smaers, Jeroen B; Jungers, William L

2015-07-14

Human hands are distinguished from apes by possessing longer thumbs relative to fingers. However, this simple ape-human dichotomy fails to provide an adequate framework for testing competing hypotheses of human evolution and for reconstructing the morphology of the last common ancestor (LCA) of humans and chimpanzees. We inspect human and ape hand-length proportions using phylogenetically informed morphometric analyses and test alternative models of evolution along the anthropoid tree of life, including fossils like the plesiomorphic ape Proconsul heseloni and the hominins Ardipithecus ramidus and Australopithecus sediba. Our results reveal high levels of hand disparity among modern hominoids, which are explained by different evolutionary processes: autapomorphic evolution in hylobatids (extreme digital and thumb elongation), convergent adaptation between chimpanzees and orangutans (digital elongation) and comparatively little change in gorillas and hominins. The human (and australopith) high thumb-to-digits ratio required little change since the LCA, and was acquired convergently with other highly dexterous anthropoids.

Truncation Depth Rule-of-Thumb for Convolutional Codes

NASA Technical Reports Server (NTRS)

Moision, Bruce

2009-01-01

In this innovation, it is shown that a commonly used rule of thumb (that the truncation depth of a convolutional code should be five times the memory length, m, of the code) is accurate only for rate 1/2 codes. In fact, the truncation depth should be 2.5 m/(1 - r), where r is the code rate. The accuracy of this new rule is demonstrated by tabulating the distance properties of a large set of known codes. This new rule was derived by bounding the losses due to truncation as a function of the code rate. With regard to particular codes, a good indicator of the required truncation depth is the path length at which all paths that diverge from a particular path have accumulated the minimum distance of the code. It is shown that the new rule of thumb provides an accurate prediction of this depth for codes of varying rates.

The evolution of human and ape hand proportions

PubMed Central

Almécija, Sergio; Smaers, Jeroen B.; Jungers, William L.

2015-01-01

Human hands are distinguished from apes by possessing longer thumbs relative to fingers. However, this simple ape-human dichotomy fails to provide an adequate framework for testing competing hypotheses of human evolution and for reconstructing the morphology of the last common ancestor (LCA) of humans and chimpanzees. We inspect human and ape hand-length proportions using phylogenetically informed morphometric analyses and test alternative models of evolution along the anthropoid tree of life, including fossils like the plesiomorphic ape Proconsul heseloni and the hominins Ardipithecus ramidus and Australopithecus sediba. Our results reveal high levels of hand disparity among modern hominoids, which are explained by different evolutionary processes: autapomorphic evolution in hylobatids (extreme digital and thumb elongation), convergent adaptation between chimpanzees and orangutans (digital elongation) and comparatively little change in gorillas and hominins. The human (and australopith) high thumb-to-digits ratio required little change since the LCA, and was acquired convergently with other highly dexterous anthropoids. PMID:26171589

A suspected malignancy in osteolytic bone tumour of the thumb

PubMed Central

Mattiassich, Georg; Ensat, Florian; Hager, Martina; Wechselberger, Gottfried

2012-01-01

A 75-year-old male patient was referred to our institution owing to a painful and gradually developing lesion of the thumb with suspicious malignancy. The patient was suffering from a swollen, red, tender left thumb for 3 months. An old scar at the finger pulp could be traced from an old minor trauma. The x-ray revealed an osteolytic lesion in the terminal phalanx of the non-dominant hand that raised concerns of malignancy. Additional investigations such as ultrasound, CT-scan and MRI have been performed to get better insight to the lesion. After performing a biopsy, no malignant cells were found. Owing to the local destroying effect of the lesion and the clinical signs of the patient, the lesion was excised in total. The histopathological evaluation confirmed the tumour as a rare intraosseous epidermoid cyst. A bone graft after resection was not needed. The postoperative follow-up of the patient was uneventful. PMID:23109418

A neural network for recognizing movement patterns during repetitive self-paced movements of the fingers in opposition to the thumb.

PubMed

Van Vaerenbergh, J; Vranken, R; Briers, L; Briers, H

2001-11-01

A data glove is a typical input device to control a virtual environment. At the same time it measures movements of wrist and fingers. The purposes of this investigation were to assess the ability of BrainMaker, a neural network, to recognize movement patterns during an opposition task that consisted of repetitive self-paced movements of the fingers in opposition to the thumb. The neural network contained 56 inputs, 3 hidden layers of 20 neurons, and one output. The 5th glove '95 (5DT), a commercial glove especially designed for virtual reality games, was used for finger motion capture. The training of the neural network was successful for recognizing the thumb, the index finger and the ring finger movements during the repetitive self-paced movements and neural network performed well during testing.

Two-Thumbed Robot Hand

NASA Technical Reports Server (NTRS)

Lee, Sukhan

1989-01-01

Robot hand includes thumblike members on left and right sides and fingerlike member at middle. Configuration of digits enables hand to adapt to variously shaped objects, grasp them robustly and reliably, and manipulate them. Reduces complexity of control mechanisms and provides kinesthetic perception of shapes of grasped objects. Mechanical hand with two thumbs and middle finger made from commercially available components. With specially designed dc motors and assemblies of gears, size of hand reduced considerably. Suited to handling objects in industrial tasks.

Rules of thumb for superfund remedy selection

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-08-01

The guidance document describes key principles and expectations, interspersed with `best practices` based on program experience, that should be consulted during the Superfund remedy selection process. These remedy selection `Rules of Thumb` are organized into three major policy areas: (1) risk assessment and risk management, (2) developing remedial alternatives, and (3) ground-water response actions. The purpose of this guide is to briefly summarize key elements of various remedy selection guidance documents and policies in one publication.

Occlusion of LTP-Like Plasticity in Human Primary Motor Cortex by Action Observation

PubMed Central

Lepage, Jean-François; Morin-Moncet, Olivier; Beaulé, Vincent; de Beaumont, Louis; Champoux, Francois; Théoret, Hugo

2012-01-01

Passive observation of motor actions induces cortical activity in the primary motor cortex (M1) of the onlooker, which could potentially contribute to motor learning. While recent studies report modulation of motor performance following action observation, the neurophysiological mechanism supporting these behavioral changes remains to be specifically defined. Here, we assessed whether the observation of a repetitive thumb movement – similarly to active motor practice – would inhibit subsequent long-term potentiation-like (LTP) plasticity induced by paired-associative stimulation (PAS). Before undergoing PAS, participants were asked to either 1) perform abductions of the right thumb as fast as possible; 2) passively observe someone else perform thumb abductions; or 3) passively observe a moving dot mimicking thumb movements. Motor evoked potentials (MEP) were used to assess cortical excitability before and after motor practice (or observation) and at two time points following PAS. Results show that, similarly to participants in the motor practice group, individuals observing repeated motor actions showed marked inhibition of PAS-induced LTP, while the “moving dot” group displayed the expected increase in MEP amplitude, despite differences in baseline excitability. Interestingly, LTP occlusion in the action-observation group was present even if no increase in cortical excitability or movement speed was observed following observation. These results suggest that mere observation of repeated hand actions is sufficient to induce LTP, despite the absence of motor learning. PMID:22701704

Relationship between Semmes-Weinstein Monofilaments perception Test and sensory nerve conduction studies in Carpal Tunnel Syndrome.

PubMed

Raji, Parvin; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Forogh, Bijan; Hasson, Scott

2014-01-01

The Semmes-Weinstein Monofilament Test (SWMT) is a clinical widely used test to quantify the sensibility in patients with Carpal Tunnel Syndrome (CTS). No study has investigated the relationship between the SWMT and sensory nerve conduction studies (SNCS) in patients with CTS. To assess the relationship between the SWMT and SNCS findings in patients with CTS. This cross-sectional clinical measurement study included 35 patients with CTS (55 hands) with a mean age of 45 ± 12 years. The outcome measures were the SWMT and SNCS measures of distal latency (DLs), amplitude (AMPs), and nerve conduction velocity (NCV). The median innervated fingers were tested using SWMT and electrodiagnostic tests. The primary outcome was the correlations between the SWMTs and NCS measures. All of the patients/hands had abnormal NCS findings. When looking at the three digits of interest (thumb, index and middle), the thumb SWMTs had the highest number of abnormal findings (58.2%), with the middle digit having the lowest (45.5%). All NCS findings were statistically different between abnormal and normal thumb SWMTs and abnormal and normal total summed SWMTs. There were significant moderate correlations between thumb SWMT scores and all NCS outcomes. Although only approximately 50% of the CTS diagnosed through NCS are corroborated through SWMT; the significant associations between SWMT and NCS measures suggest that SWMT is a valid test for assessing sensations in patients with CTS.

Occupational hand injuries: a current review of the prevalence and proposed prevention strategies for physical therapists and similar healthcare professionals.

PubMed

Gyer, Giles; Michael, Jimmy; Inklebarger, James

2018-03-01

Hand injury is the second most common work-related musculoskeletal injury among physical therapists (PTs) and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. PTs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury. Copyright © 2018 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.

[Secondary tendon reconstruction on the thumb].

PubMed

Bickert, B; Kremer, T; Kneser, U

2016-12-01

Closed tendon ruptures of the thumb that require secondary reconstruction can affect the extensor pollicis longus (EPL), extensor pollicis brevis (EPB) and flexor pollicis longus (FPL) tendons. Treatment of rupture of the EPB tendon consists of refixation to the bone and temporary transfixation of the joint. In the case of preexisting or posttraumatic arthrosis, definitive arthrodesis of the thumb is the best procedure. Closed ruptures of the EPL and FPL tendons at the wrist joint cannot be treated by direct tendon suture. Rupture of the EPL tendon occurs after distal radius fractures either due to protruding screws or following conservative treatment especially in undisplaced fractures. Transfer of the extensor indicis tendon to the distal EPL stump is a good option and free interposition of the palmaris longus tendon is a possible alternative. The tension should be adjusted to slight overcorrection, which can be checked intraoperatively by performing the tenodesis test. Closed FPL ruptures at the wrist typically occur 3-6 months after osteosynthesis of distal radius fractures with palmar plates and are mostly characterized by crepitation and pain lasting for several weeks. They can be prevented by premature plate removal, synovectomy and carpal tunnel release. For treatment of a ruptured FPL tendon in adult patients the options for tendon reconstruction should be weighed up against the less complicated tenodesis or arthrodesis of the thumb interphalangeal joint.

Tablet Keyboard Configuration Affects Performance, Discomfort and Task Difficulty for Thumb Typing in a Two-Handed Grip

PubMed Central

Trudeau, Matthieu B.; Catalano, Paul J.; Jindrich, Devin L.; Dennerlein, Jack T.

2013-01-01

When holding a tablet computer with two hands, the touch keyboard configuration imposes postural constraints on the user because of the need to simultaneously hold the device and type with the thumbs. Designers have provided users with several possible keyboard configurations (device orientation, keyboard layout and location). However, potential differences in performance, usability and postures among these configurations have not been explored. We hypothesize that (1) the narrower standard keyboard layout in the portrait orientation leads to lower self-reported discomfort and less reach than the landscape orientation; (2) a split keyboard layout results in better overall outcomes compared to the standard layout; and (3) the conventional bottom keyboard location leads to the best outcomes overall compared to other locations. A repeated measures laboratory experiment of 12 tablet owners measured typing speed, discomfort, task difficulty, and thumb/wrist joint postures using an active marker system during typing tasks for different combinations of device orientation (portrait and landscape), keyboard layout (standard and split), and keyboard location (bottom, middle, top). The narrower standard keyboard with the device in the portrait orientation was associated with less discomfort (least squares mean (and S.E.) 2.9±0.6) than the landscape orientation (4.5±0.7). Additionally, the split keyboard decreased the amount of reaching required by the thumb in the landscape orientation as defined by a reduced range of motion and less MCP extension, which may have led to reduced discomfort (2.7±0.6) compared to the standard layout (4.5±0.7). However, typing speed was greater for the standard layout (127±5 char./min.) compared to the split layout (113±4 char./min.) regardless of device orientation and keyboard location. Usage guidelines and designers can incorporate these findings to optimize keyboard design parameters and form factors that promote user performance and usability for thumb interaction. PMID:23840730

Tablet Keyboard Configuration Affects Performance, Discomfort and Task Difficulty for Thumb Typing in a Two-Handed Grip.

PubMed

Trudeau, Matthieu B; Catalano, Paul J; Jindrich, Devin L; Dennerlein, Jack T

2013-01-01

When holding a tablet computer with two hands, the touch keyboard configuration imposes postural constraints on the user because of the need to simultaneously hold the device and type with the thumbs. Designers have provided users with several possible keyboard configurations (device orientation, keyboard layout and location). However, potential differences in performance, usability and postures among these configurations have not been explored. We hypothesize that (1) the narrower standard keyboard layout in the portrait orientation leads to lower self-reported discomfort and less reach than the landscape orientation; (2) a split keyboard layout results in better overall outcomes compared to the standard layout; and (3) the conventional bottom keyboard location leads to the best outcomes overall compared to other locations. A repeated measures laboratory experiment of 12 tablet owners measured typing speed, discomfort, task difficulty, and thumb/wrist joint postures using an active marker system during typing tasks for different combinations of device orientation (portrait and landscape), keyboard layout (standard and split), and keyboard location (bottom, middle, top). The narrower standard keyboard with the device in the portrait orientation was associated with less discomfort (least squares mean (and S.E.) 2.9±0.6) than the landscape orientation (4.5±0.7). Additionally, the split keyboard decreased the amount of reaching required by the thumb in the landscape orientation as defined by a reduced range of motion and less MCP extension, which may have led to reduced discomfort (2.7±0.6) compared to the standard layout (4.5±0.7). However, typing speed was greater for the standard layout (127±5 char./min.) compared to the split layout (113±4 char./min.) regardless of device orientation and keyboard location. Usage guidelines and designers can incorporate these findings to optimize keyboard design parameters and form factors that promote user performance and usability for thumb interaction.

Embodiment and Manipulation Learning Process for a Humanoid Hand.

DTIC Science & Technology

1995-05-01

Figures 1-1 Human somatotopic mappings 16 1-2 Human anatomy terminology 18 2-1 A picture of Cog 24 2-2 A picture of Cog’s hand 27 3-1 A... human anatomy terminologies shown in Figure 1-2 [24]. The mechanical hand constructed for this thesis have three fingers, each having two segments...and two joints, and a thumb with one segment and a joint, so the terms 18 CHAPTER 1. INTRODUCTION Saddle-joint of the thumb Figure 1-2: Human

Dorsoradial capsulodesis for trapeziometacarpal joint instability.

PubMed

Rayan, Ghazi; Do, Viet

2013-02-01

We describe an alternative method for treating chronic trapeziometacarpal (TM) joint instability after acute injury or chronic repetitive use of the thumb by performing a dorsoradial capsulodesis procedure. The procedure is done by imbricating the redundant TM joint dorsoradial ligament and capsule after reducing the joint by pronating the thumb. The dorsoradial capsulodesis is a reasonable reconstructive option for chronic TM joint instability and subluxation. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

The clinical spectrum of mutations in L1, a neuronal cell adhesion molecule

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fransen, E.; Vits, L.; Van Camp, G.

1996-07-12

Mutations in the gene encoding the neuronal cell adhesion molecule L1 are responsible for several syndromes with clinical overlap, including X-linked hydrocephalus (XLH, HSAS), MASA (mental retardation, aphasia, shuffling gait, adducted thumbs) syndrome, complicated X-linked spastic paraplegia (SP 1), X-linked mental retardation-clasped thumb (MR-CT) syndrome, and some forms of X-linked agenesis of the corpus callosum (ACC). We review 34 L1 mutations in patients with these phenotypes. 22 refs., 3 figs., 4 tabs.

Sensing And Force-Reflecting Exoskeleton

NASA Technical Reports Server (NTRS)

Eberman, Brian; Fontana, Richard; Marcus, Beth

1993-01-01

Sensing and force-reflecting exoskeleton (SAFiRE) provides control signals to robot hand and force feedback from robot hand to human operator. Operator makes robot hand touch objects gently and manipulates them finely without exerting excessive forces. Device attaches to operator's hand; comfortable and lightweight. Includes finger exoskeleton, cable mechanical transmission, two dc servomotors, partial thumb exoskeleton, harness, amplifier box, two computer circuit boards, and software. Transduces motion of index finger and thumb. Video monitor of associated computer displays image corresponding to motion.

Aggressive intraosseous lipoma of the intermediate phalanges of the thumb.

PubMed

Hashimoto, Kazuhiko; Nishimura, Shunji; Kakinoki, Ryosuke; Akagi, Masao

2018-07-01

Intraosseous lipomas occurring in the bones of the upper limbs are very rare. The tumor often occurs in long bones, especially the calcaneus. Usually patients with intraosseous lipomas present with mild clinical features. Thus far, bone destruction caused by the tumor has not been reported. The present study reported a case of an aggressive intraosseous lipoma that developed in the intermediate phalanges of the thumb. This is an extremely rare case with extraosseous development, which occurred at a rare site. A 47-year old woman presented to us with right thumb pain and swelling. Computed tomography and magnetic resonance imaging revealed a mass extending to the outer edge of the phalangeal bone. The patient was treated with surgery the remove the tumor. Artificial bone was used to refill the area due to the lack of cancellous bone. During the clinical management of lipomas, it is important to consider that intraosseous lipomas may spread out of the bone; moreover, the tumor should be removed immediately to help reduce the possibility of bone destruction.

Variations in the nerves of the thumb and index finger.

PubMed

Wallace, W A; Coupland, R E

1975-11-01

The digital nerves to the thumb and index finger have been studied by dissecting twenty-five embalmed upper limbs. The palmar digital nerves to the thumb were constant in position and course, with a short lateral cutaneous branch from the radial palmar digital nerve in 30 per cent of cases. The palmar digital nerves to the index finger had a variable pattern, the commonest arrangement, well described in Gray's Anatomy, occurring in 74 per cent of cases. The variations and their frequency are described. By examining histological cross-sections of the index finger it was found that of about 5,000 endoneurial tubes entering the finger, 60 per cent passed beyond the distal digital crease to supply the pulp and nail bed. The depth of the palmar digital nerves was about 3 millimetres, but less at the digital creases, and their diameter lay between 1 and 1.5 millimetres as far as the distal digital crease. Clinical applications of the findings are discussed.

Pollicization for thumb reconstruction in severe pediatric hand burns.

PubMed

Ward, J W; Pensler, J M; Parry, S W

1985-12-01

Our experience in pollicization of the index ray for severely burned hands in children is reviewed with attention to severity of burn, functional impairment, age at pollicization, procedure used, operative time, length of hospital stay, and long-term functional results. Fifteen pollicizations were performed in 11 patients with an average follow-up of over 5 years. Indication for pollicization was lack of prehension due to total loss of the thumb with the presence of a transposable index ray. The bipedicle flap method was used in two cases and the neurovascular pedicle technique was employed in all others. Skin grafts were necessary in all cases. Results were graded according to presence or absence of tip pinch, key pinch, grasp, and opposition. Significant functional improvement was seen in 14 of 15 cases (94 percent). Four patients (27 percent) developed complications requiring secondary procedures. In our experience, pollicization provides the most rapid and effective means of restoration of thumb function in the severe pediatric hand burn with multiple digit loss.

The first metatarsal web space: its applied anatomy and usage in tracing the first dorsal metatarsal artery in thumb reconstruction.

PubMed

Xu, Yong-Qing; Li, Jun; Zhong, Shi-Zhen; Xu, Da-Chuan; Xu, Xiao-Shan; Guo, Yuan-Fa; Wang, Xin-Min; Li, Zhu-Yi; Zhu, Yue-Liang

2004-12-01

To clarify the anatomical relationship of the structures in the first toe webbing space for better dissection of toes in thumb reconstruction. The first dorsal metatarsal artery, the first deep transverse metatarsal ligament and the extensor expansion were observed on 42 adult cadaveric lower extremities. Clinically the method of tracing the first dorsal metatarsal artery around the space of the extensor expansion was used in 36 cases of thumb reconstruction. The distal segments of the first dorsal metatarsal artery of Gilbert types I and II were located superficially to the extensor expansion. The harvesting time of a toe was shortened from 90 minutes to 50 minutes with 100% survival of reconstructed fingers. The distal segment of the first dorsal metatarsal artery lies constantly at the superficial layer of the extensor expansion. Most of the first metatarsal arteries of Gilbert types I and II can be easily located via the combined sequential and reverse dissection around the space of the extensor expansion.

Estimating thumb-index finger precision grip and manipulation potential in extant and fossil primates.

PubMed

Feix, Thomas; Kivell, Tracy L; Pouydebat, Emmanuelle; Dollar, Aaron M

2015-05-06

Primates, and particularly humans, are characterized by superior manual dexterity compared with other mammals. However, drawing the biomechanical link between hand morphology/behaviour and functional capabilities in non-human primates and fossil taxa has been challenging. We present a kinematic model of thumb-index precision grip and manipulative movement based on bony hand morphology in a broad sample of extant primates and fossil hominins. The model reveals that both joint mobility and digit proportions (scaled to hand size) are critical for determining precision grip and manipulation potential, but that having either a long thumb or great joint mobility alone does not necessarily yield high precision manipulation. The results suggest even the oldest available fossil hominins may have shared comparable precision grip manipulation with modern humans. In particular, the predicted human-like precision manipulation of Australopithecus afarensis, approximately one million years before the first stone tools, supports controversial archaeological evidence of tool-use in this taxon. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Is the Factor-of-2 Rule Broadly Applicable for Evaluating the Prediction Accuracy of Metal-Toxicity Models?

PubMed

Meyer, Joseph S; Traudt, Elizabeth M; Ranville, James F

2018-01-01

In aquatic toxicology, a toxicity-prediction model is generally deemed acceptable if its predicted median lethal concentrations (LC50 values) or median effect concentrations (EC50 values) are within a factor of 2 of their paired, observed LC50 or EC50 values. However, that rule of thumb is based on results from only two studies: multiple LC50 values for the fathead minnow (Pimephales promelas) exposed to Cu in one type of exposure water, and multiple EC50 values for Daphnia magna exposed to Zn in another type of exposure water. We tested whether the factor-of-2 rule of thumb also is supported in a different dataset in which D. magna were exposed separately to Cd, Cu, Ni, or Zn. Overall, the factor-of-2 rule of thumb appeared to be a good guide to evaluating the acceptability of a toxicity model's underprediction or overprediction of observed LC50 or EC50 values in these acute toxicity tests.

Massive trapezial metastasis from gastric adenocarcinoma resected and reconstructed with a vascularized scapular bone graft

PubMed Central

Okamoto, Masanori; Yamazaki, Hiroshi; Yoshimura, Yasuo; Aoki, Kaoru; Tanaka, Atsushi; Kato, Hiroyuki

2017-01-01

Abstract Rationale: Isolated metastasis to the hand bones is very rare. Only seven cases of metastasis to the trapezium have been reported. To the best of our knowledge, this is the first report of a single metastasis to the trapezium from a gastric adenocarcinoma. Patient concerns: A 62-year-old man presented with pain and massive swelling in the right carpometacarpal joint of the thumb. Diagnoses: The patient was diagnosed with trapezial metastasis of advanced gastric adenocarcinoma. Interventions: The patient underwent systemic chemotherapy with cisplatin and S-1, radiotherapy to the metastatic bone, and treatment with denosumab. One year later, the huge metastatic tumor was resected, and the hand was reconstructed using vascularized scapular bone. Outcomes: Eighteen months postoperatively, the patient was satisfied with the appearance of the reconstructed hand and was able to use his right thumb in activities of daily living. Lessons: Although rare, metastasis to the trapezium should be considered in patients with persistent and progressive thumb CMC joint pain. PMID:29390390

Wet cooling towers: rule-of-thumb design and simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leeper, Stephen A.

1981-07-01

A survey of wet cooling tower literature was performed to develop a simplified method of cooling tower design and simulation for use in power plant cycle optimization. The theory of heat exchange in wet cooling towers is briefly summarized. The Merkel equation (the fundamental equation of heat transfer in wet cooling towers) is presented and discussed. The cooling tower fill constant (Ka) is defined and values derived. A rule-of-thumb method for the optimized design of cooling towers is presented. The rule-of-thumb design method provides information useful in power plant cycle optimization, including tower dimensions, water consumption rate, exit air temperature,more » power requirements and construction cost. In addition, a method for simulation of cooling tower performance at various operating conditions is presented. This information is also useful in power plant cycle evaluation. Using the information presented, it will be possible to incorporate wet cooling tower design and simulation into a procedure to evaluate and optimize power plant cycles.« less

Estimation of blood haemoglobin concentration using the HemoCue during caesarean section: the effect of sampling site.

PubMed

Richards, N A; Boyce, H; Yentis, S M

2010-01-01

Haemoglobin concentration measured using the HemoCue is accurate for capillary and venous/arterial blood, provided the recommended sampling method is strictly observed. Analysis of blood, particularly of capillary samples, using the HemoCue is useful during caesarean section. The toe might be preferred to the thumb since it is numb during neuraxial anaesthesia, but whether sampling at either site is accurate in this situation, given the cardiovascular effects of anaesthesia and pregnancy, is not known. We aimed to compare haemoglobin values measured in venous and capillary samples (toe and thumb) during caesarean section under neuraxial anaesthesia. Fifty healthy women having caesarean section under spinal or combined spinal-epidural anaesthesia were included. At the end of surgery, the great toe and thumb (non-i.v. fluid side) were lanced as recommended for a HemoCue reading. A venous blood sample (non-i.v. fluid side) was also taken and sent for formal laboratory measurement and tested with the HemoCue. Bland-Altman analysis was applied to the haemoglobin values. Bias (mean difference) and precision +/- 2 SD were respectively 0.2 +/-1.6 for laboratory vs. toe, 0.1 +/-1.8 for laboratory vs. thumb, and 0.2 +/-1.6 laboratory vs. venous. Our results suggest that in terms of accuracy, the two sites are equally suitable for use during caesarean section under neuraxial anaesthesia. Copyright 2009 Elsevier Ltd. All rights reserved.

Observation of Simple Intransitive Actions: The Effect of Familiarity

PubMed Central

Plata Bello, Julio; Modroño, Cristián; Marcano, Francisco; González–Mora, José Luis

2013-01-01

Introduction Humans are more familiar with index – thumb than with any other finger to thumb grasping. The effect of familiarity has been previously tested with complex, specialized and/or transitive movements, but not with simple intransitive ones. The aim of this study is to evaluate brain activity patterns during the observation of simple and intransitive finger movements with differing degrees of familiarity. Methodology A functional Magnetic Resonance Imaging (fMRI) study was performed using a paradigm consisting of the observation of 4 videos showing a finger opposition task between the thumb and the other fingers (index, middle, ring and little) in a repetitive manner with a fixed frequency (1 Hz). This movement is considered as the pantomime of a precision grasping action. Results Significant activity was identified in the bilateral Inferior Parietal Lobule and premotor regions with the selected level of significance (FDR [False Discovery Rate] = 0.01). The extent of the activation in both regions tended to decrease when the finger that performed the action was further from the thumb. More specifically, this effect showed a linear trend (index>middle>ring>little) in the right parietal and premotor regions. Conclusions The observation of less familiar simple intransitive movements produces less activation of parietal and premotor areas than familiar ones. The most important implication of this study is the identification of differences in brain activity during the observation of simple intransitive movements with different degrees of familiarity. PMID:24073213

[Fingers, toes and thumbs, correct digital nomenclature based on early Hebrew texts].

PubMed

Leibner, Efraim D; London, Eli; Elishoov, Ofer

2005-08-01

There is some dissonance as to the correct Hebrew terms for the digits of the extremities. Terms in common use include 'Etzba, 'Bohen' and 'Agudal'. While most agree that 'Etzba' in the singular represents the index finger, there is debate about the plural (Etzba'ot), whether it represents 'fingers' (upper extremity only) or 'digits' (upper and lower). The meaning of 'Bohen' is disputed as well, with proponents existing for it to represent: 'Toe', 'Big Toe' or 'Big Digit'. 'Agudal' is in the same predicament, with uses as 'Thumb' or 'Big Digit'. We undertook a computerized search of the Bible for these words and their derivatives in order to establish their correct use. The term 'Etzba' and its derivatives appeared numerous times in the scriptures both in singular and in plural. 'Bohen' appeared somewhat less, however, all appearances were in conjunction, viz" 'Bohen' of the hand" or " 'Bohen' of the foot". 'Agudal' was not found in our computerized search. According to the early Hebrew texts 'Etzba' in singular usually represents the index finger. However, the plural form 'Etzba'ot', corresponds to the term 'digits' and may be used both for fingers and toes. 'Bohen' is a term representing the large digit of all extremities, i.e. both 'Thumb' and 'Hallux'. Likewise, the term 'Agudal', while not appearing in the scriptures, appears in later contexts in early Hebrew texts, and also represents both the thumb and the hallux.

Preserving the posttrapeziectomy space with a human acellular dermal matrix spacer: a pilot case series of patients with thumb carpometacarpal joint arthritis.

PubMed

Yao, Caroline A; Ellis, Chandra V; Cohen, Myles J; Kulber, David A

2013-10-01

Advanced thumb carpometacarpal arthritis is widely treated with trapeziectomy and tendon interposition despite donor-site morbidities. Trapeziectomy alone leaves a postresection space, leading to proximal metacarpal migration and scaphoid/trapezoid impingement. Prosthetic implants have been unsuccessful due to particulate debris, silicone synovitis, osteolysis, and migration. Recent studies have shown successful use of allograft for interposition material in the posttrapeziectomy space both in animal and human models. To obviate the need for autologous tissue, maintain thumb length, and reduce the risk of scaphoid impingement, the senior author developed an interposition arthroplasty technique using a spacer constructed from human acellular dermal matrix (HADM). Sixteen patients with Eaton stage III-IV thumb carpometacarpal osteoarthritis received the above procedure from the 2 senior authors. HADM was imbricated to fill the posttrapeziectomy space and secured to the volar capsule and metacarpal base. Pre- and postoperative trapezial space on radiograph, pain scores, and grip strength were recorded. Six months postoperatively, radiographs showed an average joint space loss of 11%. Heights postoperatively were not significantly different from immediate postoperative heights (P ≥ 0.01). At 6 months, patients had improved pain and grip strength (P ≤ 0.01). No infections, foreign body reactions, or other complications occurred. HADM has been used extensively in other forms of reconstruction and has been shown to incorporate into surrounding tissues through neovascularization. Our early results illustrate that HADM can safely fill the dead space left by trapeziectomy.

Assessing predation risk: optimal behaviour and rules of thumb.

PubMed

Welton, Nicky J; McNamara, John M; Houston, Alasdair I

2003-12-01

We look at a simple model in which an animal makes behavioural decisions over time in an environment in which all parameters are known to the animal except predation risk. In the model there is a trade-off between gaining information about predation risk and anti-predator behaviour. All predator attacks lead to death for the prey, so that the prey learns about predation risk by virtue of the fact that it is still alive. We show that it is not usually optimal to behave as if the current unbiased estimate of the predation risk is its true value. We consider two different ways to model reproduction; in the first scenario the animal reproduces throughout its life until it dies, and in the second scenario expected reproductive success depends on the level of energy reserves the animal has gained by some point in time. For both of these scenarios we find results on the form of the optimal strategy and give numerical examples which compare optimal behaviour with behaviour under simple rules of thumb. The numerical examples suggest that the value of the optimal strategy over the rules of thumb is greatest when there is little current information about predation risk, learning is not too costly in terms of predation, and it is energetically advantageous to learn about predation. We find that for the model and parameters investigated, a very simple rule of thumb such as 'use the best constant control' performs well.

Microduplication of 7q36.3 encompassing the SHH long-range regulator (ZRS) in a patient with triphalangeal thumb-polysyndactyly syndrome and congenital heart disease

PubMed Central

Liu, Zhenghua; Yin, Ni; Gong, Lianghui; Tan, Zhiping; Yin, Bangliang; Yang, Yifeng; Luo, Cheng

2017-01-01

Triphalangeal thumb-polysyndactyly syndrome (TPT-PS) is an autosomal dominant disorder with complete penetrance and a variable expression consisting of opposable triphalangeal thumbs, duplication of the distal thumb phalanx, pre-axial polydactyly and duplication of the big toes (hallux). The causative gene of TPT-PS has been mapped to 7q36.3. Sonic hedgehog (SHH) expressed in the zone of polarizing activity (ZPA) has an important role in defining the anterior-posterior axis and numbers of digits in limb bud development. Point mutation or duplication in the ZPA regulatory sequence (ZRS), a cis-regulator of SHH, will lead to TPT-PS. The present study describes a 1-year-old female congenital heart disease (CHD) patient with TPT-PS phenotype. In this Han Chinese family with TPT-PS, high resolution single nucleotide polymorphism array technology identified a novel 0.29 Mb duplication comprising ZRS at 7q36.3 where LMBR1 is located. Additionally, a novel deletion of 22q11.21 was detected in the proband with Tetralogy of Fallot. However, the parents and other relatives of the patient did not harbor this genomic lesion nor CHD. The findings supported the hypothesis that an increased copy number variation of ZRS is the genetic mechanism underlying the phenotype of TPT-PS, and corroborated that 22q11.21 deletion is a genetic cause of CHD. PMID:28035386

Undamped electrostatic plasma waves

DOE Office of Scientific and Technical Information (OSTI.GOV)

Valentini, F.; Perrone, D.; Veltri, P.

2012-09-15

Electrostatic waves in a collision-free unmagnetized plasma of electrons with fixed ions are investigated for electron equilibrium velocity distribution functions that deviate slightly from Maxwellian. Of interest are undamped waves that are the small amplitude limit of nonlinear excitations, such as electron acoustic waves (EAWs). A deviation consisting of a small plateau, a region with zero velocity derivative over a width that is a very small fraction of the electron thermal speed, is shown to give rise to new undamped modes, which here are named corner modes. The presence of the plateau turns off Landau damping and allows oscillations withmore » phase speeds within the plateau. These undamped waves are obtained in a wide region of the (k,{omega}{sub R}) plane ({omega}{sub R} being the real part of the wave frequency and k the wavenumber), away from the well-known 'thumb curve' for Langmuir waves and EAWs based on the Maxwellian. Results of nonlinear Vlasov-Poisson simulations that corroborate the existence of these modes are described. It is also shown that deviations caused by fattening the tail of the distribution shift roots off of the thumb curve toward lower k-values and chopping the tail shifts them toward higher k-values. In addition, a rule of thumb is obtained for assessing how the existence of a plateau shifts roots off of the thumb curve. Suggestions are made for interpreting experimental observations of electrostatic waves, such as recent ones in nonneutral plasmas.« less

[DORSALIS PEDIS FLAP SERIES-PARALLEL BIG TOE NAIL COMPOSITE TISSUE FLAP TO REPAIR HAND SKIN OF DEGLOVING INJURY WITH THUMB DEFECT].

PubMed

Shi, Pengju; Zhang, Wenlong; Zhao, Gang; Li, Zhigang; Zhao, Shaoping; Zhang, Tieshan

2015-07-01

To investigate the effectiveness of dorsalis pedis flap series-parallel big toe nail composite tissue flap in the repairment of hand skin of degloving injury with tumb defect. Between March 2009 and June 2013, 8 cases of hand degloving injury with thumb defect caused by machine twisting were treated. There were 7 males and 1 female with the mean age of 36 years (range, 26-48 years). Injury located at the left hand in 3 cases and at the right hand in 5 cases. The time from injury to hospitalization was 1.5-4.0 hours (mean, 2.5 hours). The defect area was 8 cm x 6 cm to 15 cm x 1 cm. The thumb defect was rated as degree I in 5 cases and as degree II in 3 cases. The contralateral dorsal skin flap (9 cm x 7 cm to 10 cm x 8 cm) combined with ipsilateral big toe nail composite tissue flap (2.5 cm x 1.8 cm to 3.0 cm x 2.0 cm) was used, including 3 parallel anastomosis flaps and 5 series anastomosis flaps. The donor site of the dorsal flap was repaired with thick skin grafts, the stumps wound was covered with tongue flap at the shank side of big toe. Vascular crisis occurred in 1 big toe nail composite tissue flap, margin necrosis occurred in 2 dorsalis pedis flap; the other flaps survived, and primary healing of wound was obtained. The grafted skin at dorsal donor site all survived, skin of hallux toe stump had no necrosis. Eight cases were followed up 4-20 months (mean, 15.5 months). All flaps had soft texture and satisfactory appearance; the cutaneous sensory recovery time was 4-7 months (mean, 5 months). At 4 months after operation, the two-point discrimination of the thumb pulp was 8-10 mm (mean, 9 mm), and the two-point discrimination of dorsal skin flap was 7-9 mm (mean, 8.5 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the results were excellent in 4 cases, good in 3 cases, and fair in 1 case. The donor foot had normal function. Dorsalis pedis flap series-parallel big toe nail composite tissue flap is an ideal way to repair hand skin defect, and reconstructs the thumb, which has many advantages, including simple surgical procedure, no limitation to recipient site, soft texture, satisfactory appearance and function of reconstructing thumb, and small donor foot loss.

Daughter and her mildly affected father with Keipert syndrome.

PubMed

Dumic, Miroslav; Kokic, Durda Dovzak; Matic, Toni; Potocki, Kristina

2006-11-15

A 10-year-old girl with characteristic features of Keipert syndrome (broad terminal phalanges, especially of the thumb and hallux, sensorineural deafness, unusual facial features, large head circumference, maxillary hypoplasia, hoarse voice) and her mildly affected father (broad terminal phalanges, especially of the thumb and hallux, large head circumference, maxillary hypoplasia, and hoarse voice) are presented. The girl is the first reported female with this rare syndrome to date, and the fact that she probably inherited the disease from her father suggests an autosomal dominant pattern of inheritance. (c) 2006 Wiley-Liss, Inc.

[Hand reconstruction by microsurgical free toe transfer].

PubMed

Stamate, T; Budurcă, A R; Hermeziu, Oana

2003-01-01

Reconstruction of complex hand mutilations with multi-digital or thumb amputations are best treated with microsurgical toe transfers. We present the results of the first 15 cases operated by the first author, of which 12 are thumb reconstructions (6 great toe and 6 second toe transfers) and 3 long fingers reconstructions with combined second and third toe transfers. There were no microsurgical complications. Cortical integration and functional integration was achieved for all transferred toes, with discriminatory sensibility (m2PD between 5 and 13 mm) and active mobility range between 30 and 60 degrees.

Breaking the Thumb Sucking Habit: When Compliance Is Essential

PubMed Central

Tanaka, Orlando; Oliveira, Wagner; Galarza, Melissa; Aoki, Vanessa; Bertaiolli, Bruno

2016-01-01

The anterior open bite (AOB) and posterior cross bite are the most frequent malocclusions associated with prolonged sucking habits. This clinical case illustrates and discusses the use of a Haas-type palatal expander for stopping a thumb sucking habit. The improvement in closing the open bite with discontinuation of the habit was observed. But with the return of the habit and lack of cooperation, the relapse of anterior open bite occurred. Therefore, different approaches are necessary. The need of a multidisciplinary approach, consent, and cooperation are keys to a good prognosis. PMID:26904311

Anthropometric Survey of US Army Personnel (1988): Correlation Coefficients and Regression Equations. Part 4. Bivariate Regression Tables

DTIC Science & Technology

1990-05-01

THUMBBR THUMB BREADTH NO. VARIABLE CONSTANT REGRESS. COEF. ST.ERROR ADJUQTED (.ERR OF ESTIMATE E4 58 HANDBRTH 7.623 0.183 ( 0.006) 1.124 .319 59 HANDCIRC...945, 956, 965 TRAGION TO TOP OF HEAD (TRAGT, 255) 39,51, 718, 851, 899, 945, 956, 965 Trapezius Post 23 Trochanter 23 TROCHArNTERION HEIGHT (TROQINT...THGHCLR, 105) 33, 40, 673, M08 881,927, 955, 964 Thigh Poia 23 THUMB BREADTH (THUMBBR, 106) 34, 49, 674,88 882,94955, 964 ThumlAip 23 THUMBTIP REACH

Cross-Genotypic Examination of Hepatitis C Virus Polymerase Inhibitors Reveals a Novel Mechanism of Action for Thumb Binders

PubMed Central

Eltahla, Auda A.; Tay, Enoch; Douglas, Mark W.

2014-01-01

Direct-acting antivirals (DAAs) targeting proteins encoded by the hepatitis C virus (HCV) genome have great potential for the treatment of HCV infections. However, the efficacy of DAAs designed to target genotype 1 (G1) HCV against non-G1 viruses has not been characterized fully. In this study, we investigated the inhibitory activities of nonnucleoside inhibitors (NNIs) against the HCV RNA-dependent RNA polymerase (RdRp). We examined the ability of six NNIs to inhibit G1b, G2a, and G3a subgenomic replicons in cell culture, as well as in vitro transcription by G1b and G3a recombinant RdRps. Of the six G1 NNIs, only the palm II binder nesbuvir demonstrated activity against G1, G2, and G3 HCV, in both replicon and recombinant enzyme models. The thumb I binder JTK-109 also inhibited G1b and G3a replicons and recombinant enzymes but was 41-fold less active against the G2a replicon. The four other NNIs, which included a palm I binder (setrobuvir), two thumb II binders (lomibuvir and filibuvir), and a palm β-hairpin binder (tegobuvir), all showed at least 40-fold decreases in potency against G2a and G3a replicons and the G3a enzyme. This antiviral resistance was largely conferred by naturally occurring amino acid residues in the G2a and G3a RdRps that are associated with G1 resistance. Lomibuvir and filibuvir (thumb II binders) inhibited primer-dependent but not de novo activity of the G1b polymerase. Surprisingly, these compounds instead specifically enhanced the de novo activity at concentrations of ≥100 nM. These findings highlight a potential differential mode of RdRp inhibition for HCV NNIs, depending on their prospective binding pockets, and also demonstrate a surprising enhancement of de novo activity for thumb RdRp binders. These results also provide a better understanding of the antiviral coverage for these polymerase inhibitors, which will likely be used in future combinational interferon-free therapies. PMID:25246395

Macroscopic and microscopic analysis of the thumb carpometacarpal ligaments: a cadaveric study of ligament anatomy and histology.

PubMed

Ladd, Amy L; Lee, Julia; Hagert, Elisabet

2012-08-15

Stability and mobility represent the paradoxical demands of the human thumb carpometacarpal joint, yet the structural origin of each functional demand is poorly defined. As many as sixteen and as few as four ligaments have been described as primary stabilizers, but controversy exists as to which ligaments are most important. We hypothesized that a comparative macroscopic and microscopic analysis of the ligaments of the thumb carpometacarpal joint would further define their role in joint stability. Thirty cadaveric hands (ten fresh-frozen and twenty embalmed) from nineteen cadavers (eight female and eleven male; average age at the time of death, seventy-six years) were dissected, and the supporting ligaments of the thumb carpometacarpal joint were identified. Ligament width, length, and thickness were recorded for morphometric analysis and were compared with use of the Student t test. The dorsal and volar ligaments were excised from the fresh-frozen specimens and were stained with use of a triple-staining immunofluorescent technique and underwent semiquantitative analysis of sensory innervation; half of these specimens were additionally analyzed for histomorphometric data. Mixed-effects linear regression was used to estimate differences between ligaments. Seven principal ligaments of the thumb carpometacarpal joint were identified: three dorsal deltoid-shaped ligaments (dorsal radial, dorsal central, posterior oblique), two volar ligaments (anterior oblique and ulnar collateral), and two ulnar ligaments (dorsal trapeziometacarpal and intermetacarpal). The dorsal ligaments were significantly thicker (p < 0.001) than the volar ligaments, with a significantly greater cellularity and greater sensory innervation compared with the anterior oblique ligament (p < 0.001). The anterior oblique ligament was consistently a thin structure with a histologic appearance of capsular tissue with low cellularity. The dorsal deltoid ligament complex is uniformly stout and robust; this ligament complex is the thickest morphometrically, has the highest cellularity histologically, and shows the greatest degree of sensory nerve endings. The hypocellular anterior oblique ligament is thin, is variable in its location, and is more structurally consistent with a capsular structure than a proper ligament.

Return to football and long-term clinical outcomes after thumb ulnar collateral ligament suture anchor repair in collegiate athletes.

PubMed

Werner, Brian C; Hadeed, Michael M; Lyons, Matthew L; Gluck, Joshua S; Diduch, David R; Chhabra, A Bobby

2014-10-01

To evaluate return to play after complete thumb ulnar collateral ligament (UCL) injury treated with suture anchor repair for both skill position and non-skill position collegiate football athletes and report minimum 2-year clinical outcomes in this population. For this retrospective study, inclusion criteria were complete rupture of the thumb UCL and suture anchor repair in a collegiate football athlete performed by a single surgeon who used an identical technique for all patients. Data collection included chart review, determination of return to play, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) outcomes. A total of 18 collegiate football athletes were identified, all of whom were evaluated for follow-up by telephone, e-mail, or regular mail at an average 6-year follow-up. Nine were skill position players; the remaining 9 played in nonskill positions. All players returned to at least the same level of play. The average QuickDASH score for the entire cohort was 1 out of 100; QuickDASH work score, 0 out of 100; and sport score, 1 out of 100. Average time to surgery for skill position players was 12 days compared with 43 for non-skill position players. Average return to play for skill position players was 7 weeks postoperatively compared with 4 weeks for non-skill position players. There was no difference in average QuickDASH overall scores or subgroup scores between cohorts. Collegiate football athletes treated for thumb UCL injuries with suture anchor repair had quick return to play, reliable return to the same level of activity, and excellent long-term clinical outcomes. Skill position players had surgery sooner after injury and returned to play later than non-skill position players, with no differences in final level of play or clinical outcomes. Management of thumb UCL injuries in collegiate football athletes can be safely and effectively tailored according to the demands of the player's football position. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Epidemiology of digital amputation and replantation in Taiwan: A population-based study.

PubMed

Chang, Dun-Hao; Ye, Shih-Yu; Chien, Li-Chien; Ma, Hsu

2015-10-01

Publications on digital amputation and replantation have been mostly derived from case series in high-volume hand surgery practices, and epidemiological studies are few. This study used a population-based dataset to illustrate the incidence of digital amputation, patient and hospital characteristics, and their relationships with replantation. A claim for reimbursement dataset (2008) was provided as a research database by the Bureau of National Health Insurance, Taiwan. Patients with ICD-9-CM coded as digital amputation (885 and 886) were included. These were cross-referenced with procedure codes for replantation procedures (84.21 and 84.22). We defined the patients who underwent thumb replantation (84.21) and thumb amputation (84.01) during a single hospitalization as replantation failure. Patient and hospital characteristics were studied with statistical analysis. In total, 2358 patients with digital amputation were admitted (1859 male, 499 female), mean age 39.2 ± 15.5 years. The incidence was 10.2/100,000 person-years. The highest incidence was 14.7/100,000 person-years in the age group 45-54 years. Machinery and powered hand tools caused 68.8% of digital amputations. Thumb amputation [odds ratio (OR): 1.35, p = 0.01], private hospital (OR: 1.40, p = 0.01), medical center (OR: 2.38, p < 0.001), regional hospital (OR: 2.41, p < 0.001) and hospitals with an annual volume >20 digital amputations (OR: 4.23, p < 0.001) were associated with higher attempt rates for replantation. Elderly patients (age >65 years) had higher risk of thumb replantation failure (OR: 32.30, p = 0.045), while hospitals with >20 annual replantations had lower risk (OR: 0.11, p = 0.02). Our study of the National Health Insurance database characterized the epidemiology of digital amputation patients undergoing replantation and the facilities in Taiwan where these procedures are performed. The hospitals treating more digital amputation patients had higher attempt rates and lower thumb failure rates. Copyright © 2015. Published by Elsevier Taiwan.

Applying Space Technology to Enhance Control of an Artificial Arm

NASA Technical Reports Server (NTRS)

Atkins, Diane; Donovan, William H.; Novy, Mara; Abramczyk, Robert

1997-01-01

At the present time, myoelectric prostheses perform only one function of the hand: open and close with the thumb, index and middle finger coming together to grasp various shaped objects. To better understand the limitations of the current single-function prostheses and the needs of the individuals who use them, The Institute for Rehabilitation and Research (TIRR), sponsored by the National Institutes of Health (August 1992 - November 1994), surveyed approximately 2500 individuals with upper limb loss. When asked to identify specific features of their current electric prosthesis that needed improvement, the survey respondents overwhelmingly identified the lack of wrist and finger movement as well as poor control capability. Simply building a mechanism with individual finger and wrist motion is not enough. Individuals with upper limb loss tend to reject prostheses that require continuous visual monitoring and concentration to control. Robotics researchers at NASA's Johnson Space Center (JSC) and Rice University have made substantial progress in myoelectric teleoperation. A myoelectric teleoperation system translates signals generated by an able-bodied robot operator's muscles during hand motions into commands that drive a robot's hand through identical motions. Farry's early work in myoelectric teleoperation used variations over time in the myoelectric spectrum as inputs to neural networks to discriminate grasp types and thumb motions. The resulting schemes yielded up to 93% correct classification on thumb motions. More recently, Fernandez achieved 100% correct non-realtime classification of thumb abduction, extension, and flexion on the same myoelectric data. Fernandez used genetic programming to develop functions that discriminate between thumb motions using myoelectric signal parameters. Genetic programming (GP) is an evolutionary programming method where the computer can modify the discriminating functions' form to improve its performance, not just adjust numerical coefficients or weights. Although the function development may require much computational time and many training cases, the resulting discrimination functions can run in realtime on modest computers. These results suggest that myoelectric signals might be a feasible teleoperation medium, allowing an operator to use his or her own hand and arm as a master to intuitively control an anthropomorphic robot in a remote location such as outer space.

[Vascular crisis after multiple tissue transplantation for thumb and other finger reconstruction by toe-to-hand transfer].

PubMed

Zhang, Jian; Huang, Jian; Pan, Jiadong; Zhou, Danya; Yin, Shanqing; Li, Junjie; Wang, Xin

2017-03-01

To explore the causes of vascular crisis after thumb and other finger reconstruction by toe-to-hand transfer and effective treatment methods so as to improve the survival rate of transplanted tissues. Between February 2012 and October 2015, 59 cases of thumb and other finger defects were repaired with different hallux nail flaps with the same vascular pedicle flap to reconstruct thumb and other fingers and repair skin defect. The donor site was repaired by a perforator flap. A total of 197 free tissues were involved. There were 46 males and 13 females with the average age of 30.6 years (range, 18-42 years). Vascular crisis occurred in 21 free tissues (10.7%) of 17 patients, including 9 arterial crisis (4.6%) of 8 cases, and 12 venous crisis (6.1%) of 10 cases. Conservative treatment was performed first; in 8 free tissues of 7 cases after failure of conservative treatment, anastomotic thrombosis was found in 5 free tissues of 4 cases, twisted vascular pedicle in 1 free tissue of 1 case, surrounding hematoma in 1 free tissue of 1 case, and anastomotic thrombosis associated with hematoma in 1 free tissue of 1 case, which underwent clearing hematoma, resecting embolization, regulating vascular tension, re-anastomosis or vascular transplantation. In 8 cases of arterial crisis, 5 free tissues of 5 cases survived after conservative treatment; partial necrosis occurred in 1 free tissue (1 case) of 4 free tissues (3 cases) undergoing surgical exploration. In 10 cases of venous crisis, 1 free tissue necrosis and 1 free tissue partial necrosis occurred in 8 free tissues (6 cases) undergoing conservative treatment; partial necrosis occurred in 1 free tissue of 4 free tissues (4 cases) undergoing surgical exploration. Free flap and skin graft were performed on 2 free tissues of 4 cases having flap necrosis respectively. Vascular crisis is complex and harmful to survival of transplanted tissue in reconstruction of the thumb and other fingers. Immediate intervention is helpful to obtain a higher survival rate.

Simple heuristics and rules of thumb: where psychologists and behavioural biologists might meet.

PubMed

Hutchinson, John M C; Gigerenzer, Gerd

2005-05-31

The Centre for Adaptive Behaviour and Cognition (ABC) has hypothesised that much human decision-making can be described by simple algorithmic process models (heuristics). This paper explains this approach and relates it to research in biology on rules of thumb, which we also review. As an example of a simple heuristic, consider the lexicographic strategy of Take The Best for choosing between two alternatives: cues are searched in turn until one discriminates, then search stops and all other cues are ignored. Heuristics consist of building blocks, and building blocks exploit evolved or learned abilities such as recognition memory; it is the complexity of these abilities that allows the heuristics to be simple. Simple heuristics have an advantage in making decisions fast and with little information, and in avoiding overfitting. Furthermore, humans are observed to use simple heuristics. Simulations show that the statistical structures of different environments affect which heuristics perform better, a relationship referred to as ecological rationality. We contrast ecological rationality with the stronger claim of adaptation. Rules of thumb from biology provide clearer examples of adaptation because animals can be studied in the environments in which they evolved. The range of examples is also much more diverse. To investigate them, biologists have sometimes used similar simulation techniques to ABC, but many examples depend on empirically driven approaches. ABC's theoretical framework can be useful in connecting some of these examples, particularly the scattered literature on how information from different cues is integrated. Optimality modelling is usually used to explain less detailed aspects of behaviour but might more often be redirected to investigate rules of thumb.

Hand pressures during arboreal locomotion in captive bonobos (Pan paniscus).

PubMed

Samuel, Diana S; Nauwelaerts, Sandra; Stevens, Jeroen M G; Kivell, Tracy L

2018-04-19

Evolution of the human hand has undergone a transition from use during locomotion to use primarily for manipulation. Previous comparative morphological and biomechanical studies have focused on potential changes in manipulative abilities during human hand evolution, but few have focused on functional signals for arboreal locomotion. Here, we provide this comparative context though the first analysis of hand loading in captive bonobos during arboreal locomotion. We quantify pressure experienced by the fingers, palm and thumb in bonobos during vertical locomotion, suspension and arboreal knuckle-walking. The results show that pressure experienced by the fingers is significantly higher during knuckle-walking compared with similar pressures experienced by the fingers and palm during suspensory and vertical locomotion. Peak pressure is most often experienced at or around the third digit in all locomotor modes. Pressure quantified for the thumb is either very low or absent, despite the thumb making contact with the substrate during all suspensory and vertical locomotor trials. Unlike chimpanzees, bonobos do not show a rolling pattern of digit contact with the substrate during arboreal knuckle-walking - instead, we found that digits 3 and 4 typically touch down first and digit 5 almost always made contact with the substrate. These results have implications for interpreting extant and fossilized hand morphology; we expect bonobo (and chimpanzee) bony morphology to primarily reflect the biomechanical loading of knuckle-walking, while functional signals for arboreal locomotion in fossil hominins are most likely to appear in the fingers, particularly digit 3, and least likely to appear in the morphology of the thumb. © 2018. Published by The Company of Biologists Ltd.

[Toe transplantation in congenital malformations of the hand].

PubMed

Foucher, G

1997-11-01

Toe transfer is a well established procedure for thumb and finger reconstruction after mutilation. The indications in congenital malformations are a mater of controversy. Out of a personal series of 209 patients, 42 were children presenting a congenital malformation. Thirty six, with 46 transfers were available for review. There is only one failure at the beginning of our experience. The main indication was absence of pinch either due to absence of thumb (like in congenital band syndrome or some extreme cases of ulnar club hand or cleft hand) or absence of long finger (like in symbrachydactyly monodactylous type) or lack of both thumb and finger (like in peromelic type of symbrachydactyly). In this last type, we have been disappointed by the functional result of the distal implantation of two second toes taken from both feet; we have proposed a "stub" operation consisting in a second toe transfer on the anterior aspect of the radial epiphysis to take advantage of the mobility of the wrist and the availability of plenty tendon transfer (in this proximal situation). When planing to "built" an absent pincer, an early age is mandatory for operation (mean 12 months), to ensure a good cortical integration. A less frequent indication is a partial toe transfer with a vascularized epiphysis to provide growth and mobility in some cases of thumb hypoplasia (like in symbrachydactyly or Blauth and Manske type III b). Results are difficult to assess due to the early operation but if the mobility has been disappointing (mean 32 degrees), sensibility (mean 2PD 5 mm) and growth were excellent.

Prehension synergies: A study of digit force adjustments to the continuously varied load force exerted on a partially constrained hand-held object

PubMed Central

Friedman, Jason; Latash, Mark L.; Zatsiorsky, Vladimir M.

2009-01-01

We examined how the digit forces adjust when a load force acting on a hand-held object continuously varies. The subjects were required to hold the handle still while a linearly increasing and then decreasing force was applied to the handle. The handle was constrained, such that it could only move up and down, and rotate about a horizontal axis. In addition the moment arm of the thumb tangential force was 1.5 times the moment arm of the virtual finger (VF, an imagined finger with the mechanical action equal to that of the four fingers) force. Unlike the situation when there are equal moment arms, the experimental setup forced the subjects to choose between (a) sharing equally the increase in load force between the thumb and virtual finger but generating a moment of tangential force, which had to be compensated by negatively covarying the moment due to normal forces, or (b) sharing unequally the load force increase between the thumb and VF but preventing generation of a moment of tangential forces. We found that different subjects tended to use one of these two strategies. These findings suggest that the selection by the CNS of prehension synergies at the VF-thumb level with respect to the moment of force are non-obligatory and reflect individual subject preferences. This unequal sharing of the load by the tangential forces, in contrast to the previously observed equal sharing, suggests that the invariant feature of prehension may be a correlated increase in tangential forces rather than an equal increase. PMID:19554319

Evaluation of Physical Examination Tests for Thumb Basal Joint Osteoarthritis

PubMed Central

Model, Zina; Liu, Andrew Y.; Kang, Lana; Wolfe, Scott W.; Burket, Jayme C.; Lee, Steve K.

2016-01-01

Background: We compare the ability of 3 diagnostic tests to reproduce the pain of basilar joint arthritis (BJA): the grind test, the lever test (grasping the first metacarpal just distal to the basal joint and shucking back and forth in radial and ulnar directions), and the metacarpophalangeal extension test. Methods: Sixty-two patients with thumb BJA were enrolled. The 3 tests were performed in a random order on both hands of each patient. Prior to testing, patients reported their typical pain level and subsequently rated their pain after each test on a 0 to 10 scale, also specifying the extent to which the test reproduced their thumb pain (fully, partially, not at all). All patients had radiographs that displayed basal joint arthritis. A test was defined as positive for BJA if pain produced was greater than 0. Sensitivity and specificity for each test were calculated using the patients’ history of pain localized to the basal joint and BJA diagnosis on radiographs as the gold standard. Results: The lever test produced the greatest level of pain and best reproduced the presenting pain. The lever test also had the highest sensitivity, high specificity, and the lowest false-negative rate. The grind test had the lowest sensitivity, highest specificity, and highest false-negative rate. Conclusions: The lever test was the diagnostic test that best reproduced the pain caused by thumb basal joint osteoarthritis. We recommend using the lever physical examination test when evaluating the patient with suspected basal joint osteoarthritis. The often-quoted grind test is of limited diagnostic value. PMID:27418899

Rubinstein-Taybi 2 associated to novel EP300 mutations: deepening the clinical and genetic spectrum.

PubMed

López, María; García-Oguiza, Alberto; Armstrong, Judith; García-Cobaleda, Inmaculada; García-Miñaur, Sixto; Santos-Simarro, Fernando; Seidel, Verónica; Domínguez-Garrido, Elena

2018-03-05

Rubinstein-Taybi syndrome (RSTS) is a rare autosomal dominant neurodevelopmental disorder characterized by broad thumbs and halluces. RSTS is caused by mutations in CREBBP and in EP300 genes in 50-60% and 8%, respectively. Up to now, 76 RSTS-EP300 patients have been described. We present the clinical and molecular characterization of a cohort of RSTS patients carrying EP300 mutations. Patients were selected from a cohort of 72 individuals suspected of RSTS after being negative in CREBBP study. MLPA and panel-based NGS EP300 were performed. Eight patients were found to carry EP300 mutations. Phenotypic characteristics included: intellectual disability (generally mild), postnatal growth retardation, infant feeding problems, psychomotor and language delay and typical facial dysmorphisms (microcephaly, downslanting palpebral fissures, columella below the alae nasi, and prominent nose). Broad thumbs and/or halluces were common, but angulated thumbs were only found in two patients. We identified across the gene novel mutations, including large deletion, frameshift mutations, nonsense, missense and splicing alterations, confirming de novo origin in all but one (the mother, possibly underdiagnosed, has short and broad thumbs and had learning difficulties). The clinical evaluation of our patients corroborates that clinical features in EP300 are less marked than in CREBBP patients although it is difficult to establish a genotype-phenotype correlation although. It is remarkable that these findings are observed in a RSTS-diagnosed cohort; some patients harbouring EP300 mutations could present a different phenotype. Broadening the knowledge about EP300-RSTS phenotype may contribute to improve the management of patients and the counselling to the families.

Dubious space for Artelon joint resurfacing for basal thumb (trapeziometacarpal joint) osteoarthritis. A systematic review.

PubMed

Smeraglia, Francesco; Mariconda, Massimo; Balato, Giovanni; Di Donato, Sigismondo Luca; Criscuolo, Giovanni; Maffulli, Nicola

2018-06-01

Trapeziometacarpal arthritis is a common and disabling condition. There is no evidence in the literature of superiority of one surgical procedure over others. Several prosthetic implants have been introduced to preserve joint mobility. We searched the on Medline (PubMed), Web of Science and Scopus databases using the combined keywords 'artelon', 'thumb', 'carpometacarpal', 'trapeziometacarpal' and 'rhizoarthrosis'; 11 studies were identified. The use of Artelon implant is not recommended because of its high revision rate and worse outcomes compared to conventional techniques. Inert materials subjected to compressive and shearing forces could produce debris and subsequent inflammatory response. There is debate in the published scientific literature regarding the role of preoperative antibiotic profilaxis and post-surgery inflammatory response. Standard techniques such as trapeziectomy alone or combined with interposition or suspensionplasty offer effective treatment for thumb basal joint arthritis. Several prosthetic implants show promising results in terms of pain relief and functional request, but there is a need of long-term randomized controlled trials to demonstrate their equivalence, and eventually superiority, compared to standard techniques.

An increased duplication of ZRS region that caused more than one supernumerary digits preaxial polydactyly in a large Chinese family.

PubMed

Wang, Bin; Diao, Yutao; Liu, Qiji; An, Hongqiang; Ma, Ruiping; Jiang, Guosheng; Lai, Nannan; Li, Ziwei; Zhu, Xiaoxiao; Zhao, Lin; Guo, Qiang; Zhang, Zhen; Sun, Rong; Li, Xia

2016-12-06

Preaxial polydactyly (PPD) is inherited in an autosomal dominant fashion and characterized by the presence of one or more supernumerary digits on the thumb side. It had been identified that point mutation or genomic duplications of the long-range limb-specific cis-regulator - zone of polarizing activity regulatory sequence (ZRS) cause PPD or other limb deformities such as syndactyly type IV (SD4) and Triphalangeal thumb-polysyndactyly syndrome (TPTPS). Most previously reported cases involved with no more than one extra finger; however, the role of the point mutation or genomic duplications of ZRS in the case of more than one redundant finger polydactyly remains unclear. In this article, we reported a family case of more than one redundant finger polydactyly on the thumb side for bilateral hands with a pedigree chart of the family. Results of quantitative PCR (qPCR) and sequence analysis suggested that the relative copy number (RCN) of ZRS but not point mutation (including insertion and deletion) was involved in all affected individuals.

Simplicity and treatment of the typical cleft hand.

PubMed

Upton, J

2004-01-01

The typical cleft hand is now distinguished from symbrachydactyly. This review of the surgical treatment of 108 hands in 63 patients treated over a 28-year period concentrates upon the technical principles of surgical correction. The key to these reconstructions is a wide incision which extends from the ulnar side of the cleft around the malpositioned index finger to the thumb. This wide exposure provides clear identification of all anatomic structures within the palm. There are no tenuous flaps with narrow random pedicles. These difficult surgical corrections may often include index transposition, metacarpal and/or phalangeal osteotomies, joint releases, phalangeal ostectomies, preservation of the adductor pollicis muscle, first dorsal interosseous muscle release, syndactyly separation(s) and thumb duplication correction. Following reposition of all skeletal structures the dorsal and palmar full-thickness flaps are easily contoured to create a satisfactory first webspace. Outcomes data shows that although the pinch and grip remain weak, these hands are quite functional. It is important that the repositioned index ray not interfere with gripping and precision maneuvers between the mobile thumb and the ulnar two digits (ring and small) of the hand.

Tendon rupture associated with excessive smartphone gaming.

PubMed

Gilman, Luke; Cage, Dori N; Horn, Adam; Bishop, Frank; Klam, Warren P; Doan, Andrew P

2015-06-01

Excessive use of smartphones has been associated with injuries. A 29-year-old, right hand-dominant man presented with chronic left thumb pain and loss of active motion from playing a Match-3 puzzle video game on his smartphone all day for 6 to 8 weeks. On physical examination, the left extensor pollicis longus tendon was not palpable, and no tendon motion was noted with wrist tenodesis. The thumb metacarpophalangeal range of motion was 10° to 80°, and thumb interphalangeal range of motion was 30° to 70°. The clinical diagnosis was rupture of the left extensor pollicis longus tendon. The patient subsequently underwent an extensor indicis proprius (1 of 2 tendons that extend the index finger) to extensor pollicis longus tendon transfer. During surgery, rupture of the extensor pollicis longus tendon was seen between the metacarpophalangeal and wrist joints. The potential for video games to reduce pain perception raises clinical and social considerations about excessive use, abuse, and addiction. Future research should consider whether pain reduction is a reason some individuals play video games excessively, manifest addiction, or sustain injuries associated with video gaming.

Massive trapezial metastasis from gastric adenocarcinoma resected and reconstructed with a vascularized scapular bone graft: A case report.

PubMed

Okamoto, Masanori; Yamazaki, Hiroshi; Yoshimura, Yasuo; Aoki, Kaoru; Tanaka, Atsushi; Kato, Hiroyuki

2017-12-01

Isolated metastasis to the hand bones is very rare. Only seven cases of metastasis to the trapezium have been reported. To the best of our knowledge, this is the first report of a single metastasis to the trapezium from a gastric adenocarcinoma. A 62-year-old man presented with pain and massive swelling in the right carpometacarpal joint of the thumb. The patient was diagnosed with trapezial metastasis of advanced gastric adenocarcinoma. The patient underwent systemic chemotherapy with cisplatin and S-1, radiotherapy to the metastatic bone, and treatment with denosumab. One year later, the huge metastatic tumor was resected, and the hand was reconstructed using vascularized scapular bone. Eighteen months postoperatively, the patient was satisfied with the appearance of the reconstructed hand and was able to use his right thumb in activities of daily living. Although rare, metastasis to the trapezium should be considered in patients with persistent and progressive thumb CMC joint pain. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Phocomelia: Case report and differential diagnosis.

PubMed

Osadsky, Captain Rasto

2011-01-01

While rarely seen in the present-day Western world, phocomelia is not uncommon in underdeveloped countries. Phocomelia is an abnormality in which the limbs are not fully formed. It may be inherited as an autosomal recessive or dominant disorder. This case concerns a 12-year-old Afghan boy with multiple skeletal anomalies, most prominently of his right arm, including aplasia of the entire proximal humerus, hypoplasia of the clavicle and scapula, and absence of the radial ray and thumb. A hypoplastic left thumb was also present. Other anomalies included thoracic scoliosis, upper thoracic hemivertebrae, and mild cardiomegaly. The differential diagnosis and likely diagnosis are discussed.

Response Surface Modeling Tolerance and Inference Error Risk Specifications: Proposed Industry Standards

NASA Technical Reports Server (NTRS)

DeLoach, Richard

2012-01-01

This paper reviews the derivation of an equation for scaling response surface modeling experiments. The equation represents the smallest number of data points required to fit a linear regression polynomial so as to achieve certain specified model adequacy criteria. Specific criteria are proposed which simplify an otherwise rather complex equation, generating a practical rule of thumb for the minimum volume of data required to adequately fit a polynomial with a specified number of terms in the model. This equation and the simplified rule of thumb it produces can be applied to minimize the cost of wind tunnel testing.

Toe-to-hand transfer.

PubMed

Yoshimura, M

1980-07-01

Toe-to-hand transfer was performed in 28 patients, involving 33 fingers, using microvascular technique. Of this number, 26 patients (31 fingers) had experienced trauma, and the remaining 2 patients (2 fingers) had a congenital deformity. The toew used for grafting were the great toe (1), the second tow (30), and third toe (2). Success was achieved in all cases, sensory recovery was good, and remarkable improvement was attained in function and cosmetic appearance. Metacarpal hand, amputation of thumb, and amputation thumb and three fingers were good indications for this procedure, which gave satisfactory aesthetic results, even in patients with amputation of single digits.

Perceptual distortion of face deletion by local anaesthesia of the human lips and teeth.

PubMed

Türker, Kemal S; Yeo, Purdee L M; Gandevia, Simon C

2005-08-01

As visual guidance of facial movements is impossible, accurate movements for speech and mastication require an established body image that is formed via the information from mechanoreceptors in the skin, mucosa, periodontium, and proprioceptors in the facial and masticatory muscles and in the jaw joints. In this study we aimed to investigate how the acute deafferentation of lips and teeth alters the established image of lips, teeth and the thumb. We used a psychophysical method to determine whether the perceived sizes of the upper lip and front teeth change when the sensory input from the lips and front teeth is fully blocked. We also examined the perceived size of the thumb to test for acute interactions between the thumb and facial structures. Local anaesthetic blocking of upper lip and upper front teeth significantly increased the perceived size of the upper lip by as much as 100% (range 21-100%) in ten out of eleven subjects tested (overall mean 52%; p=0.001). The perceived size of the upper teeth also significantly increased by as much as 155% (range 30-155%) in eight of the eleven subjects during anaesthesia (overall mean 41%; p=0.035). When the region of anaesthesia was increased and both upper and lower teeth and lips were anaesthetised, the perceived size of the upper lip again increased, by 53% (p=0.040), but the change in perceived size of the upper front teeth (18%) was not significant (p=0.206). In both studies there was no change in perceived size of the thumb. The results illustrate the labile central interaction between sensory inputs and the importance of feedback from peripheral afferents in generating the subjective facial image. The timing, level, and area of anaesthesia may be important modifiers of these interactions.

Prehension synergies and control with referent hand configurations.

PubMed

Latash, Mark L; Friedman, Jason; Kim, Sun Wook; Feldman, Anatol G; Zatsiorsky, Vladimir M

2010-04-01

We used the framework of the equilibrium-point hypothesis (in its updated form based on the notion of referent configuration) to investigate the multi-digit synergies at two levels of a hypothetical hierarchy involved in prehensile actions. Synergies were analyzed at the thumb-virtual finger (VF) level (VF is an imaginary digit with the mechanical action equivalent to that of the four actual fingers) and at the individual finger level. The subjects performed very quick vertical movements of a handle into a target. A load could be attached off-center to provide a pronation or supination torque. In a few trials, the handle was unexpectedly fixed to the table and the digits slipped off the sensors. In such trials, the hand stopped at a higher vertical position and rotated into pronation or supination depending on the expected torque. The aperture showed non-monotonic changes with a large, fast decrease and further increase, ending up with a smaller distance between the thumb and the fingers as compared to unperturbed trials. Multi-digit synergies were quantified using indices of co-variation between digit forces and moments of force across unperturbed trials. Prior to the lifting action, high synergy indices were observed at the individual finger level while modest indices were observed at the thumb-VF level. During the lifting action, the synergies at the individual finger level disappeared while the synergy indices became higher at the thumb-VF level. The results support the basic premise that, within a given task, setting a referent configuration may be described with a few referent values of variables that influence the equilibrium state, to which the system is attracted. Moreover, the referent configuration hypothesis can help interpret the data related to the trade-off between synergies at different hierarchical levels.

One Digit Interruption: The Altered Force Patterns during Functionally Cylindrical Grasping Tasks in Patients with Trigger Digits

PubMed Central

Chen, Po-Tsun; Lin, Chien-Ju; Jou, I-Ming; Chieh, Hsiao-Feng; Su, Fong-Chin; Kuo, Li-Chieh

2013-01-01

Most trigger digit (TD) patients complain that they have problems using their hand in daily or occupational tasks due to single or multiple digits being affected. Unfortunately, clinicians do not know much about how this disease affects the subtle force coordination among digits during manipulation. Thus, this study examined the differences in force patterns during cylindrical grasp between TD and healthy subjects. Forty-two TD patients with single digit involvement were included and sorted into four groups based on the involved digits, including thumb, index, middle and ring fingers. Twelve healthy subjects volunteered as healthy controls. Two testing tasks, holding and drinking, were performed by natural grasping with minimal forces. The relations between the force of the thumb and each finger were examined by Pearson correlation coefficients. The force amount and contribution of each digit were compared between healthy controls and each TD group by the independent t test. The results showed all TD groups demonstrated altered correlation patterns of the thumb relative to each finger. Larger forces and higher contributions of the index finger were found during holding by patients with index finger involved, and also during drinking by patients with affected thumb and with affected middle finger. Although no triggering symptom occurred during grasping, the patients showed altered force patterns which may be related to the role of the affected digit in natural grasping function. In conclusion, even if only one digit was affected, the subtle force coordination of all the digits was altered during simple tasks among the TD patients. This study provides the information for the future studies to further comprehend the possible injuries secondary to the altered finger coordination and also to adopt suitable treatment strategies. PMID:24391799

One digit interruption: the altered force patterns during functionally cylindrical grasping tasks in patients with trigger digits.

PubMed

Chen, Po-Tsun; Lin, Chien-Ju; Jou, I-Ming; Chieh, Hsiao-Feng; Su, Fong-Chin; Kuo, Li-Chieh

2013-01-01

Most trigger digit (TD) patients complain that they have problems using their hand in daily or occupational tasks due to single or multiple digits being affected. Unfortunately, clinicians do not know much about how this disease affects the subtle force coordination among digits during manipulation. Thus, this study examined the differences in force patterns during cylindrical grasp between TD and healthy subjects. Forty-two TD patients with single digit involvement were included and sorted into four groups based on the involved digits, including thumb, index, middle and ring fingers. Twelve healthy subjects volunteered as healthy controls. Two testing tasks, holding and drinking, were performed by natural grasping with minimal forces. The relations between the force of the thumb and each finger were examined by Pearson correlation coefficients. The force amount and contribution of each digit were compared between healthy controls and each TD group by the independent t test. The results showed all TD groups demonstrated altered correlation patterns of the thumb relative to each finger. Larger forces and higher contributions of the index finger were found during holding by patients with index finger involved, and also during drinking by patients with affected thumb and with affected middle finger. Although no triggering symptom occurred during grasping, the patients showed altered force patterns which may be related to the role of the affected digit in natural grasping function. In conclusion, even if only one digit was affected, the subtle force coordination of all the digits was altered during simple tasks among the TD patients. This study provides the information for the future studies to further comprehend the possible injuries secondary to the altered finger coordination and also to adopt suitable treatment strategies.

The Envelope of Physiological Motion of the First Carpometacarpal Joint

PubMed Central

Crisco, Joseph J.; Patel, Tarpit; Halilaj, Eni; Moore, Douglas C.

2015-01-01

Much of the hand's functional capacity is due to the versatility of the motions at the thumb carpometacarpal (CMC) joint, which are presently incompletely defined. The aim of this study was to develop a mathematical model to completely describe the envelope of physiological motion of the thumb CMC joint and then to examine if there were differences in the kinematic envelope between women and men. In vivo kinematics of the first metacarpal with respect to the trapezium were computed from computed tomography (CT) volume images of 44 subjects (20M, 24F, 40.3 ± 17.7 yr) with no signs of CMC joint pathology. Kinematics of the first metacarpal were described with respect to the trapezium using helical axis of motion (HAM) variables and then modeled with discrete Fourier analysis. Each HAM variable was fit in a cyclic domain as a function of screw axis orientation in the trapezial articular plane; the RMSE of the fits was 14.5 deg, 1.4 mm, and 0.8 mm for the elevation, location, and translation, respectively. After normalizing for the larger bone size in men, no differences in the kinematic variables between sexes could be identified. Analysis of the kinematic data also revealed notable coupling of the primary rotations of the thumb with translation and internal and external rotations. This study advances our basic understanding of thumb CMC joint function and provides a complete description of the CMC joint for incorporation into future models of hand function. From a clinical perspective, our findings provide a basis for evaluating CMC pathology, especially the mechanically mediated aspects of osteoarthritis (OA), and should be used to inform artificial joint design, where accurate replication of kinematics is essential for long-term success. PMID:26201612

Corticospinal control of the thumb-index grip depends on precision of force control: a transcranial magnetic stimulation and functional magnetic resonance imagery study in humans.

PubMed

Bonnard, M; Galléa, C; De Graaf, J B; Pailhous, J

2007-02-01

The corticospinal system (CS) is well known to be of major importance for controlling the thumb-index grip, in particular for force grading. However, for a given force level, the way in which the involvement of this system could vary with increasing demands on precise force control is not well-known. Using transcranial magnetic stimulation and functional magnetic resonance imagery, the present experiments investigated whether increasing the precision demands while keeping the averaged force level similar during an isometric dynamic low-force control task, involving the thumb-index grip, does affect the corticospinal excitability to the thumb-index muscles and the activation of the motor cortices, primary and non-primary (supplementary motor area, dorsal and ventral premotor and in the contralateral area), at the origin of the CS. With transcranial magnetic stimulation, we showed that, when precision demands increased, the CS excitability increased to either the first dorsal interosseus or the opponens pollicis, and never to both, for similar ongoing electromyographic activation patterns of these muscles. With functional magnetic resonance imagery, we demonstrated that, for the same averaged force level, the amplitude of blood oxygen level-dependent signal increased in relation to the precision demands in the hand area of the contralateral primary motor cortex in the contralateral supplementary motor area, ventral and dorsal premotor area. Together these results show that, during the course of force generation, the CS integrates online top-down information to precisely fit the motor output to the task's constraints and that its multiple cortical origins are involved in this process, with the ventral premotor area appearing to have a special role.

System description document for the Anthrobot-2: A dexterous robot hand

NASA Technical Reports Server (NTRS)

Ali, Michael S.; Engler, Charles, Jr.

1991-01-01

The Anthrobot-2 is an anatomically correct, fully functioning robot hand. The number of fingers, the proportions of the links, the placement and motion of the thumb, and the shape of the palm follow those of the human hand. Each of the finger and thumb joints are servo-controlled. The Anthrobot-2 also includes a two-degree-of-freedom wrist. The entire package, including wrist, hand, and actuators, will mount on the ends of a variety of industrial manipulators. A patent has been applied for on the design. The Anthrobot-2 will be useful in tasks where dexterous manipulation or telemanipulation are required.

Pollicisation: The Myth about Creating a Pseudo-Trapezium.

PubMed

Mennen, Ulrich

2018-06-01

We have performed 14 pollicisations without creating a "pseudo-trapezium" from the metacarpal head. The entire metacarpal of the intended finger to be pollicised is removed and the proximal phalanx of the finger is inserted into the space left by the base of the excised metacarpal. The results are good to excellent in all 14 cases followed for 2-9 years. The advantages are that the operation is much simpler, thus also much quicker. The new thumb looks more like a thumb (not too long) and is more stable (ball-and-socket joint), with no long term complications often seen with the pseudo-trapezium.

Simultaneous dislocation of the metacarpophalangeal and interphalangeal joints of the thumb.

PubMed

Tabib, William; Sayegh, Samir

2002-01-01

Combined dislocation of the metacarpophalangeal and interphalangeal joints of the thumb is uncommon. We know of only four previously reported cases. We report a new case characterised by dorsal dislocation of both joints. Because of entrapment of the volar plate, open reduction at the interphalangeal joint was necessary. The metacarpophalangeal dislocation was treated by closed reduction. After three weeks of immobilisation, physiotherapy resulted in a satisfactory outcome. Even if the diagnosis of dislocation of the interphalangeal joint is obvious it would be easy to overlook a simultaneous dislocation of the metacarpophalangeal joint with serious consequences. Whole hand examination remains an essential rule.

The preferable keypad layout for ease of pressing small cell phone keys with the thumb.

PubMed

Muraki, Satoshi; Okabe, Keiichi; Abe, Tetsuji; Sai, Akishige

2010-12-01

The present study investigated the effect of keypad layout on the ease of operating small cell phones with the thumb in one-handed operations by young and elderly male and female participants. Eighteen young participants (9 males and 9 females) and 12 elderly participants (6 males and 6 females) operated 9 different keypads modeled after commercially available cordless handsets. Keypads designed by using the L9 orthogonal array differed in vertical pitch (V-Pitch: 7, 8, 9 mm) between keys, horizontal pitch (H-Pitch: 10, 11, 12 mm) between keys, the margin below the bottom row of keys (B-Margin: 5, 13, 21 mm), and phone body width (P-Width: 38, 41, 44 mm). Results concerning subjective overall usability showed the lowest scores for a V-Pitch of 7 mm and a B-Margin of 5 mm in most groups. However, for the female participants, with shorter thumbs, the increase in V-pitch did not improve operability. In the elderly participants, miskeying frequently occurred at dial keys of specific numbers. These findings suggest that the preferable keypad layout differs between different age groups and between male and female participants.

The exploded hand syndrome: a report of five industrial injury cases.

PubMed

Al-Qattan, M M

2013-10-01

The term 'exploded hand syndrome' refers to a specific type of crush injury to the hand in which a high compressive force excessively flattens the hand leading to thenar muscle extrusion through burst lacerations. Out of 89 crushed hands seen over a period of seven years, only five had exploded hand syndrome. They were all male industrial workers ranging in age between 24 and 55 years. All patients had thenar muscle extrusion. Other concurrent injuries included fractures/dislocations, compartment syndrome, and ischaemia. All patients were treated by excision of the extruded intrinsic muscles, as well as primary management of concurrent injuries. All patients had functional assessment including: motor power and sensory testing, range of motion of hand joints, and the quick DASH score. Objective testing showed reduced sensibility in the thumb, reduced grip strength (mean 52% of contralateral hand), reduced pinch strength (mean of 27% of contralateral hand), reduced thumb opposition (the mean Kapandji Score was 5 out of 10), and deficits in the range of motion of the metacarpophalangeal and interphalangeal joints of the thumb. The quick DASH score ranged from 11 to 49 and only two patients were able to go back to regular manual work.

Age related prevalence of hand osteoarthritis diagnosed by photography (HOASCORE).

PubMed

Jonsson, Helgi

2017-12-02

Hand photography has been used in a number of studies to determine the presence and severity of hand osteoarthritis (HOA). The aim of this study was to present age and gender specific prevalences of HOA diagnosed by this method. Six thousand three hundred forty three photographs (from 3676 females and 2667 males aged 40-96) were scored for hand osteoarthritis by a 0-3 grade (0 = no evidence of OA, 1 = possible OA, 2 = definite OA and 3 = severe OA) for each of the three main sites, distal interphalangeal joints (DIP), proximal interphalangeal joints (PIP) and thumb base (CMC1). An aggregate score of 0-9 was thus obtained (HOASCORE) to reflect the severity of HOA in each case. DIP joints were most commonly affected, followed by the thumb base and the PIP joints. Having definite DIP joint OA starts at a younger age compared with the other two sites, and there is a marked female preponderance in the age groups from 55 to 69, but after 70 the gender differences are less marked and the prevalence is fairly stable. PIP joint prevalence also indicates a female preponderance from 60 to 79. Thumb base OA has a more marked female preponderance and a rising prevalence thoughout life. The prevalence of individuals with no evidence of photographic OA (HOASCORE = 0) drops from 88% to 57% between the age categories 40-49 and 50-54 and decreased to 33% in the 70-74 age group with a slower decline after that age. DIP and PIP prevalence were strongly associated with each other with an OR of 16.6(12.8-21.5),p < 0.001 of having definite OA at the other site. This was less marked for the thumb base with an OR of 2.2(1.8-2.7, p < 0.001), and 2.7(2.0-3.5, p < 0.001) of having definite DIP or PIP HOA respectively. The prevalence of hand OA in DIP, PIP and thumb base joints obtained by the photographic HOASCORE method is higher in women and increases after the age of fifty. These results are in line with those obtained by clinical examination and radiography. The advantage of the method lies in easy applicability and low cost.

[Reconstruction of severe contracture of the first web space and wrist by incorporating pedicled retrograde flap of forearm transplantation].

PubMed

Chen, Jianchong; Wu, Zuhuang; Zhu, Jianxian; Huang, Yongxin; Xie, Baogen

2011-10-01

To summarize the therapeutic effectiveness of incorporating pedicled retrograde flap of forearm transplantation for reconstructing severe contracture of the first web space and wrist. Between November 2005 and February 2010, 26 patients with severe contracture of the first web and wrist were treated. There were 18 males and 8 females with an average age of 27 years (range, 12-45 years). The locations were the right sides in 15 cases and the left sides in 11 cases. The injury reason included hot water scald in 7 cases, explosion hurt in 5 cases, traffic accident in 3 cases, hot pressing in 5 cases, and flame burns in 6 cases. The duration of scar contracture ranged from 6 to 26 months with an average of 11 months. According to the evaluation standard by GU Yudong et al., all had severe contracture of the first web space, and concomitant injuries included adduction deformity thumb, limitation of the thumb extension and opposition function, and carpometacarpal flexion joint deformity. After scar contracture was released, the defect size ranged from 5.8 cm x 4.5 cm to 11.3 cm x 7.2 cm, which were repaired by the incorporating pedicled retrograde flap of forearm of 6.5 cm x 5.0 cm to 12.5 cm x 8.0 cm at size. The donor sites were directly sutured or repaired with skin graft. Blister and partial necrosis occurred at the distal end of the flaps in 2 cases, which were cured after dressing change. The other flaps survived and wounds healed by first intention. Incisions at donor sites healed by first intention. Twenty-six patients were followed up 6 to 24 months (mean, 15 months). The patients had functional recovery in thumb adduction and opposition at different degrees. At 6 months after operation, according to the Swanson et al. AMA system for total thumb activity, the total thumb function was improved significantly, and according to Jensen et al. measurement, the width and angle of the first web space were significantly increased, all showing significant differences (P < 0.05). Incorporating pedicled retrograde flap of forearm transplantation for repairing severe contracture of the first web space and wrist could augment the first web space and improve the wrist flexible function.

Transfer of supinator motor branches to the posterior interosseous nerve in C7-T1 brachial plexus palsy.

PubMed

Bertelli, Jayme Augusto; Ghizoni, Marcos Flavio

2010-07-01

In C7-T1 palsies of the brachial plexus, shoulder and elbow function are preserved, but finger motion is absent. Finger flexion has been reconstructed by tendon or nerve transfers. Finger extension has been restored ineffectively by attaching the extensor tendons to the distal aspect of the dorsal radius (termed tenodesis) or by tendon transfers. In these palsies, supinator muscle function is preserved, because innervation stems from the C-6 root. The feasibility of transferring supinator branches to the posterior interosseous nerve has been documented in a previous anatomical study. In this paper, the authors report the clinical results of supinator motor nerve transfer to the posterior interosseous nerve in 4 patients with a C7-T1 root lesion. Four adult patients with C7-T1 root lesions underwent surgery between 5 and 7 months postinjury. The patients had preserved motion of the shoulder, elbow, and wrist, but they had complete palsy of finger motion. They underwent finger flexion reconstruction via transfer of the brachialis muscle, and finger and thumb extension were restored by transferring the supinator motor branches to the posterior interosseous nerve. This nerve transfer was performed through an incision over the proximal third of the radius. Dissection was carried out between the extensor carpi radialis brevis and the extensor digitorum communis. The patients were followed up as per regular protocol and underwent a final evaluation 12 months after surgery. To document the extent of recovery, the authors assessed the degree of active metacarpophalangeal joint extension of the long fingers. The thumb span was evaluated by measuring the distance between the thumb pulp and the lateral aspect of the index finger. Surgery to transfer the supinator motor branches to the posterior interosseous nerve was straightforward. Twelve months after surgery, all patients were capable of opening their hand and could fully extend their metacarpophalangeal joints. The distance of thumb abduction improved from 0 to 5 cm from the lateral aspect of the index finger. Transferring supinator motor nerves directly to the posterior interosseous nerve is effective in at least partially restoring thumb and finger extension in patients with lower-type injuries of the brachial plexus.

Rule of Thumb Proposing the Size of Aperture Expected to be Sufficient to Resolve Double Stars with Given Parameters

NASA Astrophysics Data System (ADS)

Knapp, Wilfried

2018-01-01

Visual observation of double stars is an anachronistic passion especially attractive for amateurs looking for sky objects suitable for visual observation even in light polluted areas. Session planning then requires a basic idea which objects might be suitable for a given equipment—this question is a long term issue for visual double star observers and obviously not easy to answer, especially for unequal bright components. Based on a reasonably large database with limited aperture observations (done with variable aperture equipment iris diaphragm or aperture masks) a heuristic approach is used to derive a statistically well founded Rule of Thumb formula.

Arthroscopic Management of Scaphoid-Trapezium-Trapezoid Joint Arthritis.

PubMed

Pegoli, Loris; Pozzi, Alessandro

2017-11-01

Scaphoid-trapezium-trapezoid (STT) joint arthritis is a common condition consisting of pain on the radial side of the wrist and base of the thumb, swelling, and tenderness over the STT joint. Common symptoms are loss of grip strength and thumb function. There are several treatments, from symptomatic conservative treatment to surgical solutions, such as arthrodesis, arthroplasties, and prosthesis implant. The role of arthroscopy has grown and is probably the best treatment of this condition. Advantages of arthroscopic management of STT arthritis are faster recovery, better view of the joint during surgery, and possibility of creating less damage to the capsular and ligamentous structures. Copyright © 2017 Elsevier Inc. All rights reserved.

Nested subcritical flows within supercritical systems

NASA Technical Reports Server (NTRS)

Hendricks, R. C.; Braun, M. J.; Wheeler, R. L., III; Mullen, R. L.

1985-01-01

In supercritical systems the design inlet and outlet pressures are maintained above the thermaodynamic critical pressure P sub C. Designers rely on this simple rule of thumb to circumvent problems associated with a subcritical pressure regime nested within the supercritical pressure system along with the uncertainties in heat transfer, fluid mechanics, and thermophysical property variations. The simple rule of thumb is adequate in many low-power designs but is inadequate for high-performance turbomachines and linear systems, where nested two-phase regions can exist. Examples for a free-jet expansion with backpressure greater than P sub C and a rotor (bearing) with ambient pressure greater than P sub C illustrate the existence of subcritical pressure regimes nested within supercritical systems.

Laboratory-acquired vaccinia virus infection in a recently immunized person--Massachusetts, 2013.

PubMed

Hsu, Christopher H; Farland, Julien; Winters, Thomas; Gunn, Julia; Caron, Donna; Evans, Jennifer; Osadebe, Lynda; Bethune, Leon; McCollum, Andrea M; Patel, Nishi; Wilkins, Kimberly; Davidson, Whitni; Petersen, Brett; Barry, M Anita

2015-05-01

On November 26, 2013, the CDC poxvirus laboratory was notified by the Boston Public Health Commission (BPHC) of an inadvertent inoculation of a recently vaccinated (ACAM2000 smallpox vaccine) laboratory worker with wild type vaccinia virus (VACV) Western Reserve. A joint investigation by CDC and BPHC confirmed orthopoxvirus infection in the worker, who had reported a needle stick in his thumb while inoculating a mouse with VACV. He experienced a non-tender, red rash on his arm, diagnosed at a local emergency department as cellulitis. He subsequently developed a necrotic lesion on his thumb, diagnosed as VACV infection. Three weeks after the injury, the thumb lesion was surgically debrided and at 2 months post-injury, the skin lesion had resolved. The investigation confirmed that the infection was the first reported VACV infection in the United States in a laboratory worker vaccinated according to the Advisory Committee on Immunization Practices (ACIP) recommendations. The incident prompted the academic institution to outline biosafety measures for working with biologic agents, such as biosafety training of laboratory personnel, vaccination (if appropriate), and steps in incident reporting. Though vaccination has been shown to be an effective measure in protecting personnel in the laboratory setting, this case report underscores the importance of proper safety measures and incident reporting.

Improving Kinematic Accuracy of Soft Wearable Data Gloves by Optimizing Sensor Locations

PubMed Central

Kim, Dong Hyun; Lee, Sang Wook; Park, Hyung-Soon

2016-01-01

Bending sensors enable compact, wearable designs when used for measuring hand configurations in data gloves. While existing data gloves can accurately measure angular displacement of the finger and distal thumb joints, accurate measurement of thumb carpometacarpal (CMC) joint movements remains challenging due to crosstalk between the multi-sensor outputs required to measure the degrees of freedom (DOF). To properly measure CMC-joint configurations, sensor locations that minimize sensor crosstalk must be identified. This paper presents a novel approach to identifying optimal sensor locations. Three-dimensional hand surface data from ten subjects was collected in multiple thumb postures with varied CMC-joint flexion and abduction angles. For each posture, scanned CMC-joint contours were used to estimate CMC-joint flexion and abduction angles by varying the positions and orientations of two bending sensors. Optimal sensor locations were estimated by the least squares method, which minimized the difference between the true CMC-joint angles and the joint angle estimates. Finally, the resultant optimal sensor locations were experimentally validated. Placing sensors at the optimal locations, CMC-joint angle measurement accuracies improved (flexion, 2.8° ± 1.9°; abduction, 1.9° ± 1.2°). The proposed method for improving the accuracy of the sensing system can be extended to other types of soft wearable measurement devices. PMID:27240364

The Hand of Cercopithecoides williamsi (Mammalia, Primates): Earliest Evidence for Thumb Reduction among Colobine Monkeys

PubMed Central

Frost, Stephen R.; Gilbert, Christopher C.; Pugh, Kelsey D.; Guthrie, Emily H.; Delson, Eric

2015-01-01

Thumb reduction is among the most important features distinguishing the African and Asian colobines from each other and from other Old World monkeys. In this study we demonstrate that the partial skeleton KNM-ER 4420 from Koobi Fora, Kenya, dated to 1.9 Ma and assigned to the Plio-Pleistocene colobine species Cercopithecoides williamsi, shows marked reduction of its first metacarpal relative to the medial metacarpals. Thus, KNM-ER 4420 is the first documented occurrence of cercopithecid pollical reduction in the fossil record. In the size of its first metacarpal relative to the medial metacarpals, C. williamsi is similar to extant African colobines, but different from cercopithecines, extant Asian colobines and the Late Miocene colobines Microcolobus and Mesopithecus. This feature clearly links the genus Cercopithecoides with the extant African colobine clade and makes it the first definitive African colobine in the fossil record. The postcranial adaptations to terrestriality in Cercopithecoides are most likely secondary, while ancestral colobinans (and colobines) were arboreal. Finally, the absence of any evidence for pollical reduction in Mesopithecus implies either independent thumb reduction in African and Asian colobines or multiple colobine dispersal events out of Africa. Based on the available evidence, we consider the first scenario more likely. PMID:25993410

Aase syndrome

MedlinePlus

Aase-Smith syndrome; Hypoplastic anemia - triphalangeal thumbs, Aase-Smith type ... Jones KL, Jones MC, Del Campo M, eds. Smith's Recognizable Patterns of Human Malformation . 7th ed. Philadelphia, ...

[APPLICATION OF WRIST CREASE ISLAND FLAP BASED ON THE SUPERFICIAL PALMAR BRANCH OF THE RADIAL ARTERY FOR THUMB RECONSTRUCTION].

PubMed

Zheng Dawei; Li, Zhangcan; Xu, Li; Zhang, Xuyang; Shi, Rongjian; Sun, Feng; Shou, Kuishui

2015-04-01

To investigate the effectiveness of the island flaps based on the superficial palmar branch of the radial artery (SPBRA) to repair the thumb wound. Between February 2012 and November 2013, 8 cases of thumb defects and bilateral artery defect were treated. There were 5 males and 3 females with an average age of 30.5 years (range, 19-51 years). The injury was caused by crush (4 cases), avulsion (3 cases), and twist (1 case). The injury located at the metacarpophalangeal joints in 3 cases, at the proximal palmar side in 2 cases, and at the interphalangeal joints in 3 cases. The defect size ranged from 3.5 cm x 1.5 cm to 6.5 cm x 2.0 cm. The digital artery defect was 2.5-8.5 cm (mean, 5.3 cm). The disease duration was 2.0-4.5 hours (mean, 3.2 hours). The reversed island flaps based on the SPBRA were designed, which size was 4.0 cm x 2.0 cm to 7.5 cm x 3.0 cm. The donor sites were closed directly. The operation was successfully completed in 7 patients except 1 patient having vascular variation. All flaps survived completely. Wound and incision at the donor site healed by first intention. All patients were followed up 6-18 months (mean, 13 months). The flaps had similar color and texture to adjacent skin. Linear scar was seen at the donor site in 1 patient, with no functional limitation. According to the functional assessment criteria of upper limb by the Hand Surgery Branch of Chinese Medical Association, the results were excellent in 6 cases, good in 1 case, and fair in 1 case, with an excellent and good rate of 87.5%. The reversed island flap based on the SPBRA is an ideal flap for the thumb reconstruction because the advantages of reliable blood supply, easy dissection, less injury at donor site, and good repair results.

“The Golden Rule”: Only a starting point for quality care

PubMed Central

Corazzini, Kirsten N.; Lekan-Rutledge, Deborah; Utley-Smith, Queen; Piven, Mary L.; Colón-Emeric, Cathleen S.; Bailey, Donald; Ammarell, Natalie; Anderson, Ruth A.

2006-01-01

The Golden Rule guides people to choose for others what they would choose for themselves. The Golden Rule is often described as ‘putting yourself in someone else's shoes’, or ‘Do unto others as you would have them do unto you’(Baumrin 2004). The viewpoint held in the Golden Rule is noted in all the major world religions and cultures, suggesting that this may be an important moral truth (Cunningham 1998). The Golden Rule underlies acts of kindness, caring, and altruism that go above and beyond “business as usual” or “usual care” (Huang, 2005). As such, this heuristic or ‘rule of thumb’ has universal appeal and helps guide our behaviors toward the welfare of others. So why question the Golden Rule? Unless used mindfully, any heuristic can be overly-simplistic and lead to unintended, negative consequences. A heuristic is a rule of thumb that people use to simplify potentially overwhelming or complex events. These rules of thumb are largely unconscious, and occur irrespective of training and educational level (Gilovich, Griffin & Kahneman 2002). Rules of thumb, such as the Golden Rule, allow a person to reduce a complex situation to something manageable—e.g., ‘when in doubt, do what I would want done’. Because it is a simplifying tool, however, the Golden Rule may lead to inappropriate actions because important factors may be overlooked. In this article we describe “The Golden Rule” as used by administrators, supervisors, charge nurses, and CNAs in case studies of four nursing homes. By describing use of this rule-of-thumb, we aim to challenge nurses in nursing homes to: 1) be mindful of their use of “The Golden Rule” and its impact on staff and residents; and 2) help staff members think through how and why “The Golden Rule” may impact their relationships with staff and residents. PMID:17334452

[Klippel-Feil syndrome with tracheoesophageal fistula, bifid thumb and cerebral angiolipoma.

PubMed

Urdaneta Carruyo, Eliéxer; Rojas Zerpa, Gustavo; Urdaneta Contreras, Adriana; Maldonado Alviarez, Malvy; Brito Rodríguez, Miguel

2016-12-01

The Klippel-Feil syndrome is a congenital malformation of the skull flap involving complex cervical vertebrae and organs, characterized by a classic triad: short neck, limitation of movement of the head due to cervical spine fusion and low hairline in occipital region. It results from an error in the axial skeleton segmentation of the embryo; its incidence is estimated at 1/40,000-42,000 births and predominates in females. The aim of this paper is to describe the clinical picture of a patient with Klippel-Feil syndrome and multiple malformations, including tracheoesophageal fistula, bifid thumb and intracranial lipomas/angiolipomas,that have not been previously described in the syndrome, so it is considered an exceptional finding. Sociedad Argentina de Pediatría.

Thumb Imprint Based Detection of Hyperbilirubinemia Using Luminescent Gold Nanoclusters

NASA Astrophysics Data System (ADS)

Basu, Srestha; Sahoo, Amaresh Kumar; Paul, Anumita; Chattopadhyay, Arun

2016-12-01

Early and easy detection of diseases, using point-of-care and inexpensive devices, not only provides option for early treatment but also reduces the risk of propagation. Herein we report the fabrication of a robust film based luminescence indicator of bilirubin, which can indicate hyperbilirubinemia through the thumb imprint of the patient. The UV-light induced luminescence intensity of the film, made out of chitosan stabilised gold (Au) nanoclusters, which was effectively quenched in the presence of Cu2+ ions, recovered in the presence of bilirubin from skin or blood serum. Moreover, the sensitivity of detection of bilirubin was tuneable with the amount of Cu2+ added, thereby facilitating the detection of the desired concentration range of bilirubin.

Comparison of methods of evaluating hearing benefit of middle ear surgery.

PubMed

Toner, J G; Smyth, G D

1993-01-01

The objective of this paper is to compare two methods of predicting the level of subjective patient benefit following reconstructive middle ear surgery. This should have always been an important consideration in advising patients regarding surgery, but assumes even more relevance in these days of clinical audit and cost benefit analysis. The two methods studied were the '15/30 dB rule of thumb' (Smyth and Patterson, 1985) and the 'Glasgow plot' (Browning et al., 1991). The predictions of benefit for each of the two methods were compared to the assessment of actual benefits by the patient post-operatively. The results of this comparison in 153 patients were analysed, the rule of thumb was found to be somewhat more sensitive in predicting patient benefit.

Influence of smartphone use styles on typing performance and biomechanical exposure.

PubMed

Ko, Ping-Hsin; Hwang, Yaw-Huei; Liang, Huey-Wen

2016-06-01

Twenty-seven subjects completed 2-min typing tasks using four typing styles: right-hand holding/typing (S-thumb) and two-hand typing at three heights (B-low, B-mid and B-high). The styles had significant effects on typing performance, neck and elbow flexion and muscle activities of the right trapezius and several muscles of the right upper limb (p < 0.0001 by repeated-measure analysis of variance). The subjects typed the fewest words (error-adjusted characters per minute: 78) with the S-thumb style. S-thumb style resulted in similar flexion angles of the neck, elbow and wrist, but significantly increased muscle activities in all tested muscles compared with the B-mid style. Holding the phone high or low reduced the flexion angles of the neck and right elbow compared with the B-mid style, but the former styles increased the muscle activity of the right trapezius. Right-hand holding/typing was not a preferable posture due to high muscle activities and slow typing speed. Practitioner Summary: Right-hand holding/typing was not favoured, due to increased muscle activities and slower typing speed. Holding the phone high or low reduced the flexion angles of the neck and right elbow, but the former styles increased the muscle activity of the right trapezius compared with holding the phone at chest level.

Effect of mechanical forces on finger nail curvature: an analysis of the effect of occupation on finger nails.

PubMed

Sano, Hitomi; Shionoya, Kaori; Ogawa, Rei

2014-04-01

We studied the relationship between mechanical force and nail curvature. The effect of different frequencies and strengths of mechanical force on nail curvature was assessed. In Study 1, 63 carpenters and 63 office workers were enrolled, and the configurations of their thumb nails were assessed by measuring the curve index (defined as nail height/width) and pinch strength. In Study 2, nail curvature and pinch strength of jazz bassists, who characteristically do not use the right fourth and fifth fingers but use the left fifth finger a lot, were compared. In Study 3, the thumb nail curvature and pinch strength of the dominant and nondominant sides of the 126 participants from Study 1 were compared. Study 1: Carpenters had a significantly lower mean thumb nail curve index and higher mean pinch strength. Study 2: The nails of the unused right fourth and fifth fingers were much more curved than the nails of the frequently used left fourth and fifth fingers. The pinch strength of the right fifth finger was much weaker than the pinch strength of the left fifth finger. Study 3: The dominant side had a significantly lower nail curve index and higher pinch strength. The frequency and strength of mechanical forces on finger nails significantly affect nail appearance. © 2014 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Morphology and Mobility of the Reconstructed Basilar Joint of the Pollicized Index Finger.

PubMed

Strugarek-Lecoanet, Clotilde; Chevrollier, Jérémie; Pauchard, Nicolas; Blum, Alain; Dap, François; Dautel, Gilles

2016-09-01

To evaluate outcome and function of the reconstructed basilar thumb joint after index finger pollicization in patients presenting congenital thumb deficiency. Plain radiographs and 4-dimensional dynamic volume computed tomography scan were used to evaluate the outcome of 23 pollicizations performed on 14 children between 1996 and 2009. The mean follow-up was 8 years. Patients performed continuous movements of thumb opposition during the imaging studies. Four-dimensional scan images made it possible to visualize mobility within the reconstructed joint. In 14 cases, union occurred in the metacarpal head/metacarpal base interface. In the 9 other cases, there was a nonunion at this interface. The reconstructed joint was mobile in 20 cases, including 3 in which there was also mobility at the site of the nonunion. In 3 cases in our series, mobility was present only at the site of the nonunion, between the base and the head of the second metacarpal. Remodeling and flattening out of the metacarpal head occurred in 16 of 23 cases. The transposed metacarpal head remained spherical in 7 cases. The reconstructed joint adapts, both morphologically and functionally, allowing movement on all 3 spatial planes. Existing mechanical constraints on the reconstructed joint may explain its remodeled appearance. Therapeutic IV. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Arthrodesis of the thumb interphalangeal joint and finger distal interphalangeal joints with a headless compression screw.

PubMed

Cox, Christopher; Earp, Brandon E; Floyd, W Emerson; Blazar, Philip E

2014-01-01

To study the results of using a small, headless compression screw (AcuTwist) for thumb interphalangeal (IP) joint and finger distal interphalangeal (DIP) joint arthrodeses. Between November 2007 and January 2012, 48 primary arthrodeses of the thumb IP joint or DIP joint in the other digits were performed in 29 consecutive patients with AcuTwist devices. Indications for arthrodesis included 19 cases of osteoarthritis in 25 fingers, 3 cases of lupus in 9 fingers, 2 cases of post-traumatic osteoarthritis in 2 fingers, and 1 case and finger each of acute trauma, neuromuscular disorder, postinfectious osteoarthritis, boutonniere deformity, and Dupuytren contracture. Charts were reviewed for clinical data, and radiographs were assessed for alignment and healing. Age averaged 59 years and follow-up averaged 12 months (range, 2-50 mo). Union occurred in 43 out of 46 fingers (94%). There were no cases of nail deformity, wound complications, tip hypersensitivity, or clinically notable malalignment. Three arthrodeses failed to fuse, including 2 asymptomatic nonunions and 1 fixation loss requiring revision with autograft. The complication rate was 9%. Distal digital joint arthrodesis with the AcuTwist resulted in a fusion rate of 94% with a complication rate of 9%. Our rate of fusion compares favorably with prior series using other methods of fixation. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

How bandwidth selection algorithms impact exploratory data analysis using kernel density estimation.

PubMed

Harpole, Jared K; Woods, Carol M; Rodebaugh, Thomas L; Levinson, Cheri A; Lenze, Eric J

2014-09-01

Exploratory data analysis (EDA) can reveal important features of underlying distributions, and these features often have an impact on inferences and conclusions drawn from data. Graphical analysis is central to EDA, and graphical representations of distributions often benefit from smoothing. A viable method of estimating and graphing the underlying density in EDA is kernel density estimation (KDE). This article provides an introduction to KDE and examines alternative methods for specifying the smoothing bandwidth in terms of their ability to recover the true density. We also illustrate the comparison and use of KDE methods with 2 empirical examples. Simulations were carried out in which we compared 8 bandwidth selection methods (Sheather-Jones plug-in [SJDP], normal rule of thumb, Silverman's rule of thumb, least squares cross-validation, biased cross-validation, and 3 adaptive kernel estimators) using 5 true density shapes (standard normal, positively skewed, bimodal, skewed bimodal, and standard lognormal) and 9 sample sizes (15, 25, 50, 75, 100, 250, 500, 1,000, 2,000). Results indicate that, overall, SJDP outperformed all methods. However, for smaller sample sizes (25 to 100) either biased cross-validation or Silverman's rule of thumb was recommended, and for larger sample sizes the adaptive kernel estimator with SJDP was recommended. Information is provided about implementing the recommendations in the R computing language. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Early detection surveillance for an emerging plant pathogen: a rule of thumb to predict prevalence at first discovery.

PubMed

Parnell, S; Gottwald, T R; Cunniffe, N J; Alonso Chavez, V; van den Bosch, F

2015-09-07

Emerging plant pathogens are a significant problem for conservation and food security. Surveillance is often instigated in an attempt to detect an invading epidemic before it gets out of control. Yet in practice many epidemics are not discovered until already at a high prevalence, partly due to a lack of quantitative understanding of how surveillance effort and the dynamics of an invading epidemic relate. We test a simple rule of thumb to determine, for a surveillance programme taking a fixed number of samples at regular intervals, the distribution of the prevalence an epidemic will have reached on first discovery (discovery-prevalence) and its expectation E(q*). We show that E(q*) = r/(N/Δ), i.e. simply the rate of epidemic growth divided by the rate of sampling; where r is the epidemic growth rate, N is the sample size and Δ is the time between sampling rounds. We demonstrate the robustness of this rule of thumb using spatio-temporal epidemic models as well as data from real epidemics. Our work supports the view that, for the purposes of early detection surveillance, simple models can provide useful insights in apparently complex systems. The insight can inform decisions on surveillance resource allocation in plant health and has potential applicability to invasive species generally. © 2015 The Author(s).

Early detection surveillance for an emerging plant pathogen: a rule of thumb to predict prevalence at first discovery

PubMed Central

Parnell, S.; Gottwald, T. R.; Cunniffe, N. J.; Alonso Chavez, V.; van den Bosch, F.

2015-01-01

Emerging plant pathogens are a significant problem for conservation and food security. Surveillance is often instigated in an attempt to detect an invading epidemic before it gets out of control. Yet in practice many epidemics are not discovered until already at a high prevalence, partly due to a lack of quantitative understanding of how surveillance effort and the dynamics of an invading epidemic relate. We test a simple rule of thumb to determine, for a surveillance programme taking a fixed number of samples at regular intervals, the distribution of the prevalence an epidemic will have reached on first discovery (discovery-prevalence) and its expectation E(q*). We show that E(q*) = r/(N/Δ), i.e. simply the rate of epidemic growth divided by the rate of sampling; where r is the epidemic growth rate, N is the sample size and Δ is the time between sampling rounds. We demonstrate the robustness of this rule of thumb using spatio-temporal epidemic models as well as data from real epidemics. Our work supports the view that, for the purposes of early detection surveillance, simple models can provide useful insights in apparently complex systems. The insight can inform decisions on surveillance resource allocation in plant health and has potential applicability to invasive species generally. PMID:26336177

Investigation of force, contact area, and dwell time in finger-tapping tasks on membrane touch interface.

PubMed

Liu, Na; Yu, Ruifeng

2018-06-01

This study aimed to determine the touch characteristics during tapping tasks on membrane touch interface and investigate the effects of posture and gender on touch characteristics variables. One hundred participants tapped digits displayed on a membrane touch interface on sitting and standing positions using all fingers of the dominant hand. Touch characteristics measures included average force, contact area, and dwell time. Across fingers and postures, males exerted larger force and contact area than females, but similar dwell time. Across genders and postures, thumb exerted the largest force and the force of the other four fingers showed no significant difference. The contact area of the thumb was the largest, whereas that of the little finger was the smallest; the dwell time of the thumb was the longest, whereas that of the middle finger was the shortest. Relationships among finger sizes, gender, posture and touch characteristics were proposed. The findings helped direct membrane touch interface design for digital and numerical control products from hardware and software perspectives. Practitioner Summary: This study measured force, contact area, and dwell time in tapping tasks on membrane touch interface and examined effects of gender and posture on force, contact area, and dwell time. The findings will direct membrane touch interface design for digital and numerical control products from hardware and software perspectives.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schimmenti, L.A.; Steinberger, J.; Mammel, M.C.

Partial deletion of the short arm of chromosome 9 (p24{r_arrow}pter) and partial duplication of the long arm of chromosome 5 (q32{r_arrow}qter) were observed in an abnormal boy who died at age 8 weeks of a complex cyanotic cardiac defect. He also had minor anomalies, sagittal craniosynostosis, triphalangeal thumbs, hypospadias, and a bifid scrotum. Two other infants with similar cytogenetic abnormalities were described previously. These patients had severe congenital heart defect, genitourinary anomalies, broad nasal bridge, low hairline, apparently low-set ears, short neck, and triphalangeal thumbs, in common with our patient. We suggest that combined monosomy 9q23,24{r_arrow}pter and trisomy 5q31,32{r_arrow}qter maymore » constitute a clinically recognizable syndrome. 13 refs., 2 figs., 2 tabs.« less

A happy "thumbs up" from the crew of the Space Shuttle Endeavour and NASA Dryden Flight Research Center officials heralded the successful completion of mission STS-100

NASA Image and Video Library

2001-05-01

A happy "thumbs up" from the crew of the Space Shuttle Endeavour and NASA Dryden Flight Research Center officials heralded the successful completion of mission STS-100. Standing by the shuttle's rocket nozzles from left to right: Scott E. Prazynski, mission specialist (U.S.); Yuri V. Lonchakov, mission specialist (Russia); Kent V. Rominger, commander (U.S.); Wally Sawyer, NASA Dryden Flight Research Center deputy director; Kevin Petersen, NASA Dryden Flight Research Center director; Umberto Guidoni, mission specialist (European Space Agency); John L. Phillips, mission specialist (U.S.); Jeffrey S. Ashby, pilot (U.S.); and Chris A. Hadfield, mission specialist (Canadian Space Agency). The mission landed at Edwards Air Force Base, California, on May 1, 2001.

Ed Schneider gives a "thumbs-up" after his last flight at the Dryden Flight Research Center

NASA Image and Video Library

2000-09-19

In a lighter mood, Ed Schneider gives a "thumbs-up" after his last flight at the Dryden Flight Research Center on September 19, 2000. Schneider arrived at the NASA Ames-Dryden Flight Research Facility on July 5, 1982, as a Navy Liaison Officer, becoming a NASA research pilot one year later. He has been project pilot for the F-18 High Angle-of-Attack program (HARV), the F-15 aeronautical research aircraft, the NASA B-52 launch aircraft, and the SR-71 "Blackbird" aircraft. He also participated in such programs as the F-8 Digital Fly-By-Wire, the FAA/NASA 720 Controlled Impact Demonstration, the F-14 Automatic Rudder Interconnect and Laminar Flow, and the F-104 Aeronautical Research and Microgravity projects.

Congenital panfollicular nevus associated with polydactyly.

PubMed

Kim, Jinah; Zambrano, Eduardo V; McNiff, Jennifer M

2007-12-01

A 2-year-old girl presented with ulnar-sided duplication of the left thumb distal to the interphalangeal joint and syndactyly of the first web space. She also had several asymptomatic pink-tan cutaneous papules, involving the first and second ray of the left hand and wrist, clinically resembling a linear epidermal nevus. Microscopically, the papules were composed of well-circumscribed aggregates of basaloid epithelium within the dermis. No normal hair follicles were identified. Follicular germ and papillae were identified, representing abortive attempts at hair follicle formation. The features were remarkably similar to a novel entity described by Finn and Argenyi as congenital panfollicular nevus. In our case, the congenital panfollicular nevus was associated with distal thumb polysyndactyly, which may suggest an important link between limb patterning and hair follicle development.

The dorsal transposition flap for congenital contractures of the first web space: a 20-year experience.

PubMed

Friedman, R; Wood, V E

1997-07-01

Fifty-four dorsal transposition flaps were performed in 38 patients (46 hands) for severe congenital thumb web-space contractures. At an average follow-up interval of 6 years, complications or unsatisfactory results had occurred in 100% of symbrachydactyly patients and in 27% of all other patients. Postoperative first web-space angle was augmented an average of 59 degrees with a distal flap two-point discrimination of 8 mm. Mean postoperative pinch and grip strengths were 58% and 72%, respectively, of the normal contralateral hand. Parental satisfaction with the functional results was high, and the aesthetic results were generally acceptable. With the exception of symbrachydactyly patients, the dorsal transposition flap remains an excellent reconstructive option for severe congenital contractures of the thumb web space.

Polar decomposition of the Mueller matrix: a polarimetric rule of thumb for square-profile surface structure recognition.

PubMed

Sanz, J M; Saiz, J M; González, F; Moreno, F

2011-07-20

In this research, the polar decomposition (PD) method is applied to experimental Mueller matrices (MMs) measured on two-dimensional microstructured surfaces. Polarization information is expressed through a set of parameters of easier physical interpretation. It is shown that evaluating the first derivative of the retardation parameter, δ, a clear indication of the presence of defects either built on or dug in the scattering flat surface (a silicon wafer in our case) can be obtained. Although the rule of thumb thus obtained is established through PD, it can be easily implemented on conventional surface polarimetry. These results constitute an example of the capabilities of the PD approach to MM analysis, and show a direct application in surface characterization. © 2011 Optical Society of America

Structural Snapshots of Heparin Depolymerization by Heparin Lyase I

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han, Young-Hyun; Garron, Marie-Line; Kim, Hye-Yeon

2010-01-12

Heparin lyase I (heparinase I) specifically depolymerizes heparin, cleaving the glycosidic linkage next to iduronic acid. Here, we show the crystal structures of heparinase I from Bacteroides thetaiotaomicron at various stages of the reaction with heparin oligosaccharides before and just after cleavage and product disaccharide. The heparinase I structure is comprised of a {beta}-jellyroll domain harboring a long and deep substrate binding groove and an unusual thumb-resembling extension. This thumb, decorated with many basic residues, is of particular importance in activity especially on short heparin oligosaccharides. Unexpected structural similarity of the active site to that of heparinase II with anmore » ({alpha}/{alpha}){sub 6} fold is observed. Mutational studies and kinetic analysis of this enzyme provide insights into the catalytic mechanism, the substrate recognition, and processivity.« less

Flunisolide Nasal Spray

MedlinePlus

... class of medications called corticosteroids. It works by blocking the release of certain natural substances that cause ... your thumb. Point the applicator away from your face. If you are using the spray for the ...

Amputation and Prosthetics

MedlinePlus

... Extremity Prosthetics Find a hand surgeon near you. Videos Figures Figure 1: Thumb Prosthesis - not attached Figure ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...

Flunisolide Oral Inhalation

MedlinePlus

... that the canister is placed into the purple actuator. Hold the canister between your thumb and index ... treatment, repeat steps 4 through 9. Press the actuator back into the straight position. Rinse your mouth ...

Competency-Based Curriculum Development: A Pragmatic Approach

ERIC Educational Resources Information Center

Broski, David; And Others

1977-01-01

Examines the concept of competency-based education, describes an experience-based model for its development, and discusses some empirically derived rules-of-thumb for its application in allied health. (HD)

Thumb Sucking: Help Your Child Break the Habit

MedlinePlus

... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization and proceeds from Web advertising help support our mission. Mayo Clinic does not ...

Picking through Microcomputer Books.

ERIC Educational Resources Information Center

Lu, Cary

1984-01-01

Indicating that most microcomputer books aren't worth reading, offers several rules of thumb for selecting a microcomputer guide. Also provides a list of 13 noteworthy books, providing title, source, and current cost. (JN)

A protocol for a prospective observational study using chest and thumb ECG: transient ECG assessment in stroke evaluation (TEASE) in Sweden.

PubMed

Magnusson, Peter; Koyi, Hirsh; Mattsson, Gustav

2018-04-03

Atrial fibrillation (AF) causes ischaemic stroke and based on risk factor evaluation warrants anticoagulation therapy. In stroke survivors, AF is typically detected with short-term ECG monitoring in the stroke unit. Prolonged continuous ECG monitoring requires substantial resources while insertable cardiac monitors are invasive and costly. Chest and thumb ECG could provide an alternative for AF detection poststroke.The primary objective of our study is to assess the incidence of newly diagnosed AF during 28 days of chest and thumb ECG monitoring in cryptogenic stroke. Secondary objectives are to assess health-related quality of life (HRQoL) using short-form health survey (SF-36) and the feasibility of the Coala Heart Monitor in patients who had a stroke. Stroke survivors in Region Gävleborg, Sweden, will be eligible for the study from October 2017. Patients with a history of ischaemic stroke without documented AF before or during ECG evaluation in the stroke unit will be evaluated by the chest and thumb ECG system Coala Heart Monitor. The monitoring system is connected to a smartphone application which allows for remote monitoring and prompt advice on clinical management. Over a period of 28 days, patients will be monitored two times a day and may activate the ECG recording at symptoms. On completion, the system is returned by mail. This system offers a possibility to evaluate the presence of AF poststroke, but the feasibility of this system in patients who recently suffered from a stroke is unknown. In addition, HRQoL using SF-36 in comparison to Swedish population norms will be assessed. The feasibility of the Coala Heart Monitor will be assessed by a self-developed questionnaire. The study was approved by The Regional Ethical Committee in Uppsala (2017/321). The database will be closed after the last follow-up, followed by statistical analyses, interpretation of results and dissemination to a scientific journal. NCT03301662; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A Novel Method of Newborn Chest Compression: A Randomized Crossover Simulation Study.

PubMed

Smereka, Jacek; Szarpak, Lukasz; Ladny, Jerzy R; Rodriguez-Nunez, Antonio; Ruetzler, Kurt

2018-01-01

Objective: To compare a novel two-thumb chest compression technique with standard techniques during newborn resuscitation performed by novice physicians in terms of median depth of chest compressions, degree of full chest recoil, and effective compression efficacy. Patients and Methods: The total of 74 novice physicians with less than 1-year work experience participated in the study. They performed chest compressions using three techniques: (A) The new two-thumb technique (nTTT). The novel method of chest compressions in an infant consists in using two thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist. (B) TFT. With this method, the rescuer compresses the sternum with the tips of two fingers. (C) TTHT. Two thumbs are placed over the lower third of the sternum, with the fingers encircling the torso and supporting the back. Results: The median depth of chest compressions for nTTT was 3.8 (IQR, 3.7-3.9) cm, for TFT-2.1 (IQR, 1.7-2.5) cm, while for TTHT-3.6 (IQR, 3.5-3.8) cm. There was a significant difference between nTTT and TFT, and TTHT and TFT ( p < 0.001) for each time interval during resuscitation. The degree of full chest recoil was 93% (IQR, 91-97) for nTTT, 99% (IQR, 96-100) for TFT, and 90% (IQR, 74-91) for TTHT. There was a statistically significant difference in the degree of complete chest relaxation between nTTT and TFT ( p < 0.001), between nTTT and TTHT ( p = 0.016), and between TFT and TTHT ( p < 0.001). Conclusion: The median chest compression depth for nTTT and TTHT is significantly higher than that for TFT. The degree of full chest recoil was highest for TFT, then for nTTT and TTHT. The effective compression efficiency with nTTT was higher than for TTHT and TFT. Our novel newborn chest compression method in this manikin study provided adequate chest compression depth and degree of full chest recoil, as well as very good effective compression efficiency. Further clinical studies are necessary to confirm these initial results.

Key Principles of Superfund Remedy Selection

EPA Pesticide Factsheets

Guidance on the primary considerations of remedy selection which are universally applicable at Superfund sites. Key guidance here include: Rules of Thumb for Superfund Remedy Selection and Role of the Baseline Risk Assessment.

Thumb sucking

MedlinePlus

... MedlinePlus Connect for EHRs For Developers U.S. National Library of Medicine 8600 Rockville Pike, Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: 04 June 2018

Atmospheric Turbulence Avoidance

DOT National Transportation Integrated Search

1997-09-09

This Advisory Circular (AC) describes to pilots, aircrew members, dispatchers, : and other operations personnel the various types of clear air turbulence (CAT) : and some of the weather patterns associated with it. Also included are "Rules : of Thumb...

No More Green Thumbs!

ERIC Educational Resources Information Center

Bland, Judith A.

1977-01-01

An alternative method of bacterial spore staining using malachite green is described. This technique is designed to save time and expense by a less messy procedure. Advantages and adaptations of the technique are also given. (MR)

Ectopic banking of amputated great toe for delayed thumb reconstruction: case report.

PubMed

Valerio, Ian L; Hui-Chou, Helen G; Zelken, Jonathan; Basile, Patrick L; Ipsen, Derek; Higgins, James P

2014-07-01

Ectopic banking of amputated parts is a recognized technique for delayed replantation of an amputated part when the amputation stump will not permit immediate replantation. This is conventionally performed with the intent of transferring the injured part back to its anatomic position when the amputation stump is more appropriate for replantation. Current warfare conditions have led to a commonly encountered military trauma injury pattern of multiple extremity amputations with protected trunk and core structures. This pattern poses many challenges, including the limit or absence of donor sites for immediate or delayed flap reconstructive procedures. We describe a case in which we ectopically banked the great toe of an amputated lower extremity for delayed thumb reconstruction. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

[Symbrachydactyly].

PubMed

Samson, P; Mevio, G

2008-12-01

Symbrachydactyly is literally defined as a combination of short fingers with syndactyly. Blauth and Gekeler described four types of symbrachydactyly, ranging from simple shortness of middle phalanges to complete absence of digital rays. In type I (short finger) function is quite normal and syndactyly release is usually the only procedure needed. In type II (cleft hand), presence of a thumb and at least one ulnar finger allows pinch function. Surgical treatment, when needed, consists in separation of webbed fingers, resection of nonfunctional digital stumps, or finger translocation. In type III (monodactyly) all long fingers are absent. Pinch function can be created between the thumb and a toe transfer in ulnar location. Bone lengthening is an alternative procedure to create a pincer. Surgery is not always indicated in type IV (peromely) as function can only be restored if active motion is already present at wrist or carpometacarpal levels.

Extrinsic finger and thumb muscles command a virtual hand to allow individual finger and grasp control.

PubMed

Birdwell, J Alexander; Hargrove, Levi J; Weir, Richard F ff; Kuiken, Todd A

2015-01-01

Fine-wire intramuscular electrodes were used to obtain electromyogram (EMG) signals from six extrinsic hand muscles associated with the thumb, index, and middle fingers. Subjects' EMG activity was used to control a virtual three-degree-of-freedom (DOF) hand as they conformed the hand to a sequence of hand postures testing two controllers: direct EMG control and pattern recognition control. Subjects tested two conditions using each controller: starting the hand from a predefined neutral posture before each new posture and starting the hand from the previous posture in the sequence. Subjects demonstrated their abilities to simultaneously, yet individually, move all three DOFs during the direct EMG control trials; however, results showed subjects did not often utilize this feature. Performance metrics such as failure rate and completion time showed no significant difference between the two controllers.

Randomized controlled trial of nettle sting for treatment of base-of-thumb pain.

PubMed Central

Randall, C; Randall, H; Dobbs, F; Hutton, C; Sanders, H

2000-01-01

There are numerous published references to use of nettle sting for arthritis pain but no randomized controlled trials have been reported. We conducted a randomized controlled double-blind crossover study in 27 patients with osteoarthritic pain at the base of the thumb or index finger. Patients applied stinging nettle leaf (Urtica dioica) daily for one week to the painful area. The effect of this treatment was compared with that of placebo, white deadnettle leaf (Lamium album), for one week after a five-week washout period. Observations of pain and disability were recorded for the twelve weeks of the study. After one week's treatment with nettle sting, score reductions on both visual analogue scale (pain) and health assessment questionnaire (disability) were significantly greater than with placebo (P = 0.026 and P = 0.0027). PMID:10911825

End-state comfort trumps handedness in object manipulation.

PubMed

Coelho, Chase J; Studenka, Breanna E; Rosenbaum, David A

2014-04-01

A goal of research on human perception and performance is to explore the relative importance of constraints shaping action selection. The present study concerned the relative importance of two constraints that have not been directly contrasted: (1) the tendency to grasp objects in ways that afford comfortable or easy-to-control final postures; and (2) the tendency to grasp objects with the dominant rather than the nondominant hand. We asked participants to reach out and grasp a horizontal rod whose left or right end was to be placed into a target after a 90° rotation. In one condition, we told participants which hand to use and let them choose an overhand or underhand initial grasp. In another condition, we told participants which grasp to use and let them choose either hand. Participants sacrificed hand preference to perform the task in a way that ensured a comfortable or easy to control thumb-up posture at the time of object placement, indicating that comfort trumped handedness. A second experiment confirmed that comfort was indeed higher for thumb-down postures than thumb-up postures. A third experiment confirmed that the choice data could be linked to objective performance differences. The results point to the importance of identifying constraint weightings for action selection and support an account of hand selection that ascribes hand preference to sensitivity to performance differences. The results do not support the hypothesis that hand preference simply reflects a bias to use the dominant hand.

Long-Term Follow-Up on the Donor Foot After Thumb Reconstruction Using Big Toe Wrap-Around Flap in Two Different Operation Methods.

PubMed

Ma, Zhi-Guo; Guo, Yong-Jun; Yan, Hou-Jun; Li, Qi-Ming; Ma, Bin

2017-02-01

The function of the donor foot has been affected after using big toe wrap-around flap for thumb reconstruction. A modified operation method has been developed to reduce the adverse effect on the donor foot. The current study compared the long-term effect of the classic and the modified operation methods on the donor foot. Gait analysis was carried out, including how the patient walked, the walking speed and walking distance, and how the patient jumped and ran. Plantar pressure was measured while the patient was standing and moving. A total of 45 patients who received the 2 different operation methods were included. The follow-up time was 4-10 years with a mean of 6.5 years. Various degrees of complications occurred for the 21 patients who received the classic operation method. For these patients, plantar pressure of the donor foot was obviously different comparing with the healthy unaffected foot while the patient was standing or walking. For the 24 patients who received the modified operation method, no obvious complications were observed and the plantar pressure of the donor foot and the healthy unaffected foot was similar while the patient was standing or walking. In conclusion, both the classic and the modified operation methods have affected the function of the donor foot after using the big toe wrap-around flap for thumb reconstruction. However, the donor foot was less affected when the modified operation method was used.

Electrical apparatus lockout device

DOEpatents

Gonzales, Rick

1999-01-01

A simple lockout device for electrical equipment equipped with recessed power blades is described. The device comprises a face-plate (12) having a threaded member (14) attached thereto and apertures suitable for accommodating the power blades of a piece of electrical equipment, an elastomeric nose (16) abutting the face-plate having a hole for passage of the threaded member therethrough and power blade apertures in registration with those of the face-plate, a block (20) having a recess (34) in its forward face for receiving at least a portion of the hose, a hole therein for receiving the threaded member and an integral extension (26) extending from its rear face. A thumb screw (22) suitable for turning with the hands and having internal threads suitable for engaging the threaded member attached to the face-plate is inserted into a passage in the integral extension to engage the threaded member in such a fashion that when the device is inserted over the recessed power blades of a piece of electrical equipment and the thumb screw (22) tightened, the elastomeric nose (16) is compressed between the face-plate (12) and the block (20) forcing it to expand laterally thereby securing the device in the recess and precluding the accidental or intentional energization of the piece of equipment by attachment of a power cord to the recessed power blades. Means are provided in the interval extension and the thumb screw for the attachment of a locking device (46) which will satisfy OSHA standards.

Educational Quality of YouTube Videos in Thumb Exercises for Carpometacarpal Osteoarthritis: A Search on Current Practice.

PubMed

Villafañe, Jorge Hugo; Cantero-Tellez, Raquel; Valdes, Kristin; Usuelli, Federico Giuseppe; Berjano, Pedro

2017-09-01

Conservative treatments are commonly performed therapeutic interventions for the management of carpometacarpal (CMC) joint osteoarthritis (OA). Physical and occupational therapies are starting to use video-based online content as both a patient teaching tool and a source for treatment techniques. YouTube is a popular video-sharing website that can be accessed easily. The purpose of this study was to analyze the quality of content and potential sources of bias in videos available on YouTube pertaining to thumb exercises for CMC OA. The YouTube video database was systematically searched using the search term thumb osteoarthritis and exercises from its inception to March 10, 2017. Authors independently selected videos, conducted quality assessment, and extracted results. A total of 832 videos were found using the keywords. Of these, 10 videos clearly demonstrated therapeutic exercise for the management of CMC OA. In addition, the top-ranked video found by performing a search of "views" was a video with more than 121 863 views uploaded in 2015 that lasted 12.33 minutes and scored only 2 points on the Global Score for Educational Value rating scale. Most of the videos viewed that described conservative interventions for CMC OA management have a low level of evidence to support their use. Although patients and novice hand therapists are using YouTube and other online resources, videos that are produced by expert hand therapists are scarce.

Greying of the human hair: a worldwide survey, revisiting the '50' rule of thumb.

PubMed

Panhard, S; Lozano, I; Loussouarn, G

2012-10-01

While numerous papers have reported on the biological mechanisms of human hair pigmentation and greying, epidemiological descriptions of both natural hair colour and the greying process, worldwide, remain scarce. To assess hair colour and greying in a large world sample of human subjects, and to revisit the validity of the 50/50/50 rule of thumb, which states that 'at age 50 years, 50% of the population has at least 50% grey hair'. The natural hair colour of 4192 healthy male and female volunteers was assessed using a sensorial expert evaluation through the comparison of each volunteer's hair with standard swatches. Hair colour was studied according to age, gender and ethnic or geographical origin. Overall we observed that between 45 and 65 years of age, 74% of people were affected by grey hair with a mean intensity of 27%. Men harboured significantly more grey hair than women. Both age at onset and rate of greying with age appeared to be clearly linked to ethnic/geographical origin. Subjects of Asian and African descent showed less grey hair than those of caucasian origin, at comparable ages, confirming previously reported data. Calculating the percentage of people showing at least 50% grey hair coverage at age 50 years leads to a global range of 6-23%, according to ethnic/geographical origin and natural hair colour: well below that expressed by the '50' rule of thumb. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.

Reverse radial artery flap for soft tissue defects of hand in pediatric age group.

PubMed

Cheema, Saeed Ashraf; Talaat, Nabeela

2009-01-01

To highlight the usefulness of reverse radial artery flap in covering various soft tissue defects of hand in paediatric age group. A total of 16 reverse radial artery flaps were utilized in a period of three years to cover various soft tissue defects of hand for paediatric age group patients. The age ranged from 5-18 years. The two common causes of soft tissue defects in this series were mechanical trauma and fireworks trauma with five cases in each group. Three of the cases were burn victims and other two presented with earth quake injuries. One patient had wound because of road traffic accident. Soft tissue defects of palm were covered with this flap in eight cases while in three cases it was wrapped around the thumb. First web space defects were covered with this flap in two cases. Two cases required coverage of amputation stump at transmetacarpal level and yet another required a big flap to cover the soft tissue defects at palm, dorsum and thumb. Donor site was covered with split skin graft in all cases but one, which was closed primarily. We had partial loss of flap in one case. Grafted donor sites healed uneventfully and were quite acceptable to the patients in due course of time. Reverse radial artery flap has a quite long arc of rotation which brings it great ease to cover the soft tissue defects of various areas of hand like palm, dorsum, first web space and thumb.

Hand kinematics of piano playing

PubMed Central

Flanders, Martha; Soechting, John F.

2011-01-01

Dexterous use of the hand represents a sophisticated sensorimotor function. In behaviors such as playing the piano, it can involve strong temporal and spatial constraints. The purpose of this study was to determine fundamental patterns of covariation of motion across joints and digits of the human hand. Joint motion was recorded while 5 expert pianists played 30 excerpts from musical pieces, which featured ∼50 different tone sequences and fingering. Principal component analysis and cluster analysis using an expectation-maximization algorithm revealed that joint velocities could be categorized into several patterns, which help to simplify the description of the movements of the multiple degrees of freedom of the hand. For the thumb keystroke, two distinct patterns of joint movement covariation emerged and they depended on the spatiotemporal patterns of the task. For example, the thumb-under maneuver was clearly separated into two clusters based on the direction of hand translation along the keyboard. While the pattern of the thumb joint velocities differed between these clusters, the motions at the metacarpo-phalangeal and proximal-phalangeal joints of the four fingers were more consistent. For a keystroke executed with one of the fingers, there were three distinct patterns of joint rotations, across which motion at the striking finger was fairly consistent, but motion of the other fingers was more variable. Furthermore, the amount of movement spillover of the striking finger to the adjacent fingers was small irrespective of the finger used for the keystroke. These findings describe an unparalleled amount of independent motion of the fingers. PMID:21880938

Designing a placebo device: involving service users in clinical trial design.

PubMed

Gooberman-Hill, Rachael; Jinks, Clare; Bouças, Sofia Barbosa; Hislop, Kelly; Dziedzic, Krysia S; Rhodes, Carol; Burston, Amanda; Adams, Jo

2013-12-01

Service users are increasingly involved in the design of clinical trials and in product and device development. Service user involvement in placebo development is crucial to a credible and acceptable placebo for clinical trials, but such involvement has not yet been reported. To enhance the design of a future clinical trial of hand splints for thumb-base osteoarthritis (OA), service users were involved in splint selection and design of a placebo splint. This article describes and reflects on this process. Two fora of service users were convened in 2011. Service users who had been prescribed a thumb splint for thumb-base OA were approached about involvement by Occupational Therapy (OT) practitioners. A total of eight service users took part in the fora. Service users discussed their experience of OA and their own splints and then tried a variety of alternative splints. Through this they identified the active features of splints alongside acceptable and unacceptable design features. Service users focused on wearability and support with or without immobilization. Fora discussed whether a placebo group ('arm') was an acceptable feature of a future trial, and service users developed a potential design for a placebo splint. This is the first project that to involve service users in placebo design. Service users are increasingly involved in product and device design and are ideally placed to identify features to make a placebo credible yet lacking key active ingredients. The future trial will include research into its acceptability. © 2013 John Wiley & Sons Ltd.

Pointers, Lessons Learned, and Rules of Thumb for Successful Vibro-Acoustic Data Acquisition

NASA Technical Reports Server (NTRS)

Rossoni, Peter

1998-01-01

This presentation contains helpful pointers for successful vibroacoustic data acquisition in the following three areas: Instrumentation, Vibration Control and Pyro-shock data acquisition and analysis. A helpful bibliography is provided.

Aircraft noise measurement instrumentation and techniques

DOT National Transportation Integrated Search

1996-08-01

This letter report describes aircraft noise measurement instrumentation to : be used in the field. It includes guidance on good field-measurement : practice, general rules-of-thumb, as well as references to appropriate : national and international st...

De Quervain's Tenosynovitis

MedlinePlus

... Quervain's tenosynovitis than do other age groups, including children. Sex. The condition is more common in women. Being pregnant. The condition may be associated with pregnancy. Baby care. Lifting your child repeatedly involves using your thumbs as leverage and ...

Understanding Singular Vectors

ERIC Educational Resources Information Center

James, David; Botteron, Cynthia

2013-01-01

matrix yields a surprisingly simple, heuristical approximation to its singular vectors. There are correspondingly good approximations to the singular values. Such rules of thumb provide an intuitive interpretation of the singular vectors that helps explain why the SVD is so…

Heuristics and Problem Solving.

ERIC Educational Resources Information Center

Abel, Charles F.

2003-01-01

Defines heuristics as cognitive "rules of thumb" that can help problem solvers work more efficiently and effectively. Professors can use a heuristic model of problem solving to guide students in all disciplines through the steps of problem-solving. (SWM)

Pitfalls in the Evaluation of Teachers by Principals.

ERIC Educational Resources Information Center

Natriello, Gary; Dornbusch, Sanford M.

1980-01-01

Presents the findings of several studies of evaluation processes and identifies a model that helps to make explicit the components of the evaluation process. Suggests rules of thumb for conducting successful evaluations. (Author/JM)

Arnold on Discovery Middeck (MDDK)

NASA Image and Video Library

2009-03-16

S119-E-005004 (15 March 2009) --- Astronaut Richard Arnold, STS-119 mission specialist, attired in his shuttle launch and entry suit, gives a “thumbs-up” signal on the middeck of Space Shuttle Discovery during postlaunch activities.

Homestake Vein, False Color

NASA Image and Video Library

2011-12-07

This false-color view of a mineral vein called Homestake comes from the panoramic camera Pancam on NASA Mars Exploration Rover Opportunity. The vein is about the width of a thumb and about 18 inches 45 centimeters long.

Heads Up, Shoulders Straight, Stick and Twirl Together

ERIC Educational Resources Information Center

Warrick, James

1977-01-01

With so many roles to juggle and so many complex music problems to resolve, some marching band directors overlook simple rules of thumb to increase their bands' visual and musical impact. Here are some guidelines. (Author/RK)

Arnold on Discovery Flightdeck (FD)

NASA Image and Video Library

2009-03-16

S119-E-005010 (15 March 2009) --- Astronaut Richard Arnold, STS-119 mission specialist, attired in his shuttle launch and entry suit, gives a “thumbs-up” signal on the aft flight deck of Space Shuttle Discovery during postlaunch activities.

Sturckow uses Cycle Ergometer on Middeck (MDDK) during STS-128

NASA Image and Video Library

2009-08-29

S128-E-006315 (29 Aug. 2009) --- Astronaut Rick Sturckow, STS-128 commander, gives a “thumbs-up” signal while exercising on a bicycle ergometer on the middeck of the Earth-orbiting Space Shuttle Discovery.

s125e008027

NASA Image and Video Library

2009-05-16

S125-E-008027 (16 May 2009) --- Astronauts John Grunsfeld (left) and Andrew Feustel, both STS-125 mission specialists, give a `thumbs-up? sign on the middeck of Space Shuttle Atlantis following the mission?s third session of extravehicular activity (EVA).

Linear Hand Burn Contracture Release under Local Anesthesia without Tourniquet.

PubMed

Prasetyono, Theddeus O H; Koswara, Astrid F

2015-10-01

The objective of this report is to present a case of hand burn linear contracture release performed under local anesthesia. It also introduces the one-per-mil tumescent solution consisted of 0.2% lidocaine and 1:1.000.000 epinephrine as a local anesthesia formula, which has the potential of providing adequate anesthesia as well as hemostatic effect during surgery of the hand without tourniquet. The surgery was performed on a 19 year-old male patient with multiple thumb and fingers flexion linear contracture for 105 minutes without any obstacle. The patient did not complain any pain and discomfort during the procedure; while bloodless operative field was successfully achieved. At four-month follow up, the patient could fully extend his thumb, middle and ring finger, while the index was limited by 10° at the DIP joint. Overall, the patient was satisfied with the outcome.

Metacarpophalangeal joint of the thumb arthrodesis using intramedullary interlocking screws XMCP™.

PubMed

Novoa-Parra, C N; Montaner-Alonso, D; Morales-Rodríguez, J

2017-09-04

The study objective was to assess the results of a thumb metacarpophalangeal joint (MCPJ) arthrodesis using intramedullary interlocking screws at 25°, XMCP ™ (Extremity Medical, Parsippany, NJ). Radiographs evaluated the angle of arthrodesis, time of fusion and fixation of the implant. Clinical and functional outcomes were assessed using the DASH questionnaire and the VAS scale. Any complications found during surgery or the follow-up period were noted. We studied 9 patients. The mean follow-up was 27.6 months. Patients showed clinical and radiological evidence of fusion in an average of 8 weeks, the angle of fusion was 25°. There were no complications and no implant had to be removed. The XMCP™ system provides a reliable method for MCPJ arthrodesis for several indications and can be used with other procedures in the complex hand. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Case report: prenatal diagnosis of diastrophic dysplasia by ultrasound at 21 weeks of gestation in a mother with massive obesity.

PubMed

Jung, C; Sohn, C; Sergi, C

1998-04-01

Routine prenatal ultrasound of a massively obese mother at 21 weeks of gestation revealed short-limb dwarfism in the fetus. The proportionate shortening of tubular bones of about 50 per cent of the normal length, the absence of thoracic dysplasia, and a normal head circumference narrowed the diagnosis down to a severe but non-lethal skeletal dysplasia. Ulnar deviation of the hands and talipes made diastrophic dysplasia the most likely differential diagnosis. At post-mortem clinical examination, the diagnosis of diastrophic dysplasia was clearly apparent due to highly specific 'hitch-hiker thumbs', similarly luxated big toes, facial dysmorphism, and a cleft palate. Retrospective re-evaluation of the prenatal ultrasound videos revealed the misplaced thumbs, which together with the ulnar deviation of the wrist and suspected talipes, led to the conclusion that the definitive diagnosis can be established prenatally, even in a mother with massive obesity.

Writing Forces Associated With Four Pencil Grasp Patterns in Grade 4 Children

PubMed Central

Schwellnus, Heidi; Carnahan, Heather; Kushki, Azadeh; Polatajko, Helene; Missiuna, Cheryl

2013-01-01

OBJECTIVE. We investigated differences in handwriting kinetics, speed, and legibility among four pencil grasps after a 10-min copy task. METHOD. Seventy-four Grade 4 students completed a handwriting assessment before and after a copy task. Grip and axial forces were measured with an instrumented stylus and force-sensitive tablet. We used multiple linear regression to analyze the relationship between grasp pattern and grip and axial forces. RESULTS. We found no kinetic differences among grasps, whether considered individually or grouped by the number of fingers on the barrel. However, when grasps were grouped according to the thumb position, the adducted grasps exhibited higher mean grip and axial forces. CONCLUSION. Grip forces were generally similar across the different grasps. Kinetic differences resulting from thumb position seemed to have no bearing on speed and legibility. Interventions for handwriting difficulties should focus more on speed and letter formation than on grasp pattern. PMID:23433277

Two-phase flows within systems with ambient pressure

NASA Technical Reports Server (NTRS)

Hendricks, R. C.; Braun, M. J.; Wheeler, R. L., III; Mullen, R. L.

1985-01-01

In systems where the design inlet and outlet pressures are maintained above the thermodynamic critical pressure, it is often assumed that two phase flows within the system cannot occur. Designers rely on this simple rule of thumb to circumvent problems associated with a highly compressible two phase flow occurring within the supercritical pressure system along with the uncertainties in rotordynamics, load capacity, heat transfer, fluid mechanics, and thermophysical property variations. The simple rule of thumb is adequate in many low power designs but is inadequate for high performance turbomachines and linear systems, where two phase regions can exist even though outlet pressure is greater than critical pressure. Rotordynamic-fluid-mechanic restoring forces depend on momentum differences, and those for a two phase zone can differ significantly from those for a single-phase zone. Using the Reynolds equation the angular velocity, eccentricity, geometry, and ambient conditions are varied to determine the point of two phase flow incipience.

Mayer Rokitansky Kuster Hauser (MRKH) syndrome with absent thumbs and big toes.

PubMed

Yunus, Mahira

2014-01-01

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare developmental failure of Müllerian ducts. Principle clinical features of MRKH syndrome are primary amenorrhoea associated with congenital absence of vagina, uterine anomalies, normal ovaries, 46 XX karyotype with normal female secondary sexual characteristics and frequent association with renal, skeletal, and other congenital anomalies. A case of a 3-year-old child with congenitally absent thumbs and big toes is reported herein; she was brought in with complaints of urinary incontinence. Radiological investigation (ultrasound and magnetic resonance imaging (MRI) scan) revealed absent uterus and vagina while both ovaries were normal. Intravenous urography (IVU) study showed bifid pelvicalyceal systems bilaterally. Karyotyping revealed a 46 XX female phenotype. Laparoscopy confirmed normal ovaries bilaterally and small unfused uterine buds lying beside both ovaries on each side of pelvis. Early diagnosis of MRKH syndrome is essential for timely planning of vaginal and (if possible) uterine reconstructive surgeries.

Epithelioid sarcoma of the thumb associated with hydrazine fuel exposure: a case report.

PubMed

Helmers, Scott; Ruland, Robert T; Jacob, Lionel N

2004-01-01

Hydrazine fuels are commonly used propellants for missiles and tactical jet aircraft used by the U.S. Air Force and the National Aeronautical and Space Administration. Hydrazine fuels are known to cause cancer after respiratory exposure or ingestion in laboratory animals and humans. Although hydrazine is known to cause skin irritation, there are no published reports describing cancer developing after cutaneous exposure to hydrazine in humans. Hydrazine is known to cause cancer in animals after skin exposure and is used to induce angiosarcomas in mice after cutaneous exposure. We present a case of an epithelioid sarcoma developing in the thumb of a patient after repeated exposure to hydrazine fuel. We hypothesize that the epithelioid sarcoma is a consequence of cutaneous exposure to hydrazine fuel. Continued efforts to develop less toxic alternative fuels and increased personal protection from occupational exposure are highly recommended.

Mask roughness induced LER: a rule of thumb -- paper

DOE Office of Scientific and Technical Information (OSTI.GOV)

McClinton, Brittany; Naulleau, Patrick

2010-03-12

Much work has already been done on how both the resist and line-edge roughness (LER) on the mask affect the final printed LER. What is poorly understood, however, is the extent to which system-level effects such as mask surface roughness, illumination conditions, and defocus couple to speckle at the image plane, and currently factor into LER limits. Here, we propose a 'rule-of-thumb' simplified solution that provides a fast and powerful method to obtain mask roughness induced LER. We present modeling data on an older generation mask with a roughness of 230 pm as well as the ultimate target roughness ofmore » 50 pm. Moreover, we consider feature sizes of 50 nm and 22 nm, and show that as a function of correlation length, the LER peaks at the condition that the correlation length is approximately equal to the resolution of the imaging optic.« less

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms.

PubMed

Deshaies, Eric M; Villwock, Mark R; Singla, Amit; Toshkezi, Gentian; Padalino, David J

2015-08-11

Less invasive surgical approaches for intracranial aneurysm clipping may reduce length of hospital stay, surgical morbidity, treatment cost, and improve patient outcomes. We present our experience with a minimally invasive pterional approach for anterior circulation aneurysms performed in a major tertiary cerebrovascular center and compare the results with an aged matched dataset from the Nationwide Inpatient Sample (NIS). From August 2008 to December 2012, 22 elective aneurysm clippings on patients ≤55 years of age were performed by the same dual fellowship-trained cerebrovascular/endovascular neurosurgeon. One patient (4.5%) experienced transient post-operative complications. 18 of 22 patients returned for follow-up imaging and there were no recurrences through an average duration of 22 months. A search in the NIS database from 2008 to 2010, also for patients aged ≤55 years of age, yielded 1,341 hospitalizations for surgical clip ligation of unruptured cerebral aneurysms. Inpatient length of stay and hospital charges at our institution using the minimally invasive thumb-sized pterional technique were nearly half that of NIS (length of stay: 3.2 vs 5.7 days; hospital charges: $52,779 vs. $101,882). The minimally invasive thumb-sized pterional craniotomy allows good exposure of unruptured small and medium-sized supraclinoid anterior circulation aneurysms. Cerebrospinal fluid drainage from key subarachnoid cisterns and constant bimanual microsurgical techniques avoid the need for retractors which can cause contusions, localized venous infarctions, and post-operative cerebral edema at the retractor sites. Utilizing this set of techniques has afforded our patients with a shorter hospital stay at a lower cost compared to the national average.

Patterns of Dupuytren disease in fingers: studying correlations with a multivariate ordinal logit model.

PubMed

Lanting, Rosanne; Nooraee, Nazanin; Werker, Paul M N; van den Heuvel, Edwin R

2014-09-01

Dupuytren disease affects fingers in a variable fashion. Knowledge about specific disease patterns (phenotype) based on location and severity of the disease is lacking. In this cross-sectional study, 344 primary affected hands with Dupuytren disease were physically examined. The Pearson correlation coefficient between the coexistence of Dupuytren disease in pairs of fingers was calculated, and agglomerative hierarchical clustering was applied to identify possible clusters of affected fingers. With a multivariate ordinal logit model, the authors studied the correlation on severity, taking into account age and sex, and tested hypotheses on independence between groups of fingers. The ring finger was most frequently affected by Dupuytren disease, and contractures were seen in 15.1 percent of affected rays. The severity of thumb and index finger, middle and ring fingers, and middle and little fingers was significantly correlated. Occurrences in pairs of fingers were highest in the middle and ring fingers and lowest in the thumb and index finger. Correlation between the ring and little fingers and a correlation between fingers from the ulnar and radial sides could not be demonstrated. Rays on the ulnar side of the hand are predominantly affected. The middle finger is substantially correlated with other fingers on the ulnar side, and the thumb and index finger are correlated; however, there was no evidence that the ulnar side and the radial side were correlated in any way, which suggests that occurrence on one side of the hand does not predict Dupuytren disease on the other side of the hand. Risk, III.

A Scottish cost analysis of interceptive orthodontics for thumb sucking habits.

PubMed

Borrie, Felicity R P; Elouafkaoui, Paula; Bearn, David R

2013-06-01

There is a potential cost saving to be made within the NHS by providing simple interceptive treatment rather than comprehensive treatment at a later date. The focus of this study is to determine the size of this potential cost by looking at the cost to NHS Tayside for the provision of interceptive treatment for cessation of thumb sucking and where this has been unsuccessful (or not provided) the costs of correction of the associated malocclusion. A cost analysis is described, investigating the costs of treatment solely to the NHS, both in the primary and secondary setting. Three potential treatment pathways are identified with the costs calculated for each pathway. The actual cost of providing this treatment in NHS Tayside, and the potential cost saving in Tayside if there was a change in clinical practice are calculated. Both discounting of costs and a sensitivity analysis are performed. The cost to NHS Tayside of current practice was calculated to be between £123,710 and £124,930 per annum. Change in practice to replace use of a removable with a fixed habit breaker for the interceptive treatment of thumb sucking reduced the calculated cost to between £99,581 and £105,017. A saving could be made to the NHS, both locally and nationally, if the provision of a removable habit breaker was changed to a fixed habit breaker. In addition, increasing the proportion receiving active treatment, in the form of a fixed habit breaker, rather than monitoring, would appear to further reduce the cost to the NHS considerably.

Effect of thumb joint mobilization on pressure pain threshold in elderly patients with thumb carpometacarpal osteoarthritis.

PubMed

Villafañe, Jorge H; Silva, Guillermo B; Fernandez-Carnero, Josue

2012-02-01

This study evaluated the effects of Maitland's passive accessory mobilization on local hypoalgesia and strength in thumb carpometacarpal osteoarthritis (TCOA). Twenty-eight patients between 70 and 90 years old with secondary TCOA were randomized into glide mobilization and sham groups. This study was designed as a double-blind, randomized controlled trial. Therapy consisted of Maitland's passive accessory mobilization of the dominant hand during 4 sessions over 2 weeks. We measured pressure pain threshold (PPT) at the trapeziometacarpal joint (TMJ), the tubercle of the scaphoid bone, and the unciform apophysis of the hamate bone by algometry. The tip and tripod pinch strength was also measured. Grip strength was measured by a grip dynamometer. Measurements were taken before treatment and after 1 week (first follow-up [FU]) and 2 weeks (second FU). All values in sham group remained unchanged along the treatment period. In the treated group, the PPT in the TMJ was 3.85 ± 0.35 kg/cm(2), which increased after treatment to 3.99 ± 0.37 and was maintained at the same level during the first FU 3.94 ± 0.39 and second FU 4.74 ± 0.40. In contrast, we found no differences in PPT in the other studied structures after treatment. Similarly, tip, tripod pinch, and grip strength remained without change after treatment. Passive accessory mobilization increased PPT in the TMJ; however, it did not increase motor function in patients with TCOA. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Comparative Dermatoglyphic Study between Autistic Patients and Normal People in Iran

PubMed Central

Kazemi, Mansoureh; Fayyazi-Bordbar, Mohammad Reza; Mahdavi-Shahri, Nasser

2017-01-01

Autism is a neurodevelopmental disorder originating from early childhood; nevertheless, its diagnosis is in older ages. In addition to heredity, environmental factors are also of great significance in the etiology of the disease. Dermatoglyphic patterns, albeit varied, remain stable for a lifetime and yield a large number of patterns upon examination. Studies have shown a significant association between dermatoglyphics and some diseases, especially genetic ones. We compared fingerprints between patients with autism and normal individuals in a Fars population living in Khorasan-Razavi Province, Iran, in 2015. The right and left hand fingerprints of 104 autistic individuals (case group; age range=5–15 y) were collected using a fingerprint scanner. The same process was performed for 102 healthy individuals, in the age range of 6 to 25 years. All dermatoglyphic patterns and ridge counts were determined. The data were analyzed using the Mann–Whitney nonparametric test and binomial distribution. There was a significant difference in the distribution of the dermatoglyphic patterns on the right and left thumbs and the index fingers between the case and control groups (P<0.05). The patients had a significantly higher count of loops on their right and left thumbs and their index fingers. A significant decrease in ridge counts for the right and left thumbs and the index fingers was observed in the patients compared to the controls. The results suggested that the patterns were associated with the risk of autism. The patterns may be drawn upon as biometric parameters in the screening of children with autism. PMID:28761206

Effect of Complete Syndesmotic Disruption and Deltoid Injuries and Different Reduction Methods on Ankle Joint Contact Mechanics.

PubMed

LaMothe, Jeremy; Baxter, Josh R; Gilbert, Susannah; Murphy, Conor I; Karnovsky, Sydney C; Drakos, Mark C

2017-06-01

Syndesmotic injuries can be associated with poor patient outcomes and posttraumatic ankle arthritis, particularly in the case of malreduction. However, ankle joint contact mechanics following a syndesmotic injury and reduction remains poorly understood. The purpose of this study was to characterize the effects of a syndesmotic injury and reduction techniques on ankle joint contact mechanics in a biomechanical model. Ten cadaveric whole lower leg specimens with undisturbed proximal tibiofibular joints were prepared and tested in this study. Contact area, contact force, and peak contact pressure were measured in the ankle joint during simulated standing in the intact, injured, and 3 reduction conditions: screw fixation with a clamp, screw fixation without a clamp (thumb technique), and a suture-button construct. Differences in these ankle contact parameters were detected between conditions using repeated-measures analysis of variance. Syndesmotic disruption decreased tibial plafond contact area and force. Syndesmotic reduction did not restore ankle loading mechanics to values measured in the intact condition. Reduction with the thumb technique was able to restore significantly more joint contact area and force than the reduction clamp or suture-button construct. Syndesmotic disruption decreased joint contact area and force. Although the thumb technique performed significantly better than the reduction clamp and suture-button construct, syndesmotic reduction did not restore contact mechanics to intact levels. Decreased contact area and force with disruption imply that other structures are likely receiving more loads (eg, medial and lateral gutters), which may have clinical implications such as the development of posttraumatic arthritis.

Pain is Associated to Clinical, Psychological, Physical, and Neurophysiological Variables in Women With Carpal Tunnel Syndrome.

PubMed

Fernández-Muñoz, Juan J; Palacios-Ceña, María; Cigarán-Méndez, Margarita; Ortega-Santiago, Ricardo; de-la-Llave-Rincón, Ana I; Salom-Moreno, Jaime; Fernández-de-las-Peñas, César

2016-02-01

To investigate potential relationships of clinical (age, function, side of pain, years with pain), physical (cervical range of motion, pinch grip force), psychological (depression), and neurophysiological (pressure and thermal pain thresholds) outcomes and hand pain intensity in carpal tunnel syndrome (CTS). Two hundred and forty-four (n=224) women with CTS were recruited. Demographic data, duration of the symptoms, function and severity of the disease, pain intensity, depression, cervical range of motion, pinch tip grip force, heat/cold pain thresholds (HPT/CPT), and pressure pain thresholds (PPT) were collected. Correlation and regression analysis were performed to determine the association among those variables and to determine the proportions of explained variance in hand pain intensity. Significant negative correlations existed between the intensity of pain and PPTs over the radial nerve, C5/C6 zygapophyseal joint, carpal tunnel and tibialis anterior muscle, HPT over the carpal tunnel, cervical extension and lateral-flexion, and thumb-middle, fourth, and little finger pinch tip forces. Significant positive correlations between the intensity of hand pain with function and depression were also observed. Stepwise regression analyses revealed that function, thumb-middle finger pinch, thumb-little finger pinch, depression, PPT radial nerve, PPT carpal tunnel, and HPT carpal tunnel were significant predictors of intensity of hand pain (R²=0.364; R² adjusted=0.343; F=16.87; P<0.001). This study showed that 36.5% of the variance of pain intensity was associated to clinical (function), neurophysiological (localized PPT and HPT), psychological (depression), and physical (finger pinch tip force) outcomes in women with chronic CTS.

In vivo recruitment patterns in the anterior oblique and dorsoradial ligaments of the first carpometacarpal joint.

PubMed

Halilaj, Eni; Rainbow, Michael J; Moore, Douglas C; Laidlaw, David H; Weiss, Arnold-Peter C; Ladd, Amy L; Crisco, Joseph J

2015-07-16

The anterior oblique ligament (AOL) and the dorsoradial ligament (DRL) are both regarded as mechanical stabilizers of the thumb carpometacarpal (CMC) joint, which in older women is often affected by osteoarthritis. Inferences on the potential relationship of these ligaments to joint pathomechanics are based on clinical experience and studies of cadaveric tissue, but their functions has been studied sparsely in vivo. The purpose of this study was to gain insight into the functions of the AOL and DRL using in vivo joint kinematics data. The thumbs of 44 healthy subjects were imaged with a clinical computed tomography scanner in functional-task and thumb range-of-motion positions. The origins and insertion sites of the AOL and the DRL were identified on the three-dimensional bone models and each ligament was modeled as a set of three fibers whose lengths were the minimum distances between insertion sites. Ligament recruitment, which represented ligament length as a percentage of the maximum length across the scanned positions, was computed for each position and related to joint posture. Mean AOL recruitment was lower than 91% across the CMC range of motion, whereas mean DRL recruitment was generally higher than 91% in abduction and flexion. Under the assumption that ligaments do not strain by more than 10% physiologically, our findings of mean ligament recruitments across the CMC range of motion indicate that the AOL is likely slack during most physiological positions, whereas the DRL may be taut and therefore support the joint in positions of CMC joint abduction and flexion. Copyright © 2015 Elsevier Ltd. All rights reserved.

In vivo recruitment patterns in the anterior oblique and dorsoradial ligaments of the first carpometacarpal joint

PubMed Central

Halilaj, Eni; Rainbow, Michael J.; Moore, Douglas C.; Laidlaw, David H.; Weiss, Arnold-Peter C.; Ladd, Amy L.; Crisco, Joseph J.

2015-01-01

The anterior oblique ligament (AOL) and the dorsoradial ligament (DRL) are both regarded as mechanical stabilizers of the thumb carpometacarpal (CMC) joint, which in older women is often affected by osteoarthritis. Inferences on the potential relationship of these ligaments to joint pathomechanics are based on clinical experience and studies of cadaveric tissue, but their function has been studied sparsely in vivo. The purpose of this study was to gain insight into the functions of the AOL and DRL using in vivo joint kinematic data. The thumbs of 44 healthy subjects were imaged with a clinical computed tomography scanner in functional-task and thumb range-of-motion positions. The origins and insertion sites of the AOL and the DRL were identified on the 3D bone models and each ligament was modeled as a set of three fibers whose lengths were the minimum distances between insertion sites. Ligament recruitment, which represented ligament length as a percentage of the maximum length across the scanned positions, was computed for each position and related to joint posture. Mean AOL recruitment was lower than 91% across the CMC range of motion, whereas mean DRL recruitment was generally higher than 91% in abduction and flexion. Under the assumption that ligaments do not strain by more than 10% physiologically, our findings of mean ligament recruitments across the CMC range of motion indicate that the AOL is likely slack during most physiological positions, whereas the DRL may be taut and therefore support the joint in positions of CMC joint abduction and flexion. PMID:25964211

25 CFR 117.33 - Signature of illiterates.

Code of Federal Regulations, 2010 CFR

2010-04-01

... order and sign receipts or other documents by making an imprint of the ball of the right thumb (or the left, if he has lost his right) after his name. This imprint shall be clear and distinct, showing the...

Intermodal Ground Access to Airports: A Planning Guide - A Good Start

DOT National Transportation Integrated Search

1997-01-01

This Guide is designed to provide policy guidance, rules of thumb, data, and analytical techniques related to airport access. It has been prepared to help airport operator, local governments, metropolitan planning organizations, consultants and other...

Increment and mortality in a virgin Douglas-fir forest.

Treesearch

Robert W. Steele; Norman P. Worthington

1955-01-01

Is there any basis to the forester's rule of thumb that virgin forests eventually reach an equilibrium where increment and mortality approximately balance? Are we wasting potential timber volume by failing to salvage mortality in old-growth stands?

Research Update: Write Research to be Read.

ERIC Educational Resources Information Center

Murray, Donald M.

1982-01-01

Discusses 10 rules of thumb for writing educational research reports that are concise and accessible. The principles include writing in terms of people, emphasizing the positive, editing for simplicity, and breaking any of the previously discussed rules when necessary. (HTH)

Watermelon quality traits as affected by ploidy

USDA-ARS?s Scientific Manuscript database

Growers offering high quality watermelons [Citrullus lanatus (Thumb.), Matsum & Nakai] that are also high in phytonutrients will have stronger market opportunities. In order to offer highly nutritious fruit, the industry must understand the nature of phytonutrient accumulation as it is affected by ...

Unexplained Weight Loss

MedlinePlus

... weight is affected by your calorie intake, activity level, overall health, age, nutrient absorption, and economic and social factors. If you're losing weight without trying and you're concerned about it, consult your doctor — as a rule of thumb, losing more than 5 ...

Making Simple Folk Instruments for Children.

ERIC Educational Resources Information Center

Cline, Dallas

1980-01-01

Instructions are provided for making these simple musical instruments from inexpensive materials: an Indian bull-roarer; bottle chimes; a ham can guitar; flower pot, box, and steel drums; a xylophone; a musical sawhorse; rattles; a melody box; and a box thumb harp. (SJL)

Expedition 15 FE Kotov poses for a photo in the US Lab

NASA Image and Video Library

2007-10-07

ISS015-E-32250 (7 Oct. 2007) --- Cosmonaut Oleg V. Kotov, Expedition 15 flight engineer representing Russia's Federal Space Agency, gives a "thumbs-up" signal while floating in the Destiny laboratory of the International Space Station.

Mukai gives thumbs up on middeck

NASA Image and Video Library

1998-10-29

STS095-E-5037 (10-29-98) --- Holding a notebook filled with Flight Day 1 activity, payload specialist Chiaki Mukai gives an "all okay" signal. The photograph was taken with an electronic still camera (ESC) at 10:04:30 GMT, Oct. 29.

Payload bay activity during second EVA of STS-72 mission

NASA Image and Video Library

1996-01-16

STS072-393-008 (17 Jan. 1996) --- Astronaut Leroy Chiao gives a thumbs up signal, marking the success of his second extravehicular activity (EVA) in three days. Chiao was joined by astronaut Winston E. Scott on this EVA.

Right-Handed and Left-Footed? How Andrea Learned to Question the Facts.

ERIC Educational Resources Information Center

Lord, Thomas R.

1986-01-01

Describes several tests for determining dominance of children's hands, eyes, feet, and thumbs. Discusses the relationship between hemispheric brain dominance and dominant sides of the body. Suggests that raising questions about generalizations can lead to new learning. (TW)

How to handle stuck pipe and fishing problems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brouse, M.

1983-01-01

This paper presents valuable information on evaluating fishing problems, including a rule of thumb equation for estimating the number of days that should be spent fishing. Also given is a description and usage breakdown of the numerous tools available to the operator.

The Greatest Gift.

ERIC Educational Resources Information Center

Chamberlin, Leslie J.

1981-01-01

Argues that the teacher's most significant contribution is to help children believe in their capabilities. Several rules of thumb for teachers are mentioned: avoid negativism, create success opportunities for students, relate to students as individuals, encourage risk-taking, communicate help with social needs, and build student feelings of…

Administrative Decision Making and Quasi Decision Making: An Empirical Study Using the Protocol Method.

ERIC Educational Resources Information Center

Fraser, Hugh W.; Anderson, Mary E.

1982-01-01

This exploratory study attempted to identify variables in need of further investigation. Those to emerge included heuristics or rules of thumb used by administrators in decision making, personality variables, and methods for evaluating alternatives. (Author/JM)

Parents and Computers: Partners in Helping Children Learning to Read (Reading Technology).

ERIC Educational Resources Information Center

Rickelman, Robert J.; Henk, William A.

1991-01-01

Provides suggestions that teachers can pass on to parents about how computers can be used to provide meaningful early literacy opportunities. Includes seven rules of thumb useful for parents who want information on using computers for educational purposes. (MG)

STS-99 crewmembers in aircraft prior to leaving Ellington Field for KSC

NASA Image and Video Library

2000-01-27

JSC2000-00924 (27 January 2000) --- Astronaut Kevin R. Kregel, mission commander, signals thumbs up as he prepares to pilot a T-38 jet aircraft to southern Florida in preparation for launch next week aboard the Space Shuttle Endeavour.

Investigating Patients' Perception of Microvascular Free Toe Flap for Reconstruction of Amputated Thumbs: A Guide for Surgeons during Informed Consent.

PubMed

Efanov, Johnny Ionut; Wong, Christopher; Guilbault, Clarence; Bou-Merhi, Joseph; Harris, Patrick G; Izadpanah, Ali; Danino, Michel Alain

2018-04-24

 After thumb amputations, restoration of function and aesthetic can be accomplished with microvascular free toe flaps. However, many patients in clinical practice do not choose this reconstruction despite positive reported outcomes. This study aims to determine patients' perceptions with respect to free toe flaps to improve areas of informed consent.  A retrospective survey was administered to patients with thumb amputations. Participants were required to complete a questionnaire about patient demographics, the Brief Michigan Hand Questionnaire (bMHQ), the standard gamble/time trade-off questionnaires for utility scores, and a questionnaire investigating potential reasons for electing not to undergo a free toe transfer.  Thirty patients were enrolled in the study wherein 53% underwent a replantation procedure, 27% a revision amputation, and 20% a delayed reconstruction. Mean normalized score on the bMHQ was recorded as 63.54. Utility questionnaires yielded mean measures of 0.8967 and 0.86 on the standard gamble and time trade-off, respectively. From 14 elements, a majority (87%) stated flap failure as a major source of concern, followed by lack of understanding of risks and benefits (80%) and prolonged hospital stay (53%). Cultural/religious beliefs, aesthetic appearance of the foot, and concerns about footwear were not reported as important reasons in 90, 80, and 79% of patients, respectively.  A better understanding of patients' attitudes and beliefs with respect to free toe flaps will allow surgeons to better address their concerns during informed consent. This study emphasizes the importance to discuss about failure rates, risks, and benefits of the operation and prolonged hospital stay. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Catastrophic Disruption Threshold and Maximum Deflection from Kinetic Impact

NASA Astrophysics Data System (ADS)

Cheng, A. F.

2017-12-01

The use of a kinetic impactor to deflect an asteroid on a collision course with Earth was described in the NASA Near-Earth Object Survey and Deflection Analysis of Alternatives (2007) as the most mature approach for asteroid deflection and mitigation. The NASA DART mission will demonstrate asteroid deflection by kinetic impact at the Potentially Hazardous Asteroid 65803 Didymos in October, 2022. The kinetic impactor approach is considered to be applicable with warning times of 10 years or more and with hazardous asteroid diameters of 400 m or less. In principle, a larger kinetic impactor bringing greater kinetic energy could cause a larger deflection, but input of excessive kinetic energy will cause catastrophic disruption of the target, leaving possibly large fragments still on collision course with Earth. Thus the catastrophic disruption threshold limits the maximum deflection from a kinetic impactor. An often-cited rule of thumb states that the maximum deflection is 0.1 times the escape velocity before the target will be disrupted. It turns out this rule of thumb does not work well. A comparison to numerical simulation results shows that a similar rule applies in the gravity limit, for large targets more than 300 m, where the maximum deflection is roughly the escape velocity at momentum enhancement factor β=2. In the gravity limit, the rule of thumb corresponds to pure momentum coupling (μ=1/3), but simulations find a slightly different scaling μ=0.43. In the smaller target size range that kinetic impactors would apply to, the catastrophic disruption limit is strength-controlled. A DART-like impactor won't disrupt any target asteroid down to significantly smaller size than the 50 m below which a hazardous object would not penetrate the atmosphere in any case unless it is unusually strong.

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

PubMed Central

Deshaies, Eric M; Villwock, Mark R; Singla, Amit; Toshkezi, Gentian; Padalino, David J

2015-01-01

Less invasive surgical approaches for intracranial aneurysm clipping may reduce length of hospital stay, surgical morbidity, treatment cost, and improve patient outcomes. We present our experience with a minimally invasive pterional approach for anterior circulation aneurysms performed in a major tertiary cerebrovascular center and compare the results with an aged matched dataset from the Nationwide Inpatient Sample (NIS). From August 2008 to December 2012, 22 elective aneurysm clippings on patients ≤55 years of age were performed by the same dual fellowship-trained cerebrovascular/endovascular neurosurgeon. One patient (4.5%) experienced transient post-operative complications. 18 of 22 patients returned for follow-up imaging and there were no recurrences through an average duration of 22 months. A search in the NIS database from 2008 to 2010, also for patients aged ≤55 years of age, yielded 1,341 hospitalizations for surgical clip ligation of unruptured cerebral aneurysms. Inpatient length of stay and hospital charges at our institution using the minimally invasive thumb-sized pterional technique were nearly half that of NIS (length of stay: 3.2 vs 5.7 days; hospital charges: $52,779 vs. $101,882). The minimally invasive thumb-sized pterional craniotomy allows good exposure of unruptured small and medium-sized supraclinoid anterior circulation aneurysms. Cerebrospinal fluid drainage from key subarachnoid cisterns and constant bimanual microsurgical techniques avoid the need for retractors which can cause contusions, localized venous infarctions, and post-operative cerebral edema at the retractor sites. Utilizing this set of techniques has afforded our patients with a shorter hospital stay at a lower cost compared to the national average. PMID:26325337

The dermal arteries of the human thumb pad

PubMed Central

Geyer, S H; Nöhammer, M M; Tinhofer, I E; Weninger, W J

2013-01-01

The arteries of the skin have been postulated to form a profound plexus at the dermal/hypodermal junction and a superficial plexus in the papillary dermis. Our article aims to rebut this concept and to provide an alternative description of the arrangement of the dermal arteries. Employing a novel technique, we produced digital volume data (volume size: 2739 × 2054 × 3000 μm3; voxel size: 1.07 × 1.07 × 2 μm3) from biopsies of the skin of the thumb pads of 15 body donors. Utilizing these data, we analysed the arrangement of the dermal arteries with the aid of virtual re-sectioning tools, and, in three specimens, with high-quality three-dimensional (3D) surface models. In all specimens we observed a tree-like ramification of discrete dermal arteries. The terminal branches of the arterial trees gave rise to the ascending segments of the capillary loops of the dermal papillae. None of the specimens showed a superficial arterial plexus. This suggests that the skin of the human thumb pad can be split in discrete ‘arterial units’. Each unit represents the zone of the papillary dermis and epidermal/dermal junction, to which blood is supplied exclusively by the branches of a single dermal artery. The concept of dermal arterial units is in contrast to all existing descriptions of the architecture of the dermal arteries. However, whether it can be transferred to the skin of other body parts, remains to be tested. Likewise, the consequences of arterial units for understanding the mechanisms of wound healing and the appearance and genesis of skin diseases remain to be examined. PMID:24205910

Association between breast-feeding practices and sucking habits: a cross-sectional study of children in their first year of life.

PubMed

Moimaz, Suzely A S; Zina, Lívia G; Saliba, Nemre A; Saliba, Orlando

2008-09-01

In addition to providing nutrition and immunological protection, breast-feeding has positive effects on the development of the infant's oral cavity. The aim of the present study is to assess breast-feeding patterns and to analyze the influence of breast-feeding practices and maternal sociodemographic variables on the prevalence of non-nutritive sucking habits in a sample of Brazilian infants. This cross-sectional study was carried out in Southern Brazil. A random sample of 100 mothers of infants up to 12 months of age was interviewed during the National Vaccination Campaign Day. The prevalence and median duration of breast-feeding were assessed. Breast-feeding practice, the exposure factor, was categorized as exclusive breast-feeding, predominant breast-feeding, complementary breast-feeding, or weaning. Maternal sociodemographic variables included age, race, marital status, educational level, profession, and family income. The outcome investigated was the prevalence of sucking habits (pacifier use and thumb sucking). We used two-sample tests, the chi-square test and FISHER'S EXACT TEST for statistical analyses of the data. The study revealed that 75% of infants were being breast-fed. Pacifier use and thumb sucking were common in 55%. Bottle-feeding was prevalent in 74% of infants. Breast-feeding was negatively correlated with pacifier use and thumb sucking (OR=0.11; 95% CI: 0.03 to 0.4). Bottle-feeding was strongly associated with weaning (p=0.0003). Among the sociodemographic variables, only marital status showed a statistical association with sucking habits (p=0.04). These findings suggest that breast-feeding can prevent the occurrence of sucking habits. Although we could not evaluate causality assessment, malocclusion prevention seems to be yet one more reason for promoting breast-feeding practices.

Optimal Normalization Tests for Muscle Activation of the Levator Scapulae, Pectoralis Minor, and Rhomboid Major: An Electromyography Study Using Maximum Voluntary Isometric Contractions.

PubMed

Castelein, Birgit; Cagnie, Barbara; Parlevliet, Thierry; Danneels, Lieven; Cools, Ann

2015-10-01

To identify maximum voluntary isometric contraction (MVIC) test positions for the deeper-lying scapulothoracic muscles (ie, levator scapulae, pectoralis minor, rhomboid major), and to provide a standard set of a limited number of test positions that generate an MVIC in all scapulothoracic muscles. Cross-sectional study. Physical and rehabilitation medicine department. Healthy subjects (N=21). Not applicable. Mean peak electromyographic activity from levator scapulae, pectoralis minor, and rhomboid major (investigated with fine-wire electromyography) and from upper trapezius, middle trapezius, lower trapezius, and serratus anterior (investigated with surface electromyography) during the performance of 12 different MVICs. The results indicated that various test positions generated similar high mean electromyographic activity and that no single test generated maximum activity for a specific muscle in all subjects. The results of this study support using a series of test positions for normalization procedures rather than a single exercise to increase the likelihood of recruiting the highest activity in the scapulothoracic muscles. A standard set of 5 test positions was identified as being sufficient for generating an MVIC of all scapulothoracic muscles: seated T, seated U 135°, prone T-thumbs up, prone V-thumbs up, and supine V-thumbs up. A standard set of test positions for normalization of scapulothoracic electromyographic data that also incorporates the levator scapulae, pectoralis minor, and rhomboid major muscles is 1 step toward a more comprehensive understanding of normal and abnormal muscle function of these muscles and will help to standardize the presentation of scapulothoracic electromyographic muscle activity. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Learning modifies subsequent induction of long-term potentiation-like and long-term depression-like plasticity in human motor cortex.

PubMed

Ziemann, Ulf; Ilić, Tihomir V; Iliać, Tihomir V; Pauli, Christian; Meintzschel, Frank; Ruge, Diane

2004-02-18

Learning may alter rapidly the output organization of adult motor cortex. It is a long-held hypothesis that modification of synaptic strength along cortical horizontal connections through long-term potentiation (LTP) and long-term depression (LTD) forms one important mechanism for learning-induced cortical plasticity. Strong evidence in favor of this hypothesis was provided for rat primary motor cortex (M1) by showing that motor learning reduced subsequent LTP but increased LTD. Whether a similar relationship exists in humans is unknown. Here, we induced LTP-like and LTD-like plasticity in the intact human M1 by an established paired associative stimulation (PAS) protocol. PAS consisted of 200 pairs of electrical stimulation of the right median nerve, followed by focal transcranial magnetic stimulation of the hand area of the left M1 at an interval equaling the individual N20 latency of the median nerve somatosensory-evoked cortical potential (PAS(N20)) or N20-5 msec (PAS(N20-5)). PAS(N20) induced reproducibly a LTP-like long-lasting (>30 min) increase in motor-evoked potentials from the left M1 to a thumb abductor muscle of the right hand, whereas PAS(N20-5) induced a LTD-like decrease. Repeated fastest possible thumb abduction movements resulted in learning, defined by an increase in maximum peak acceleration of the practiced movements, and prevented subsequent PAS(N20)-induced LTP-like plasticity but enhanced subsequent PAS(N20-5)-induced LTD-like plasticity. The same number of repeated slow thumb abduction movements did not result in learning and had no effects on PAS-induced plasticity. Findings support the view that learning in human M1 occurs through LTP-like mechanisms.

Single-arm open-label study of Durolane (NASHA nonanimal hyaluronic acid) for the treatment of osteoarthritis of the thumb.

PubMed

Velasco, Eloisa; Ribera, Mª Victoria; Pi, Joan

2017-01-01

Osteoarthritis of the trapeziometacarpal (TMC) joint of the thumb - also known as rhizarthrosis - is painful and has a significant impact on quality of life. Intra-articular injection of hyaluronic acid may potentially meet the need for effective, minimally invasive intervention in patients not responding adequately to initial treatment. We aimed to confirm the safety and effectiveness of viscosupplementation with Durolane (NASHA nonanimal hyaluronic acid) in rhizarthrosis. This was a prospective, single-arm, multicenter, open-label study with a 6-month follow-up period. Eligible patients had Eaton-Littler grade II-III rhizarthrosis in one TMC joint with pain and visual analog scale (VAS) pain score ≥4 (scale: 0-10). A single injection of NASHA was administered to the affected TMC joint. The primary effectiveness variable was change from baseline in VAS pain score. Thirty-five patients (mean age 60.8 years; 85.7% female) received NASHA and completed the study. The least-squares mean change from baseline in VAS pain score over 6 months was -2.00, a reduction of 27.8% ( p <0.001). The reduction in pain exceeded 25% as early as month 1 (26.5%), and gradual improvement was observed throughout the 6-month follow-up period. Secondary effectiveness parameters included QuickDASH (shortened version of Disabilities of the Arm, Shoulder, and Hand [DASH]), Kapandji thumb opposition test, radial abduction, metacarpophalangeal (MCP) joint flexion, and pinch (clamp) strength. Most of these measurements showed statistically significant improvements from baseline over 6 months. Five adverse events (injection site reactions) were reported in four patients (11.4%), and there were no serious or allergic reactions. This study suggests that viscosupplementation using NASHA is effective and well tolerated in treating the symptoms of rhizarthrosis.

Interpersonal synergies: static prehension tasks performed by two actors.

PubMed

Solnik, Stanislaw; Reschechtko, Sasha; Wu, Yen-Hsun; Zatsiorsky, Vladimir M; Latash, Mark L

2016-08-01

We investigated multidigit synergies stabilizing components of the resultant force vector during joint performance of a static prehension task by two persons as compared to similar tasks performed by a single person using both hands. Subjects transferred the instrumented handle from the right hand to the left hand (one-person condition) or passed that handle to another person (two-person condition) while keeping the handle's position and orientation stationary. Only three digits were involved per hand, the thumb, the index finger, and the middle finger; the forces and moments produced by the digits were measured by six-component sensors. We estimated the performance-stabilizing synergies within the uncontrolled manifold framework by quantifying the intertrial variance structure of digit forces and moments. The analysis was performed at three levels: between hands, between virtual finger and virtual thumb (imagined digits producing the same mechanical variables as the corresponding actual digits combined) produced by the two hands (in both interpersonal and intrapersonal conditions), and between the thumb and virtual finger for one hand only. Additionally, we performed correlation and phase synchronization analyses of resultant tangential forces and internal normal forces. Overall, the one-person conditions were characterized by higher amount of intertrial variance that did not affect resultant normal force components, higher internal components of normal forces, and stronger synchronization of the normal forces generated by the hands. Our observations suggest that in two-person tasks, when participants try to achieve a common mechanical outcome, the performance-stabilizing synergies depend on non-visual information exchange, possibly via the haptic and proprioceptive systems. Therefore, synergies quantified in tasks using visual feedback only may not be generalizable to more natural tasks.

Cardiopulmonary resuscitation (CPR)-related posterior rib fractures in neonates and infants following recommended changes in CPR techniques.

PubMed

Franke, I; Pingen, A; Schiffmann, H; Vogel, M; Vlajnic, D; Ganschow, R; Born, M

2014-07-01

Posterior rib fractures are highly indicative of non-accidental trauma (NAT) in infants. Since 2000, the "two-thumbs" technique for cardiopulmonary resuscitation (CPR) of newborns and infants has been recommended by the American Heart Association (AHA). This technique is similar to the grip on an infant's thorax while shaking. Is it possible that posterior rib fractures in newborns and infants could be caused by the "two-thumbs" technique? Using computerized databases from three German children's hospitals, we identified all infants less than 12 months old who underwent professional CPR within a 10-year period. We included all infants with anterior-posterior chest radiographs taken after CPR. Exclusion criteria were sternotomy, osteopenia, various other bone diseases and NAT. The radiographs were independently reviewed by the Chief of Pediatric Radiology (MB) and a Senior Pediatrician, Head of the local Child Protection Team (IF). Eighty infants with 546 chest radiographs were identified, and 50 of those infants underwent CPR immediately after birth. Data concerning the length of CPR was available for 41 infants. The mean length of CPR was 11min (range: 1-180min, median: 3min). On average, there were seven radiographs per infant. A total of 39 infants had a follow-up radiograph after at least 10 days. No rib fracture was visible on any chest X-ray. The results of this study suggest rib fracture after the use of the "two-thumbs" CPR technique is uncommon. Thus, there should be careful consideration of abuse when these fractures are identified, regardless of whether CPR was performed and what technique used. The discovery of rib fractures in an infant who has undergone CPR without underlying bone disease or major trauma warrants a full child protection investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Associations between a history of breast feeding, malocclusion and parafunctional habits in Puerto Rican children.

PubMed

López Del Valle, Lydia M; Singh, G Dave; Feliciano, Nilma; Machuca, María del Carmen

2006-03-01

Studies relating breast-feeding, malocclusion and parafunctional habits in young children are scarce. The purpose of this study is to evaluate the associations of a history of breast-feeding, incidence of malocclusion and parafunctional habits. The dental records of a sample of 540 children aged 6 to 72 months screened for oral conditions and behavioral risk factors were evaluated for variables such as a history of breastfeeding, malocclusion and parafunctional habits. Descriptive statistics using the EPI-INFO Program and Chi-square test at the 0.05 level of probability were performed. The results showed that the mean age of the children was 28 months +/- 14. The mothers' mean age was 26.4 years +/- 6. The prevalence of breast-feeding was 34% with a mean breast-feeding time period of 3 m +/- 3.7. About 95% of the children had a history of bottle-feeding and 90% showed some evidence of malocclusion at the time of dental examination. The main malocclusion problems were space deficiency (closed contacts among incisors) (31%), open bites (6%) and crossbites (5%). A habit of thumb sucking was reported in 32% of the cases and pacifier use in 21%. there were significant differences for the following variables: mother's age and breast-feeding time period; number of children in family and breast-feeding time period; breast-feeding history and breast-feeding time with bottle use, malocclusion and thumb sucking habit; and gender and thumb-sucking habit. It is concluded that breast-feeding practices and time period are behavioral factors that contribute in the prevention of malocclusion in addition to decreasing the practice of parafunctional habits in preschool children.

Return to Play After Forearm and Hand Injuries in the National Basketball Association.

PubMed

Morse, Kyle W; Hearns, Krystle A; Carlson, Michelle Gerwin

2017-02-01

Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Descriptive epidemiology study. The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play ( P < .05). All thumb ligament tears required surgery and had the longest return to play of 67.5 ± 17.7 days ( P < .05). The return to play for surgically treated metacarpal fractures (56.7 ± 26.3 days) was significantly greater than nonsurgically treated metacarpal fractures (26.3 ± 12.1 days; P < .01). Return to play for surgically repaired phalangeal fractures (46.2 ± 10.8 days) trended greater but was not significantly different than phalangeal fractures treated nonsurgically (33.3 ± 28.5 days; P = .21). Hand injuries in professional basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries.

The structure of unliganded reverse transcriptase from the human immunodeficiency virus type 1.

PubMed Central

Rodgers, D W; Gamblin, S J; Harris, B A; Ray, S; Culp, J S; Hellmig, B; Woolf, D J; Debouck, C; Harrison, S C

1995-01-01

The crystal structure of the reverse transcriptase (RT) from the type 1 human immunodeficiency virus has been determined at 3.2-A resolution. Comparison with complexes between RT and the polymerase inhibitor Nevirapine [Kohlstaedt, L.A., Wang, J., Friedman, J.M., Rice, P.A. & Steitz, T.A. (1992) Science 256, 1783-1790] and between RT and an oligonucleotide [Jacobo-Molina, A., Ding, J., Nanni, R., Clark, A. D., Lu, X., Tantillo, C., Williams, R. L., Kamer, G., Ferris, A. L., Clark, P., Hizi, A., Hughes, S. H. & Arnold, E. (1993) Proc. Natl. Acad. Sci. USA 90, 6320-6324] reveals changes associated with ligand binding. The enzyme is a heterodimer (p66/p51), with domains labeled "fingers," "thumb," "palm," and "connection" in both subunits, and a ribonuclease H domain in the larger subunit only. The most striking difference between RT and both complex structures is the change in orientation of the p66 thumb (approximately 33 degrees rotation). Smaller shifts relative to the core of the molecule were also found in other domains, including the p66 fingers and palm, which contain the polymerase active site. Within the polymerase catalytic region itself, there are no rearrangements between RT and the RT/DNA complex. In RT/Nevirapine, the drug binds in the p66 palm near the polymerase active site, a region that is well-packed hydrophobic core in the unliganded enzyme. Room for the drug is provided by movement of a small beta-sheet within the palm domain of the Nevirapine complex. The rearrangement within the palm and thumb, as well as domain shifts relative to the enzyme core, may prevent correct placement of the oligonucleotide substrate when the drug is bound. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:7532306

77 FR 25161 - Combined Notice of Filings #2

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-27

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 2 Take notice that the Commission received the following electric rate filings: Docket Numbers: ER10-1484-002... Numbers: ER12-1573-000. Applicants: The Detroit Edison Company. Description: Thumb Electric WPS-2 Service...

8. COLLAPSED AND SCATTERED BUILDING ON FLOOR OF PIT, WITH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. COLLAPSED AND SCATTERED BUILDING ON FLOOR OF PIT, WITH PILE OF RHYOLITE BOULDERS IN BACKGROUND, VIEW TO SOUTH - Iron Springs Quarry, 150 feet west of Grand Loop Road, 20 miles east of U.S. Highway 287, West Thumb, Teton County, WY

76 FR 40359 - Product Cancellation Order for Certain Pesticide Registrations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

... to a particular entity, consult the person listed under FOR FURTHER INFORMATION CONTACT. B. How can I... Chemsico Home Insect Tralomethrin. Control A. 009688-00081 Chemsico Home Insect Tralomethrin. Control B.... 009688-00113 Chemsico Tralomethrin. Tralomethrin Insecticide D. 009688-00119 Green Thumb Home...

A Bicentennial Without a Puerto Rican Colony

ERIC Educational Resources Information Center

Thomas, Piri

1975-01-01

The United States revolution of 1776 is said to lose validity in light of Puerto Rico's colonial situation under American rule. The plight of the Puerto Rican people is compared to that of the Euro-American settlers under the thumb-screw of British imperialism. (Author/AM)

Researchers’ Intuitions About Power in Psychological Research

PubMed Central

Bakker, Marjan; Hartgerink, Chris H. J.; Wicherts, Jelte M.; van der Maas, Han L. J.

2016-01-01

Many psychology studies are statistically underpowered. In part, this may be because many researchers rely on intuition, rules of thumb, and prior practice (along with practical considerations) to determine the number of subjects to test. In Study 1, we surveyed 291 published research psychologists and found large discrepancies between their reports of their preferred amount of power and the actual power of their studies (calculated from their reported typical cell size, typical effect size, and acceptable alpha). Furthermore, in Study 2, 89% of the 214 respondents overestimated the power of specific research designs with a small expected effect size, and 95% underestimated the sample size needed to obtain .80 power for detecting a small effect. Neither researchers’ experience nor their knowledge predicted the bias in their self-reported power intuitions. Because many respondents reported that they based their sample sizes on rules of thumb or common practice in the field, we recommend that researchers conduct and report formal power analyses for their studies. PMID:27354203

Researchers' Intuitions About Power in Psychological Research.

PubMed

Bakker, Marjan; Hartgerink, Chris H J; Wicherts, Jelte M; van der Maas, Han L J

2016-08-01

Many psychology studies are statistically underpowered. In part, this may be because many researchers rely on intuition, rules of thumb, and prior practice (along with practical considerations) to determine the number of subjects to test. In Study 1, we surveyed 291 published research psychologists and found large discrepancies between their reports of their preferred amount of power and the actual power of their studies (calculated from their reported typical cell size, typical effect size, and acceptable alpha). Furthermore, in Study 2, 89% of the 214 respondents overestimated the power of specific research designs with a small expected effect size, and 95% underestimated the sample size needed to obtain .80 power for detecting a small effect. Neither researchers' experience nor their knowledge predicted the bias in their self-reported power intuitions. Because many respondents reported that they based their sample sizes on rules of thumb or common practice in the field, we recommend that researchers conduct and report formal power analyses for their studies. © The Author(s) 2016.

Customized dynamic splinting: orthoses that promote optimal function and recovery after radial nerve injury: a case report.

PubMed

McKee, Pat; Nguyen, Cecilia

2007-01-01

Radial nerve injury is a relatively common occurrence and recovery depends on the level of injury and extent of connective tissue damage. Orthoses (splints) are often provided to compensate for lost motor power. This article chronicles the recovery, over 27 months, of a 76-year-old woman who sustained a high radial nerve injury of her dominant arm during surgery for total shoulder replacement (Delta Reverse). Customized, low-profile dynamic splints, unlike any previously published design, were developed to address her goals for functional independence and the biological needs of the tissues. Dynamic power was provided to the wrist, fingers, and thumb by elastic cords and thin, flexible thermoplastic, without the need of an outrigger, thus avoiding the need for wire bending and cutting. At the outset, the splint was forearm-based and when wrist extension power was recovered, a hand-based splint was designed. Eventually, a circumferential hand-based thumb-stabilizing splint fulfilled most of the remaining orthotic requirements.

Use of mathematics to guide target selection in systems pharmacology; application to receptor tyrosine kinase (RTK) pathways.

PubMed

Benson, Neil; van der Graaf, Piet H; Peletier, Lambertus A

2017-11-15

A key element of the drug discovery process is target selection. Although the topic is subject to much discussion and experimental effort, there are no defined quantitative rules around optimal selection. Often 'rules of thumb', that have not been subject to rigorous exploration, are used. In this paper we explore the 'rule of thumb' notion that the molecule that initiates a pathway signal is the optimal target. Given the multi-factorial and complex nature of this question, we have simplified an example pathway to its logical minimum of two steps and used a mathematical model of this to explore the different options in the context of typical small and large molecule drugs. In this paper, we report the conclusions of our analysis and describe the analysis tool and methods used. These provide a platform to enable a more extensive enquiry into this important topic. Copyright © 2017 Elsevier B.V. All rights reserved.

Trends in Thumb Carpometacarpal Interposition Arthroplasty in the United States, 2005-2011.

PubMed

Werner, Brian C; Bridgforth, Andrew B; Gwathmey, F Winston; Dacus, A Rashard

2015-08-01

We conducted a study to investigate current trends in carpometacarpal (CMC) interposition arthroplasty across time, sex, age, and region of the United States; per-patient charges and reimbursements; and the association between this procedure and concomitantly performed carpal tunnel syndrome (CTS) and carpal tunnel release (CTR). Patients who underwent CMC interposition arthroplasty (N = 41,171) were identified in a national database. Between 2005 and 2011, the number of patients who had CMC interposition arthroplasty increased 46.2%. Females had the procedure more frequently than males at all time points, though the percentage of patients who were male increased throughout the study period. Of the patients who had CMC interposition arthroplasty, 40.9% also had a diagnosis of CTS. Between 15.5% and 17.3% of these patients had CTR performed concomitantly. Despite a lack of evidence that thumb CMC interposition arthroplasty is superior to other surgical treatment options, the number of patients who are having this procedure has increased significantly. The impetus for these trends requires additional investigation.

Microsurgical transfer of the second toe for congenital deficiency of the thumb.

PubMed

Lister, G

1988-10-01

Twelve second-toe transfers have been performed to substitute for thumbs congenitally deficient through constriction ring syndrome, symbrachydactyly, and true transverse arrest. The children were on average 3 years of age, and the youngest was undertaken at 10 months. Anatomic variations were the rule in the six cases of transverse absence and the three cases of symbrachydactyly, requiring nerves, tendons, and vessels in the toe be connected to whatever appropriate structure could be located. All transfers survived, and only one required exploration. Sensation appeared good in the 11 seen in later review, but interphalangeal motion was achieved in only 3. However, good use was made of the digit by all except one patient, an early patient in whom there was not an adequate skeleton on which to base the transfer. This small series suggests that in appropriate cases toe transfer can be undertaken early for congenital deficiency with little fear of encountering microsurgical problems unique to the infant.

Application of the IFSSH(3)-classification for congenital anomalies of the hand; results and problems.

PubMed

De Smet, L; Matton, G; Monstrey, S; Cambier, E; Fabry, G

1997-09-01

The extended classification proposed by the IFSSH was used to classify 1013 hand anomalies in 925 hands of 650 patients. We found associated anomalies in 26.7%. The classification was straightforward in 86%, difficult in 6.6% and not possible in 7.8%. In group I the radial and ulnar deficiencies, limited to the hand and without forearm deficiencies should be included. Group II was the most important group including 513 anomalies. We propose to include in this group the Madelung deformity, the Kirner deformity and congenital trigger fingers and trigger thumbs. Triphalangeal thumbs are a problem, we suggest to list this anomaly in group III and to consider it as a duplication in length. It is not always possible to evaluate the (transverse) absence of the fingers or hand. Longitudinal deficiencies (group IIB), symbrachydactyly group (V) and amniotic bands (group VI) occasionally develop a phenotype similar to the genuine transverse deficiency (group IA).

Writing forces associated with four pencil grasp patterns in grade 4 children.

PubMed

Schwellnus, Heidi; Carnahan, Heather; Kushki, Azadeh; Polatajko, Helene; Missiuna, Cheryl; Chau, Tom

2013-01-01

OBJECTIVE. We investigated differences in handwriting kinetics, speed, and legibility among four pencil grasps after a 10-min copy task. METHOD. Seventy-four Grade 4 students completed a handwriting assessment before and after a copy task. Grip and axial forces were measured with an instrumented stylus and force-sensitive tablet. We used multiple linear regression to analyze the relationship between grasp pattern and grip and axial forces. RESULTS. We found no kinetic differences among grasps, whether considered individually or grouped by the number of fingers on the barrel. However, when grasps were grouped according to the thumb position, the adducted grasps exhibited higher mean grip and axial forces. CONCLUSION. Grip forces were generally similar across the different grasps. Kinetic differences resulting from thumb position seemed to have no bearing on speed and legibility. Interventions for handwriting difficulties should focus more on speed and letter formation than on grasp pattern. Copyright © 2013 by the American Occupational Therapy Association, Inc.

Simulator comparison of thumball, thumb switch, and touch screen input concepts for interaction with a large screen cockpit display format

NASA Technical Reports Server (NTRS)

Jones, Denise R.; Parrish, Russell V.

1990-01-01

A piloted simulation study was conducted comparing three different input methods for interfacing to a large screen, multiwindow, whole flight deck display for management of transport aircraft systems. The thumball concept utilized a miniature trackball embedded in a conventional side arm controller. The multifunction control throttle and stick (MCTAS) concept employed a thumb switch located in the throttle handle. The touch screen concept provided data entry through a capacitive touch screen installed on the display surface. The objective and subjective results obtained indicate that, with present implementations, the thumball concept was the most appropriate for interfacing with aircraft systems/subsystems presented on a large screen display. Not unexpectedly, the completion time differences between the three concepts varied with the task being performed, although the thumball implementation consistently outperformed the other two concepts. However, pilot suggestions for improved implementations of the MCTAS and touch screen concepts could reduce some of these differences.

Three cases with L1 syndrome and two novel mutations in the L1CAM gene.

PubMed

Marín, Rosario; Ley-Martos, Miriam; Gutiérrez, Gema; Rodríguez-Sánchez, Felicidad; Arroyo, Diego; Mora-López, Francisco

2015-11-01

Mutations in the L1CAM gene have been identified in the following various X-linked neurological disorders: congenital hydrocephalus; mental retardation, aphasia, shuffling gait, and adducted thumbs (MASA) syndrome; spastic paraplegia; and agenesis of the corpus callosum. These conditions are currently considered different phenotypes of a single entity known as L1 syndrome. We present three families with L1 syndrome. Sequencing of the L1CAM gene allowed the identification of the following mutations involved: a known splicing mutation (c.3531-12G>A) and two novel ones: a missense mutation (c.1754A>C; p.Asp585Ala) and a nonsense mutation (c.3478C>T; p.Gln1160Stop). The number of affected males and carrier females identified in a relatively small population suggests that L1 syndrome may be under-diagnosed. L1 syndrome should be considered in the differential diagnosis of intellectual disability or mental retardation in children, especially when other signs such as hydrocephalus or adducted thumbs are present.

A simple rule of thumb for elegant prehension.

PubMed

Mon-Williams, M; Tresilian, J R

2001-07-10

Reaching out to grasp an object (prehension) is a deceptively elegant and skilled behavior. The movement prior to object contact can be described as having two components, the movement of the hand to an appropriate location for gripping the object, the "transport" component, and the opening and closing of the aperture between the fingers as they prepare to grip the target, the "grasp" component. The grasp component is sensitive to the size of the object, so that a larger grasp aperture is formed for wider objects; the maximum grasp aperture (MGA) is a little wider than the width of the target object and occurs later in the movement for larger objects. We present a simple model that can account for the temporal relationship between the transport and grasp components. We report the results of an experiment providing empirical support for our "rule of thumb." The model provides a simple, but plausible, account of a neural control strategy that has been the center of debate over the last two decades.

Upper limb congenital muscular hypertrophy and aberrant muscle syndrome in children.

PubMed

Dahan, Emmanuel; Chaves, Camilo; Bachy, Manon; Fitoussi, Frank

2018-01-01

Congenital muscle hypertrophy of the upper limb is a very rare condition with unknown aetiology. This descriptive observational and retrospective series included eight children followed by a multidisciplinary team from 2005 to 2017. The diagnosis was based on a cluster of clinical and radiological characteristics after elimination of differential diagnoses. Patients were categorized according to: anomalies of the wrist, anomalies of long fingers of intrinsic or extrinsic origin; and anomalies of the thumb with or without first web space contracture. Treatment begins in young children with hand orthoses to limit muscle contraction and joint malposition. The purpose of surgical treatment was to release contractures and to restore muscle balance through, in the main, finger intrinsic releases and first web releases. At the 2-year follow-up, we found that limited surgical procedures improved finger, thumb and wrist positions. We conclude that muscle hypertrophy is the main cause of deformity and that selective releases of contracted musculo-tendinous units and skin lengthening are effective. IV.

The choice of procedure following thumb amputation.

PubMed

Lister, G

1985-05-01

The attributes that make the thumb unique are position, stability, strength, length, motion, sensibility, and appearance. Of these qualities, the first four must be present to an acceptable extent for function to approach normality, while the latter three are very desirable but not essential. Reconstructive alternatives following amputation can be considered in four broad groups: where the length is acceptable but the covering is poor; subtotal amputation, where length is equivocal; total amputation with the basal joint preserved; and total amputation with the basal joint destroyed. In the first group, soft-tissue cover can be improved by local flaps with or without a neurovascular pedicle or by microvascular free pulp transfer. In the second group, metacarpal lengthening by distraction, with or without phalangization, may give adequate length. In total amputations, one may choose osteoplastic reconstruction, pollicization, or toe-to-hand transfer. Which solution is selected depends on the level of the amputation, the presence and nature of injuries to other digits, occupational and social factors, and the availability of tissues.

A comparison of the reliability of make versus break testing in measuring palmar abduction strength of the thumb.

PubMed

Lim, J X; Toh, R X; Chook, S K H; Sebastin, S J; Karjalainen, T

2014-06-01

Previous studies have established the role of quantitative measurements of palmar abduction strength of the thumb (PAST). This study compares the reliability of the 'make' versus the 'break' test in measuring PAST in healthy volunteers. In a 'make' test, the body part being tested is positioned at the start of its range of motion and the participant is asked to exert his/her maximal force. In a 'break' test, increasing force is applied to a body part after it has completed its range of motion, until the joint being tested gives way. PAST was measured in both hands in 100 healthy volunteers using a handheld device. Two examiners measured PAST using both the 'make' and 'break' test to determine inter-rater reliability. The tests were repeated in 30 volunteers 6 weeks after the initial testing to determine intra-rater reliability. Our results showed that the 'make' test has better inter and intra-rater reliability.

46,XX/46,XX,r(15) mosaiciam: report of a case.

PubMed Central

Pfeiffer, R A; Dhadial, R; Lenz, W

1977-01-01

Mosaicism of cells with a normal karyotype or with a ring chromosome no. 15 was found in a girl with hypoplasia of the thumbs, club feet, mental retardation, and short stature, which seems to be a feature of this chromosomal aberration. Images PMID:839504

Improvement of the geotechnical axial design methodology for Colorado's drilled shafts socketed in weak rocks

DOT National Transportation Integrated Search

2003-07-01

Drilled shaft foundations embedded in weak rock formations (e.g., Denver blue claystone and sandstone) support a significant portion of bridges in Colorado. Since the 1960s, empirical methods and rules of thumb have been used to design drilled shafts...

Linkage mapping in a watermelon population segregating for fusarium wilt resistance

Treesearch

Leigh K. Hawkins; Fenny Dane; Thomas L. Kubisiak; Billy B. Rhodes; Robert L. Jarret

2001-01-01

Isozyme, randomly amplified polymorphic DNA (RAPD), and simple sequence repeats (SSR) markers were used to generate a linkage map in an F2 and F3 watermelon (Citrullus lanatus (Thumb.) Matsum. & Nakai) population derived from a cross between the fusarium wilt (Fusarium oxysporum f....

Look Inside for Conflicts of Interest.

ERIC Educational Resources Information Center

Bakewell, Thomas F.

2002-01-01

Discusses conflicts of interest in higher education, offering rules of thumb for judging individual situations, tools to help board members address such conflicts, and possible standards to apply when considering conflicts of interest. Also touches on the need to be realistic and the importance of collegiality and trust. (EV)

Swanson, Wiseman and Gerst in Node 2

NASA Image and Video Library

2014-05-29

ISS040-E-006033 (29 May 2014) --- NASA astronaut Steve Swanson (center), Expedition 40 commander; along with European Space Agency astronaut Alexander Gerst (left) and NASA astronaut Reid Wiseman, both flight engineers, give a “thumbs up” signal in the Harmony node of the International Space Station.

Sturckow uses Cycle Ergometer on Middeck (MDDK) during STS-128

NASA Image and Video Library

2009-08-29

S128-E-006313 (29 Aug. 2009) --- Astronaut Rick Sturckow, STS-128 commander, gives a “thumbs-up” signal while exercising on a bicycle ergometer on the middeck of the Earth-orbiting Space Shuttle Discovery. Astronaut Nicole Stott, mission specialist, is visible at right.

Evolution of Elections Management in Tanzania

ERIC Educational Resources Information Center

Norman, A. S.; Mdegella, O. M.; Lubawa, R. M.

2011-01-01

This paper provides a discussion on the evolution of elections management in Tanzania with a focus on technological advancement in administering registration of voters. The paper provides the merits that permanent voters register has brought over the thumb practice. It traces the management of elections during colonialism, after independence…

Development of Kinematic Graphs of Median Nerve during Active Finger Motion: Implications of Smartphone Use

PubMed Central

2016-01-01

Background Certain hand activities cause deformation and displacement of the median nerve at the carpal tunnel due to the gliding motion of tendons surrounding it. As smartphone usage escalates, this raises the public’s concern whether hand activities while using smartphones can lead to median nerve problems. Objective The aims of this study were to 1) develop kinematic graphs and 2) investigate the associated deformation and rotational information of median nerve in the carpal tunnel during hand activities. Methods Dominant wrists of 30 young adults were examined with ultrasonography by placing a transducer transversely on their wrist crease. Ultrasound video clips were recorded when the subject performing 1) thumb opposition with the wrist in neutral position, 2) thumb opposition with the wrist in ulnar deviation and 3) pinch grip with the wrist in neutral position. Six still images that were separated by 0.2-second intervals were then captured from the ultrasound video for the determination of 1) cross-sectional area (CSA), 2) flattening ratio (FR), 3) rotational displacement (RD) and 4) translational displacement (TD) of median nerve in the carpal tunnel, and these collected information of deformation, rotational and displacement of median nerve were compared between 1) two successive time points during a single hand activity and 2) different hand motions at the same time point. Finally, kinematic graphs were constructed to demonstrate the mobility of median nerve during different hand activities. Results Performing different hand activities during this study led to a gradual reduction in CSA of the median nerve, with thumb opposition together with the wrist in ulnar deviation causing the greatest extent of deformation of the median nerve. Thumb opposition with the wrist in ulnar deviation also led to the largest extent of TD when compared to the other two hand activities of this study. Kinematic graphs showed that the motion pathways of median nerve during different hand activities were complex. Conclusion We observed that the median nerve in the carpal tunnel was rotated, deformed and displaced during the hand activities that people may be performed when using a smartphone, suggesting an increased risk of carpal tunnel syndrome (CTS). In addition, the kinematic graphs of median nerve developed in the present study provide new clues for further studies on the pathophysiology of CTS, and alerting smartphone users to establish proper postural habits when using handheld electronic devices. PMID:27367447

NCEA Scientists - Past and Present

EPA Science Inventory

Les Grant

Dr. Les Grant, Director of EPA's National Center for Environmental Assessment's Research Triangle Park Divisi...

43 CFR 2531.1 - Qualifications of applicants.

Code of Federal Regulations, 2014 CFR

2014-10-01

... proper form, and must contain information as to the applicant's identity, such as thumb print, age, sex... heirs without further use or occupancy on the part of such heirs being shown. (d) Minor children. An... also eligible upon application for allotments made thereunder to his minor children, stepchildren, or...

Thumbs Up: High-Quality, Low-Cost Teaching Aids.

ERIC Educational Resources Information Center

Paine, Carolyn

1982-01-01

Exemplary teaching aids--games, workbooks, student and teacher resource books, reading materials, and records--are recommended by subject area and grade level. Materials include an ice cream cone game for mathematics, a "Life Skills Reading" book on telephone usage, a "Dictionary of Recent American History," and many other items. (PP)

Teaching Students Not to Dismiss the Outermost Observations in Regressions

ERIC Educational Resources Information Center

Kasprowicz, Tomasz; Musumeci, Jim

2015-01-01

One econometric rule of thumb is that greater dispersion in observations of the independent variable improves estimates of regression coefficients and therefore produces better results, i.e., lower standard errors of the estimates. Nevertheless, students often seem to mistrust precisely the observations that contribute the most to this greater…

Two Thumbs Up, Five Stars, and an Oscar?

ERIC Educational Resources Information Center

Riley, Tracy

1998-01-01

Discusses the themes of "Good Will Hunting" and "Titanic" and their messages to educators. The need for gifted children to have an array of people in their lives to nurture their abilities and the need for the development of a New Zealand national policy for gifted children is emphasized. (CR)

The needle in the hay stack: Keeping it lost

USDA-ARS?s Scientific Manuscript database

A recent advertisement on American commercial television depicts a well-dressed young man reaching into a haystack. In less than a second he removes his hand from the straw and briefly examines something held between his thumb and forefinger. With feigned surprise and a slight smirk, he quips, “Huh,...

No safety in numbers

Treesearch

Steven R. Beissinger; Curtis H. Flather; Gregory D. Hayward; Philip A. Stephens

2011-01-01

Clements et al. (Front Ecol Environ 2011; 9[9]: 521-525) proposed a single metric that describes a "species' ability to forestall extinction" (referred to by the acronym "SAFE") as a "scientifically defendable rule of thumb for when complete demographic data are unavailable" to rank the relative threat status of a species. SAFE is...

43 CFR 2531.1 - Qualifications of applicants.

Code of Federal Regulations, 2011 CFR

2011-10-01

... proper form, and must contain information as to the applicant's identity, such as thumb print, age, sex... heirs without further use or occupancy on the part of such heirs being shown. (d) Minor children. An... also eligible upon application for allotments made thereunder to his minor children, stepchildren, or...

43 CFR 2531.1 - Qualifications of applicants.

Code of Federal Regulations, 2012 CFR

2012-10-01

... proper form, and must contain information as to the applicant's identity, such as thumb print, age, sex... heirs without further use or occupancy on the part of such heirs being shown. (d) Minor children. An... also eligible upon application for allotments made thereunder to his minor children, stepchildren, or...

43 CFR 2531.1 - Qualifications of applicants.

Code of Federal Regulations, 2013 CFR

2013-10-01

... proper form, and must contain information as to the applicant's identity, such as thumb print, age, sex... heirs without further use or occupancy on the part of such heirs being shown. (d) Minor children. An... also eligible upon application for allotments made thereunder to his minor children, stepchildren, or...

Learning, Dynamic Capabilities and Operating Routines: A Consumer Package Goods Company

ERIC Educational Resources Information Center

Swift, Peter E.; Hwang, Alvin

2008-01-01

Purpose: This paper seeks to present organizational learning processes of knowledge accumulation, articulation, codification and subsequent routine development in a marketing services organization where judgment and rules of thumb were more the norm than codified knowledge and explicit routines. The case illustrates how organizational learning…

Survey Design Recommendations.

ERIC Educational Resources Information Center

Fisher, William P., Jr.

2000-01-01

Presents 17 rules of thumb to create surveys that are likely to provide data of high enough quality to meet the requirements for measurement specified in a probabilistic conjoint measurement model. Use of these steps should allow the survey to be joined with others measuring the same variable to ensure continued equating with a single reference…

Engineers' Non-Scientific Models in Technology Education

ERIC Educational Resources Information Center

Norstrom, Per

2013-01-01

Engineers commonly use rules, theories and models that lack scientific justification. Examples include rules of thumb based on experience, but also models based on obsolete science or folk theories. Centrifugal forces, heat and cold as substances, and sucking vacuum all belong to the latter group. These models contradict scientific knowledge, but…

Remarks on a Johann spectrometer for exotic-atom research and more

NASA Astrophysics Data System (ADS)

Gotta, Detlev E.; Simons, Leopold M.

2016-06-01

General properties of a Johann-type spectrometer equipped with spherically bent crystals are described leading to simple rules of thumb for practical use. They are verified by comparing with results from Monte-Carlo studies and demonstrated by selected measurements in exotic-atom and X-ray fluorescence research.

Knowledge and Vision in Teaching

ERIC Educational Resources Information Center

Kennedy, Mary M.

2006-01-01

The author challenges the role of knowledge in teaching by pointing out the variety of issues and concerns teachers must simultaneously address. Teachers use two strategies to manage their multidimensional space: They develop integrated habits and rules of thumb for handling situations as they arise, and they plan their lessons by envisioning them…

Improving the Bandwidth Selection in Kernel Equating

ERIC Educational Resources Information Center

Andersson, Björn; von Davier, Alina A.

2014-01-01

We investigate the current bandwidth selection methods in kernel equating and propose a method based on Silverman's rule of thumb for selecting the bandwidth parameters. In kernel equating, the bandwidth parameters have previously been obtained by minimizing a penalty function. This minimization process has been criticized by practitioners…

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

Stations Idle Reduction Transportation Infrastructure Biofuels Production Clean Cities Petroleum Use : Category Most Recent Most Popular 2 results Ccities_map Clean Cities Coalition Locations Ccities_map Last update May 2017 View Image Graph Generated_thumb20170515-25423-1c6vokd Clean Cities Funding

Under the Green Thumb: Totalitarian Sustainability on Campus

ERIC Educational Resources Information Center

Kissel, Adam

2010-01-01

What's wrong with the sustainability movement, the author contends, is the uncritical homogenization of humanity. Sustainability advocates inevitably seek to homogenize people's deepest values, because their goal is to save Earth from ecological, economic, and social disaster. Everyone must participate--everyone must share the same key values and…

Heritability and genetic variance for citrulline, arginine and lycopene content in a diverse set of watermelon cultigens

USDA-ARS?s Scientific Manuscript database

Citrulline, arginine, and lycopene are naturally occurring compounds found in watermelon, Citrullus lanatus (Thumb) Matsum & Nakai, with beneficial effects on plant growth and human health. This study evaluated seven commercial cultivars and one breeding line for citrulline, arginine, and lycopene c...

78 FR 72755 - Version 5 Critical Infrastructure Protection Reliability Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

... (e.g., thumb drives and laptop computers) that fall outside of the BES Cyber Asset definition.\\5... implementation study is part of a larger program that includes the development of guidance, outreach to industry... the goals of the implementation study include: (1) Improving industry's understanding of the technical...

STS-131 crew preparing for their T-38 flight to KSC for TCDT

NASA Image and Video Library

2010-03-01

JSC2010-E-032825 (1 March 2010) --- NASA astronaut Stephanie Wilson, STS-131 mission specialist, gives a ?thumbs-up? signal as she prepares for a flight in a NASA T-38 trainer jet from Ellington Field near NASA's Johnson Space Center to Kennedy Space Center, Florida.

STS118-S-073

NASA Image and Video Library

2007-08-21

STS118-S-073 (21 Aug. 2007) --- NASA Administrator Michael Griffin (center in white shirt) and other NASA managers give thumbs up signals to the crew of the Space Shuttle Endeavour shortly after its touchdown August 21, 2007, at the Kennedy Space Center, Florida, concluding STS-118. Photo Credit: NASA/Bill Ingalls

Extravehicular Mobility Unit (EMU) Preparations in Joint Airlock Quest

NASA Image and Video Library

2009-03-23

ISS018-E-042704 (23 March 2009) --- Astronaut Richard Arnold, STS-119 mission specialist, attired in his Extravehicular Mobility Unit (EMU) spacesuit, gives a ?thumbs-up? signal as he prepares for the mission's third scheduled session of extravehicular activity (EVA) in the Quest Airlock of the International Space Station.

Cyber Strategic Inquiry: Enabling Change through a Strategic Simulation and Megacommunity Concept

DTIC Science & Technology

2009-02-01

malicious software embedded in thumb drives and CDs that thwarted protections, such as antivirus software , on computers. In the scenario, these...Executives for National Security • The Carlyle Group • Cassat Corporation • Cisco Systems, Inc. • Cyveillance • General Dynamics • General Motors

The Vod Couple

ERIC Educational Resources Information Center

Schaffhauser, Dian

2009-01-01

This article features two high school chemistry teachers, Aaron Sams and Jonathan Bergmann, who have overturned conventional classroom instruction by using video podcasts to form the root of a new learning model. Thumbing through an issue of "MacWorld" a few years ago, Aaron Sams was struck by an article about an application called ProfCast that…

Using Low-Tech Interactions in the Chemistry Classroom to Engage Students in Active Learning

ERIC Educational Resources Information Center

Shaver, Michael P.

2010-01-01

Two complementary techniques to gauge student understanding and inspire interactive learning in the chemistry classroom are presented. Specifically, this article explores the use of student responses with their thumbs as an alternative to electronic-response systems and complementing these experiences with longer, task-based questions in an…

Relating Local to Global Spatial Knowledge: Heuristic Influence of Local Features on Direction Estimates

ERIC Educational Resources Information Center

Phillips, Daniel W.; Montello, Daniel R.

2015-01-01

Previous research has examined heuristics--simplified decision-making rules-of-thumb--for geospatial reasoning. This study examined at two locations the influence of beliefs about local coastline orientation on estimated directions to local and distant places; estimates were made immediately or after fifteen seconds. This study goes beyond…

Methodological Choices in Peer Nomination Research

ERIC Educational Resources Information Center

Cillessen, Antonius H. N.; Marks, Peter E. L.

2017-01-01

Although peer nomination measures have been used by researchers for nearly a century, common methodological practices and rules of thumb (e.g., which variables to measure; use of limited vs. unlimited nomination methods) have continued to develop in recent decades. At the same time, other key aspects of the basic nomination procedure (e.g.,…

Investigating the Impacts of Design Heuristics on Idea Initiation and Development

ERIC Educational Resources Information Center

Kramer, Julia; Daly, Shanna R.; Yilmaz, Seda; Seifert, Colleen M.; Gonzalez, Richard

2015-01-01

This paper presents an analysis of engineering students' use of Design Heuristics as part of a team project in an undergraduate engineering design course. Design Heuristics are an empirically derived set of cognitive "rules of thumb" for use in concept generation. We investigated heuristic use in the initial concept generation phase,…

The Book Club Exploded

ERIC Educational Resources Information Center

Hoffert, Barbara

2006-01-01

One leader, 12 readers, and a few well-thumbed copies of Jane Austen's "Pride and Prejudice." That is all a book club once required, but this is no longer the case. This article describes how the runaway popularity of book clubs has brought with it a whole new set of possibilities. Thematic discussion? A fiction/nonfiction mix? Videoconferencing?…

Bright ideas. Some rules of thumb for interior lighting design and selection.

PubMed

Hunter, Claudia M

2002-07-01

Interior lighting design and selection can be a demanding assignment for a health facilities manager or department head. It requires a balance between conflicting needs, such as providing good task lighting for a nursing station while also shielding luminaires that are visible from patients' rooms to avoid glare.

Art as Social Concern

ERIC Educational Resources Information Center

Hodge, Stephanie

2010-01-01

In this article, the author describes how her eleventh- and twelfth-grade portfolio class used art as a social concern through a sketchbook and a linoleum print. Students thumbed through copies of the "New York Times" to find an article that described a modern-day social concern. Students were assigned to choose an article, summarize it, and come…

Case report of patients treated with an orthodontic and myofunctional protocol.

PubMed

Saccomanno, S; Antonini, G; D'Alatri, L; D'Angeloantonio, M; Fiorita, A; Deli, R

2014-07-01

Occlusion alterations can be associated to bad habits (such as thumb sucking, oral breathing, atypical swallowing and labial interposition) which can lead to functional anomalies. Three cases are reported with the good results of myofunctional and orthodontic therapy. When there are bad habits, orthodontics should be combined with a myofunctional therapy.

Design tools

Treesearch

Anton TenWolde; Mark T. Bomberg

2009-01-01

Overall, despite the lack of exact input data, the use of design tools, including models, is much superior to the simple following of rules of thumbs, and a moisture analysis should be standard procedure for any building envelope design. Exceptions can only be made for buildings in the same climate, similar occupancy, and similar envelope construction. This chapter...

Implications of Small Samples for Generalization: Adjustments and Rules of Thumb

ERIC Educational Resources Information Center

Tipton, Elizabeth; Hallberg, Kelly; Hedges, Larry V.; Chan, Wendy

2015-01-01

Policy-makers are frequently interested in understanding how effective a particular intervention may be for a specific (and often broad) population. In many fields, particularly education and social welfare, the ideal form of these evaluations is a large-scale randomized experiment. Recent research has highlighted that sites in these large-scale…

Becoming an Architect: Designing and Building

ERIC Educational Resources Information Center

Bates, Janet

2010-01-01

Sometimes, the inspiration for an art idea comes from the strangest and most unexpected places! The author wanted to provide students in grades 5-7 in a fine-arts module an opportunity to be creative in a unique and inexpensive way, while incorporating a three-dimensional element. Since she personally enjoys thumbing through "Architectural…

Multiple-Try Feedback and Higher-Order Learning Outcomes

ERIC Educational Resources Information Center

Clariana, Roy B.; Koul, Ravinder

2005-01-01

Although feedback is an important component of computer-based instruction (CBI), the effects of feedback on higher-order learning outcomes are not well understood. Several meta-analyses provide two rules of thumb: any feedback is better than no feedback and feedback with more information is better than feedback with less information. …

Put on Your Dancing Shoes! Choreographing Positive Partnerships with Parents of Gifted Children.

ERIC Educational Resources Information Center

Riley, Tracy L.

1999-01-01

Uses the analogy of dance to discuss development of positive relationships between teachers and parents of gifted children. Emphasis is on providing parents with necessary information, overcoming barriers to true partnerships, and rules of thumb for implementing the partnership on an ongoing basis, such as following the golden rule in…

Item-Writing Rules: Collective Wisdom

ERIC Educational Resources Information Center

Frey, B.B.; Petersen, S.; Edwards, L.M.; Pedrotti, J.T.; Peyton, V.

2005-01-01

In student assessment, teachers place the greatest weight on tests they have constructed themselves and have an equally great interest in the quality of those tests. To increase the validity of teacher-made tests, many item-writing rules-of-thumb are available in the literature, but few rules have been tested experimentally. In light of the…

5,4,3,2,...Thumbs Up!

ERIC Educational Resources Information Center

Brannon, Frank

1997-01-01

Presents activities for K-4 students that explore two areas of body mechanics--bones and joints--with an emphasis on the human hand. Relates knowledge of how the body functions to comparable examples in robotics such as the "hand" of the Canadarm of the space shuttle. Activities are geared for students in pairs. (AIM)

76 FR 25334 - Notice of Receipt of Requests To Voluntarily Cancel Certain Pesticide Registrations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... person listed under FOR FURTHER INFORMATION CONTACT. B. What should I consider as I prepare my comments... A. 009688-00081 Chemsico Home Tralomethrin. Insect Control B. 009688-00082 Chemsico Tralomethrin... Insecticide D. 009688-00119 Green Thumb Home Tralomethrin. Insect Fogger. 009688-00144 Dethmor 3.75% EC...

1998 Anthropometric Survey of U.S. Army Personnel: Bivariate Frequency Tables

DTIC Science & Technology

1990-05-01

trapezius landmark at the base of the neck and the acromion landmark at the tip of the shoulder. 94 SITTING HEIGHT (SITTHGHT) - vertical distance...wall against which the posterior trunk is in contact and the tip of the thumb when the arm is extended anteriorly. 110 VERTICAL TRUNK CIRCUMFERENCE

Standards for School Leaders Get New Thumbs Up

ERIC Educational Resources Information Center

Olson, Lynn

2008-01-01

A coalition of education groups came together in the mid-1990s to draft model standards for school leaders that would refocus the profession on student learning. Since then, the resulting Interstate School Leaders Licensure Consortium standards have been used or adapted by more than 40 states to guide their own preparation, licensure, and…

STS-131 crew preparing for their T-38 flight to KSC for TCDT

NASA Image and Video Library

2010-03-01

JSC2010-E-032826 (1 March 2010) --- NASA astronaut Dorothy Metcalf-Lindenburger, STS-131 mission specialist, gives a ?thumbs-up? signal as she prepares for a flight in a NASA T-38 trainer jet from Ellington Field near NASA's Johnson Space Center to Kennedy Space Center, Florida.

An Investigation of Double Bass Vibrato Characteristics

ERIC Educational Resources Information Center

Mick, James

2015-01-01

The purpose of this study was to investigate and describe various vibrato characteristics of university double bass students. The primary objectives were: (1) to describe vibrato rate and width for commonly used fingers in first, fourth, and thumb positions; (2) to investigate whether students initiate vibrato in an upward or downward direction;…

The orthodontic practice ownership transition.

PubMed

Caplan, C M

1993-12-01

Any orthodontist contemplating a transfer of ownership interests would be well served ensuring that the decision-making process is handled objectively and analytically and that appropriate advice is acquired before entering into an arrangement. Boiler plate agreements and rules of thumb do not work any more effectively than developing a single diagnosis and treatment plan for all patients.

Development of novel 3D-printed robotic prosthetic for transradial amputees.

PubMed

Gretsch, Kendall F; Lather, Henry D; Peddada, Kranti V; Deeken, Corey R; Wall, Lindley B; Goldfarb, Charles A

2016-06-01

Upper extremity myoelectric prostheses are expensive. The Robohand demonstrated that three-dimensional printing reduces the cost of a prosthetic extremity. The goal of this project was to develop a novel, inexpensive three-dimensional printed prosthesis to address limitations of the Robohand. The prosthesis was designed for patients with transradial limb amputation. It is shoulder-controlled and externally powered with an anthropomorphic terminal device. The user can open and close all five fingers, and move the thumb independently. The estimated cost is US$300. After testing on a patient with a traumatic transradial amputation, several advantages were noted. The independent thumb movement facilitated object grasp, the device weighed less than most externally powered prostheses, and the size was easily scalable. Limitations of the new prosthetic include low grip strength and decreased durability compared to passive prosthetics. Most children with a transradial congenital or traumatic amputation do not use a prosthetic. A three-dimensional printed shoulder-controlled robotic prosthesis provides a cost effective, easily sized and highly functional option which has been previously unavailable. © The International Society for Prosthetics and Orthotics 2015.

Design of Embedded System for Multivariate Classification of Finger and Thumb Movements Using EEG Signals for Control of Upper Limb Prosthesis.

PubMed

Rashid, Nasir; Iqbal, Javaid; Javed, Amna; Tiwana, Mohsin I; Khan, Umar Shahbaz

2018-01-01

Brain Computer Interface (BCI) determines the intent of the user from a variety of electrophysiological signals. These signals, Slow Cortical Potentials, are recorded from scalp, and cortical neuronal activity is recorded by implanted electrodes. This paper is focused on design of an embedded system that is used to control the finger movements of an upper limb prosthesis using Electroencephalogram (EEG) signals. This is a follow-up of our previous research which explored the best method to classify three movements of fingers (thumb movement, index finger movement, and first movement). Two-stage logistic regression classifier exhibited the highest classification accuracy while Power Spectral Density (PSD) was used as a feature of the filtered signal. The EEG signal data set was recorded using a 14-channel electrode headset (a noninvasive BCI system) from right-handed, neurologically intact volunteers. Mu (commonly known as alpha waves) and Beta Rhythms (8-30 Hz) containing most of the movement data were retained through filtering using "Arduino Uno" microcontroller followed by 2-stage logistic regression to obtain a mean classification accuracy of 70%.

A scoping review on smart mobile devices and physical strain.

PubMed

Tegtmeier, Patricia

2018-01-01

Smart mobile devices gain increasing importance at work. Integrating these smart mobile devices into the workplace creates new opportunities and challenges for occupational health and safety. Therefore the aim of the following scoping review was to identify ergonomic challenges with the use of smart mobile devices at work with respect to physical problems. A review of 36 papers based on literature including January 2016 was conducted. Biomechanical measures in the reviewed studies demonstrated i.e., head flexion angles exceeding 20° in 20 out of 26 different conditions described. Furthermore, laterally deviated wrists were frequently noted and thumb and finger flexor muscle activities generally greater than 5% MVC were reported. The reviewed literature indicated an elevated biomechanical risk, especially for the neck, the wrists and thumb. This was due to poor posture, ongoing and intermitted muscle tension, and/or repetitive movements. Papers addressing specific risks for smartphone and tablet use in different work environments are scarce. As the technology, as well as the use of smart mobile devices is rapidly changing, further research, especially for prolonged periods in the workplace is needed.

Extensor Tendon Injuries and Repairs in the Hand

PubMed Central

Kontor, J. A.

1982-01-01

Due to their superficial course, the extensor tendons are frequently lacerated over the dorsum of the hand and fingers. Excellent functional results are obtained in repairs of simple tendon lacerations. ‘Open’ mallet lacerations over the distal IP joint or involving the central extensor slip over the proximal IP joint require more precise suturing methods. More proximal extensor tendon divisions near the wrist involve dissection of the retracted finger extensors or long thumb extensor in the distal forearm and more formal tendon repairs, including a possible tendon transfer to the thumb. ‘Closed injuries’, with varying degrees of extensor tendon disruption, occur at three main sites. The mallet injury at the DIP joint and the boutonnière deformity over the PIP joint are sometimes recognized late, but respond to conservative splinting for a minimum of four weeks with guarded motion avoiding secondary stiffening of the remaining small joints of the hand. Surgery of closed injuries most frequently involves the intra-articular traction fracture type of mallet deformities in which the DIP joint has taken the brunt of the injury. PMID:21286174

A two DoF finger for a biomechatronic artificial hand.

PubMed

Carrozza, M C; Massa, B; Dario, P; Zecca, M; Micera, S; Pastacaldi, P

2002-01-01

Current prosthetic hands are basically simple grippers with one or two degrees of freedom, which barely restore the capability of the thumb-index pinch. Although most amputees consider this performance as acceptable for usual tasks, there is ample room for improvement by exploiting recent progresses in mechatronics design and technology. We are developing a novel prosthetic hand featured by multiple degrees of freedom, tactile sensing capabilities, and distributed control. Our main goal is to pursue an integrated design approach in order to fulfill critical requirements such as cosmetics, controllability, low weight, low energy consumption and noiselessness. This approach can be synthesized by the definition "biomechatronic design", which means developing mechatronic systems inspired by living beings and able to work harmoniously with them. This paper describes the first implementation of one single finger of a future biomechatronic hand. The finger has a modular design, which allows to obtain hands with different degrees of freedom and grasping capabilities. Current developments include the implementation of a hand comprising three fingers (opposing thumb, index and middle) and an embedded controller.

Smoking in top-grossing movies --- United States, 1991-2009.

PubMed

2010-08-20

Exposure to onscreen smoking in movies increases the probability that youths will start smoking. Youths who are heavily exposed to onscreen smoking are approximately two to three times more likely to begin smoking than youths who are lightly exposed; a similar, but smaller effect exists for young adults. To monitor the extent to which tobacco use is shown in popular movies, Thumbs Up! Thumbs Down! (TUTD), a project of Breathe California of Sacramento-Emigrant Trails, counted the occurrences of tobacco use (termed "incidents") shown in U.S. top-grossing movies during 1991-2009. This report summarizes the results of that study, which found that the number of tobacco incidents depicted in the movies during this period peaked in 2005 and then progressively declined. Top-grossing movies released in 2009 contained 49% of the number of onscreen smoking incidents as observed in 2005 (1,935 incidents in 2009 versus 3,967 incidents in 2005). Further reduction of tobacco use depicted in popular movies could lead to less initiation of smoking among adolescents. Effective methods to reduce the potential harmful influence of onscreen tobacco use should be implemented.

Effects of smartphone overuse on hand function, pinch strength, and the median nerve.

PubMed

İnal, Esra Erkol; Demİrcİ, kadİr; Çetİntürk, Azİze; Akgönül, Mehmet; Savaş, Serpİl

2015-08-01

In this study we investigated the flexor pollicis longus (FPL) tendon and median nerve in smartphone users by ultrasonography to assess the effects of smartphone addiction on the clinical and functional status of the hands. One hundred two students were divided into 3 groups: non-users, and high or low smartphone users. Smartphone Addiction Scale (SAS) scores and grip and pinch strengths were recorded. Pain in thumb movement and rest and hand function were evaluated on the visual analog scale (VAS) and the Duruöz Hand Index (DHI), respectively. The cross-sectional areas (CSAs) of the median nerve and the FPL tendon were calculated bilaterally using ultrasonography. Significantly higher median nerve CSAs were observed in the dominant hands of the high smartphone users than in the non-dominant hands (P<0.001). SAS scores correlated with VAS pain for movement and rest, DHI scores, and pinch strength (P<0.05; r=0.345, 0.272, 0.245, and 0.281, respectively). Smartphone overuse enlarges the median nerve, causes pain in the thumb, and decreases pinch strength and hand functions. © 2015 Wiley Periodicals, Inc.

Role of Genetic Factors in the Pathogenesis of Radial Deficiencies in Humans

PubMed Central

Elmakky, Amira; Stanghellini, Ilaria; Landi, Antonio; Percesepe, Antonio

2015-01-01

Radial deficiencies (RDs), defined as under/abnormal development or absence of any of the structures of the forearm, radial carpal bones and thumb, occur with a live birth incidence ranging from 1 out of 30,000 to 1 out 6,000 newborns and represent about one third/one fourth of all the congenital upper limb anomalies. About half of radial disorders have a mendelian cause and pattern of inheritance, whereas the remaining half appears sporadic with no known gene involved. In sporadic forms certain anomalies, such as thumb or radial hypoplasia, may occur either alone or in association with systemic conditions, like vertebral abnormalities or renal defects. All the cases with a mendelian inheritance are syndromic forms, which include cardiac defects (in Holt-Oram syndrome), bone marrow failure (in Fanconi anemia), platelet deficiency (in thrombocytopenia-absent-radius syndrome), ocular motility impairment (in Okihiro syndrome). The genetics of radial deficiencies is complex, characterized by genetic heterogeneity and high inter- and intra-familial clinical variability: this review will analyze the etiopathogenesis and the genotype/phenotype correlations of the main radial deficiency disorders in humans. PMID:26962299

The use of blocking screws with internal lengthening nail and reverse rule of thumb for blocking screws in limb lengthening and deformity correction surgery.

PubMed

Muthusamy, Saravanaraja; Rozbruch, S Robert; Fragomen, Austin T

2016-11-01

Internal lengthening nail (ILN) is a recent development in limb lengthening and deformity correction specialty. The ILN has the distinct advantage of combining acute deformity correction with gradual lengthening of bone. While using ILN, the short metaphyseal bone fragment may develop a deformity at the time of osteotomy and nail insertion or during bone lengthening because of the wide medullary canal. These deformities are typically predictable, and blocking screws (Poller screws) are helpful in these situations. This manuscript describes the common deformities that occur in femur and tibia with osteotomies at different locations while using ILN in antegrade and retrograde nailing technique. Also, a systematic approach to the appropriate use of blocking screws in these deformities is described. In addition, the "reverse rule of thumb" is introduced as a quick reference to determine the ideal location(s) and number of blocking screws. These principles are applicable to limb lengthening and deformity correction as well as fracture fixation using intramedullary nails.

Control of FES thumb force using slip information obtained from the cutaneous electroneurogram in quadriplegic man.

PubMed

Haugland, M; Lickel, A; Haase, J; Sinkjaer, T

1999-06-01

A tetraplegic volunteer was implanted with percutaneous intramuscular electrodes in hand and forearm muscles. Furthermore, a sensory nerve cuff electrode was implanted on the volar digital nerve to the radial side of the index finger branching off the median nerve. In laboratory experiments a stimulation system was used to produce a lateral grasp (key grip) while the neural activity was recorded with the cuff electrode. The nerve signal contained information that could be used to detect the occurrence of slips and further to increase stimulation intensity to the thumb flexor/adductor muscles to stop the slip. Thereby the system provided a grasp that could catch an object if it started to slip due to, e.g., decreasing muscle force or changes in load forces tangential to the surface of the object. This method enabled an automatic adjustment of the stimulation intensity to the lowest possible level without loosing the grip and without any prior knowledge about the strength of the muscles and the weight and surface texture of the object.

Conservative management of partial extensor tendon lacerations greater than half the width of the tendon in manual workers.

PubMed

Al-Qattan, Mohammad M

2015-04-01

Conservative management (without suturing or splints) of partial extensor tendon lacerations greater than half the width of the tendon has not been previously investigated. In this prospective study, a total of 45 injured tendons (with lacerations involving 55%-90% of the width of the tendon) in 39 patients were treated conservatively. Injury zones I, III, and V of the fingers; and zones I and III of the thumb were excluded. Immediate non-resistive active mobilization was initiated and continued for 4 weeks, followed by resistive exercises. Patients were allowed to go back to work after 6 weeks. There were no cases of ruptures, triggering, infection, or complex regional pain syndrome. At final follow-up (8-9 months after injury), all patients obtained full range of motion with no extension lags. All patients were able to go back to normal duties. We conclude that early active motion without the use of splints or sutures in major extensor tendon lacerations in zones II, IV, VI-VIII of the fingers; and zones II, IV, and V of the thumb is safe.

Rod gripper, changer, and storage system

NASA Technical Reports Server (NTRS)

Benson, Mark; Demi, Todd; Mcneill, Robert; Waldo, Keith; Afghan, Alex; Oliver, Jim

1989-01-01

A rod changer and storage design is presented for the lunar deep drill apparatus to be used in conjunction with the Skitter walking platform. The design must take into account all of the lunar environment and working conditions. Some of these are: (1) the moon has one sixth the gravity of earth; (2) temperature gradients can range from about -170 to 265 C; (3) because of the high transportation costs, the design must be as light as possible; and (4) the process must be remotely operated (from earth or satellite) and must be automated. Because of Skitter's multiple degree of freedom movement, the design will utilize Skitter's movement to locate an implement and transport it from the rack to the drill string. The implement will be gripped by a thumb and two finger device, identified through an electronic sensing device on the thumb, and transported from the rack to the footplate and back from the footplate to the rack. The major designs discussed in this report have been broken down into three major areas: (1) gripper design (linear transport mechanism); (2) indexing system; and (3) rack design.

Impact of Finger Type in Fingerprint Authentication

NASA Astrophysics Data System (ADS)

Gafurov, Davrondzhon; Bours, Patrick; Yang, Bian; Busch, Christoph

Nowadays fingerprint verification system is the most widespread and accepted biometric technology that explores various features of the human fingers for this purpose. In general, every normal person has 10 fingers with different size. Although it is claimed that recognition performance with little fingers can be less accurate compared to other finger types, to our best knowledge, this has not been investigated yet. This paper presents our study on the topic of influence of the finger type into fingerprint recognition performance. For analysis we employ two fingerprint verification software packages (one public and one commercial). We conduct test on GUC100 multi sensor fingerprint database which contains fingerprint images of all 10 fingers from 100 subjects. Our analysis indeed confirms that performance with small fingers is less accurate than performance with the others fingers of the hand. It also appears that best performance is being obtained with thumb or index fingers. For example, performance deterioration from the best finger (i.e. index or thumb) to the worst fingers (i.e. small ones) can be in the range of 184%-1352%.

Force Myography to Control Robotic Upper Extremity Prostheses: A Feasibility Study

PubMed Central

Cho, Erina; Chen, Richard; Merhi, Lukas-Karim; Xiao, Zhen; Pousett, Brittany; Menon, Carlo

2016-01-01

Advancement in assistive technology has led to the commercial availability of multi-dexterous robotic prostheses for the upper extremity. The relatively low performance of the currently used techniques to detect the intention of the user to control such advanced robotic prostheses, however, limits their use. This article explores the use of force myography (FMG) as a potential alternative to the well-established surface electromyography. Specifically, the use of FMG to control different grips of a commercially available robotic hand, Bebionic3, is investigated. Four male transradially amputated subjects participated in the study, and a protocol was developed to assess the prediction accuracy of 11 grips. Different combinations of grips were examined, ranging from 6 up to 11 grips. The results indicate that it is possible to classify six primary grips important in activities of daily living using FMG with an accuracy of above 70% in the residual limb. Additional strategies to increase classification accuracy, such as using the available modes on the Bebionic3, allowed results to improve up to 88.83 and 89.00% for opposed thumb and non-opposed thumb modes, respectively. PMID:27014682

[Reconstruction of the extensor pollicis longus tendon by transposition of the extensor indicis tendon].

PubMed

Loos, A; Kalb, K; Van Schoonhoven, J; Landsleitner Dagger, B

2003-12-01

Rupture of the extensor pollicis longus-tendon (EPL) is a frequent complication after distal radius fractures. Other traumatic and non-traumatic reasons for this tendon lesion are known, including a theory about a disorder in the blood supply to the tendon itself. We examined 40 patients after reconstruction of the EPL-tendon in a mean follow-up time of 30 months. All patients were clinically examined and a DASH questionnaire was answered by all patients. The method to reconstruct the EPL-tendon was the transposition of the extensor indicis-tendon. After the operations the thumb was put in a splint for four weeks in a "hitch-hiker's-position". 31 ruptures of the tendon (77.5 %) were a result of trauma. In 20 of them (50 %) a distal radius fracture had occurred. Clinical examination included measurements of the movement of the thumb- and index-finger joints, the grip strength and the maximal span of the hand. Significant differences were not found. The isolated extension of the index finger was possible in all patients. But it was reduced in ten cases which represent 25 %. Our results were evaluated by the Geldmacher score to evaluate the reconstruction of the EPL-tendon. 20 % excellent, 65 % good, 12.5 % fair and 2.5 % poor results were reached. The Geldmacher score was used critically. We suggest its modification for the evaluation of thumb abduction. The DASH score reached a functional value of ten points which represents a very good result. In conclusion the extensor indicis-transposition is a safe method to reconstruct the EPL-tendon. Its substantial advantage is taking a healthy muscle as the motor, thereby avoiding the risk of using a degenerated muscle in late tendon reconstruction. A powerful extension of the index finger will be maintained by physical education. Generally, the loss of the extension of the index finger is negligible. It does not disturb the patients. But it has to be discussed with the patient before the operation.

The prevalence of the sesamoid bones of the hand: a systematic review and meta-analysis.

PubMed

Yammine, Kaissar

2014-11-01

The literature contains various estimates of the prevalence and distribution of the sesamoid bones in the hands. The aims of this systematic review are to provide a better estimate of the frequency of hand sesamoids and its association with variables such as ancestry, gender, and side. Nineteen studies met the inclusion criteria. The pooled rates of the sensitive meta-analyses from large-sample studies in adults showed: (a) true overall rates of 99.9% for the metacarpophalangeal (MCP) joint of the thumb (MCP-I), 53% for the interphalangeal joint (IP-I), 43.4% for the MCP of the index (MCP-II), 1.47% for the MCP of the medius finger (MCP-III), 0.6% for the MCP of the ring finger (MCP-IV), and 67.7% for the MCP of the auricular finger (MCP-V); (b) true radiological rates of 99.9% for the radial thumb sesamoid, 99.6% for the ulnar thumb sesamoid, 47.8% for IP-I, 40% for MCP-II, 1.3% for MCP-III, 0.8% for MCP-VI, and 62.8% for MCP-V. Black, Middle Eastern, and European ancestries conferred significantly higher sesamoid frequencies at IP-I, MCP-II, and MCP-V, respectively. There was a significant association with female gender at MCP-II, MCP-IV, and MCP-V, with ORs of 1.53, 4, and 1.3, respectively, and a nonsignificant "female" trend for the other locations. There was no significant association with hand side. The pooled rates of hand sesamoids in children aged 10-17 years were 92.7, 42.2, 33.8, 0.5, 0.3, and 36.5% for MCP-I, IP-I, MCP-II, MCP-III, MCP-IV, and MCP-V, respectively. The findings of this evidence-based anatomical review provide quantitative evidence that the incidence of sesamoid bones in human hands depends on genetic rather than functional factors. © 2014 Wiley Periodicals, Inc.

GROWTH DISTURBANCES IN BONE AFTER X IRRADIATION AND RADIUM IRRADIATION FOR HEMANGIOMATA IN CHILDHOOD (in German)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weiss, J.; Gregl, A.

1961-08-01

A number of injuries from radiation treatment of hemangiomata have been reported in the literature; two additional instances are reported here. The left hand of a 9-monthold child was treated for hemangiomata by exposure to 480 mg-hr of Ra. This was followed by skin necrosis with poor healing, and a permanent flexion of the wrist toward the radial side. At age 13, corrective surgery was required. The wrist was scarred on the thumb side, and the flexion formed almost a right angle. The left underarm on the ulnar side was shortened by 4 cm, the reach was shortened by 3.5more » cm, arsi the ball of the thumb was atrophied by 2 cm. The thumb was shortened by 1.7 cm, and the middle and forefinger were each shortened by 0.5 cm. The skeleta1 injuries visualized by x ray showed hypoplasia and shortening of the radius. The radial epiphysis was displaced. The distal end of the ulna was raised and bent. The os naviculare was stunted, the os multangulum was completely missing, and there was hypoplasia of metacarpal I. A satisfactory correction was made by partial resection of the ulna and osteotomy of the radius with 90 deg traction on the peripheral fragments. The patient reported that the hand became occupationally useful. In the second case, hemangioma on the right hand of an 18-month-old child was exposed to five x-ray treatments of 700 r each. After about seven months radial abduction increased at the right wrist. X ray showed 3.5-cm shortening of the right radius, with the epiphysis turned approximates 30 deg toward the radius side. The metaphysis was abnormal and partly sclerotic. The epiphysial trabeculae were coarsened. The wrist bones were hypoplastic. The radius was straightened and the ulna was shortened by osteotomy. (BBB)« less

Prevalence and Risk Factors Associated with Musculoskeletal Discomfort in Spay and Neuter Veterinarians

PubMed Central

White, Sara C.

2013-01-01

Simple Summary This study examined musculoskeletal pain and discomfort in spay and neuter veterinarians using an internet-based questionnaire. Hand pain was most common in the right thumb and wrist, and body pain was most common in the lower back, shoulders, and neck. Several work-related risk factors for discomfort were discovered, including long career in spay and neuter, increasing weekly hours in surgery, and decreasing job satisfaction. Although most respondents felt posture during surgery was important, few spay and neuter veterinarians have received any instruction in posture or ergonomics in surgery. Abstract A cross-sectional study to investigate musculoskeletal discomfort (MSD) surveyed 219 veterinarians who currently or previously perform spays and neuters at least 4 hours per week. Participants were asked about the presence and severity of hand and body MSD during the previous month, whether MSD interfered with work or daily activities, whether they attributed their MSD to their spay/neuter work, and whether MSD had ever necessitated absence from work. The period prevalence of MSD was 99.1%, with 76.7% experiencing hand or wrist pain and 98.2% experiencing body pain. Hand discomfort was most commonly reported in the right thumb and/or thumb base (49.8%) and the right wrist (37.9%). Body discomfort was most commonly reported in the lower back (76.7%), shoulders (72.6%), and neck (71.7%). Increasing career length, increasing weekly hours in surgery and decreasing job satisfaction were the work-related factors with the greatest relative contribution accounting for variation in hand pain severity and total pain. Although 94.4% of respondents felt that posture during surgery is important, only 30.6% had received any instruction in posture and positioning for surgery. Future interventions should aim to optimize surgical efficiency, surgeon work schedules, and working environment. Analysis and intervention studies are required to determine further causes of MSD in these veterinarians and develop interventions to prevent MSD. PMID:26487311

Single-arm open-label study of Durolane (NASHA nonanimal hyaluronic acid) for the treatment of osteoarthritis of the thumb

PubMed Central

Velasco, Eloisa; Ribera, Mª Victoria; Pi, Joan

2017-01-01

Introduction Osteoarthritis of the trapeziometacarpal (TMC) joint of the thumb – also known as rhizarthrosis – is painful and has a significant impact on quality of life. Intra-articular injection of hyaluronic acid may potentially meet the need for effective, minimally invasive intervention in patients not responding adequately to initial treatment. We aimed to confirm the safety and effectiveness of viscosupplementation with Durolane (NASHA nonanimal hyaluronic acid) in rhizarthrosis. Patients and methods This was a prospective, single-arm, multicenter, open-label study with a 6-month follow-up period. Eligible patients had Eaton–Littler grade II–III rhizarthrosis in one TMC joint with pain and visual analog scale (VAS) pain score ≥4 (scale: 0–10). A single injection of NASHA was administered to the affected TMC joint. The primary effectiveness variable was change from baseline in VAS pain score. Results Thirty-five patients (mean age 60.8 years; 85.7% female) received NASHA and completed the study. The least-squares mean change from baseline in VAS pain score over 6 months was −2.00, a reduction of 27.8% (p<0.001). The reduction in pain exceeded 25% as early as month 1 (26.5%), and gradual improvement was observed throughout the 6-month follow-up period. Secondary effectiveness parameters included QuickDASH (shortened version of Disabilities of the Arm, Shoulder, and Hand [DASH]), Kapandji thumb opposition test, radial abduction, metacarpophalangeal (MCP) joint flexion, and pinch (clamp) strength. Most of these measurements showed statistically significant improvements from baseline over 6 months. Five adverse events (injection site reactions) were reported in four patients (11.4%), and there were no serious or allergic reactions. Conclusion This study suggests that viscosupplementation using NASHA is effective and well tolerated in treating the symptoms of rhizarthrosis. PMID:28392718

Hand burns surface area: A rule of thumb.

PubMed

Dargan, Dallan; Mandal, Anirban; Shokrollahi, Kayvan

2018-08-01

Rapid estimation of acute hand burns is important for communication, standardisation of assessment, rehabilitation and research. Use of an individual's own thumbprint area as a fraction of their total hand surface area was evaluated to assess potential utility in hand burn evaluation. Ten health professionals used an ink-covered dominant thumb pulp to cover the surfaces of their own non-dominant hand using the contralateral thumb. Thumbprints were assessed on the web spaces, sides of digits and dorsum and palm beyond the distal wrist crease. Hand surface area was estimated using the Banerjee and Sen method, and thumbprint ellipse area calculated to assess correlation. Mean estimated total hand surface area was 390.0cm 2 ±SD 51.5 (328.3-469.0), mean thumbprint ellipse area was 5.5cm 2 ±SD 1.3 (3.7-8.4), and mean estimated print number was 73.5±SD 11.0 (range 53.1-87.8, 95% CI 6.8). The mean observed number of thumbprints on one hand was 80.1±SD 5.9 (range 70.0-88.0, 95% CI 3.7), χ 2 =0.009. The combined mean of digital prints was 42, comprising a mean of two prints each on volar, dorsal, radial and ulnar digit surfaces, except volar middle and ring (3 prints each). Palmar prints were 15 (11-19), dorsal 15 (11-19), ulnar palm border 3, first web space 2, and second, third and fourth web spaces one each. Using the surface of the palm alone, excluding digits, as 0.5% of total body surface area, the area of one thumbprint was approximated as 1/30th of 1%. We have demonstrated how thumbprint area serves as a simple method for evaluating hand burn surface area. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

Hand synergies during reach-to-grasp.

PubMed

Mason, C R; Gomez, J E; Ebner, T J

2001-12-01

An emerging viewpoint is that the CNS uses synergies to simplify the control of the hand. Previous work has shown that static hand postures for mimed grasps can be described by a few principal components in which the higher order components explained only a small fraction of the variance yet provided meaningful information. Extending that earlier work, this study addressed whether the entire act of grasp can be described by a small number of postural synergies and whether these synergies are similar for different grasps. Five right-handed adults performed five types of reach-to-grasps including power grasp, power grasp with a lift, precision grasp, and mimed power grasp and mimed precision grasp of 16 different objects. The object shapes were cones, cylinders, and spindles, systematically varied in size to produce a large range of finger joint angle combinations. Three-dimensional reconstructions of 21 positions on the hand and wrist throughout the reach-to-grasp were obtained using a four-camera video system. Singular value decomposition on the temporal sequence of the marker positions was used to identify the common patterns ("eigenpostures") across the 16 objects for each task and their weightings as a function of time. The first eigenposture explained an average of 97.3 +/- 0.89% (mean +/- SD) of the variance of the hand shape, and the second another 1.9 +/- 0.85%. The first eigenposture was characterized by an open hand configuration that opens and closes during reach. The second eigenposture contributed to the control of the thumb and long fingers, particularly in the opening of the hand during the reach and the closing in preparation for object grasp. The eigenpostures and their temporal evolutions were similar across subjects and grasps. The higher order eigenpostures, although explaining only small amounts of the variance, contributed to the movements of the fingers and thumb. These findings suggest that much of reach-to-grasp is effected using a base posture with refinements in finger and thumb positions added in time to yield unique hand shapes.

Limited independent flexion of the thumb and fingers in human subjects.

PubMed Central

Kilbreath, S L; Gandevia, S C

1994-01-01

1. We investigated whether human subjects can activate selectively flexor pollicis longus (FPL) and digital portions of flexor digitorum profundus (FDP). These muscles were selected because they are the only flexors of the distal phalanges. 2. Electromyographic activity (EMG) was recorded with intramuscular electrodes from one digital component of the deep flexors ('test') while subjects lifted weights by flexing the distal interphalangeal joint of the other digits in turn ('lifting' digits). Only recording sites at which single motor units were recruited selectively at low forces were used. The weights lifted represented 2.5-50% of the maximal voluntary contraction (MVC). We measured the lowest weight lifted which produced phasic and tonic coactivation in the 'test' muscle. 3. The extent of coactivation varied with the 'distance' between the test and lifting digits although no significant difference occurred in the pattern of coactivation thresholds among the digital flexors. The extent of coactivation increased when angular displacement or velocity at the distal interphalangeal joint of the lifting digit increased but was not critically dependent on restraint of the hand. 4. Because mechanical 'connections' could interfere with the ability to move a distal phalanx independently, the arms of nine cadavers were studied. The separation of tendons between the thumb (FPL) and the index portion of FDP, and between the index and middle portions of FDP, usually extended more proximally in the forearm than separation between the tendons to the middle and ring fingers and between the ring and little fingers. Direct intertendinous links were also noted. 5. It is not possible to direct a sufficiently focal motor command to flex selectively the distal joint of the fingers and thumb when forces exceeding 2.5% MVC are generated. For the middle, ring and little fingers in particular, movement of adjacent digits may also involve 'in-series' mechanical links between adjacent components of FDP. Images Figure 6 PMID:7837104

Return to Play After Forearm and Hand Injuries in the National Basketball Association

PubMed Central

Morse, Kyle W.; Hearns, Krystle A.; Carlson, Michelle Gerwin

2017-01-01

Background: Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. Purpose: To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Study Design: Descriptive epidemiology study. Methods: The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. Results: One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play (P < .05). All thumb ligament tears required surgery and had the longest return to play of 67.5 ± 17.7 days (P < .05). The return to play for surgically treated metacarpal fractures (56.7 ± 26.3 days) was significantly greater than nonsurgically treated metacarpal fractures (26.3 ± 12.1 days; P < .01). Return to play for surgically repaired phalangeal fractures (46.2 ± 10.8 days) trended greater but was not significantly different than phalangeal fractures treated nonsurgically (33.3 ± 28.5 days; P = .21). Conclusion: Hand injuries in professional basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries. PMID:28251168

Frequency of De Quervain’s tenosynovitis and its association with SMS texting

PubMed Central

Ali, Maryam; Asim, Muhammad; Danish, Syed Hasan; Ahmad, Farah; Iqbal, Afsheen; Hasan, Syed Danish

2014-01-01

Summary Objective: to assess the frequency of De Quervain’s tenosynovitis and its association with SMS texting. Method: a cross-sectional survey was conducted among undergraduate students studying in different physical therapy schools of Karachi belonging to both public and private sectors. Sample size was 300 students which were selected through convenience sampling. Data was collected through self-administered questionnaire and severity of the pain was assessed through Universal Pain Assessment Tool and De Quervain’s tenosynovitis was diagnosed through Finkelstein test. Data entry and analysis were done using computer software SPSS version 20. Frequency and percentages were taken for categorical variable. Chi-square was applied to determine association between different variables and Finkelstein test. P value < 0.05 was considered significant. Results: male/female ratio was 1:4. Regarding the use of cell phones, majority 165 (55%) were using regular cell phones, another 89 (30%) were using touch screen and 38 (13%) were using QWERTY key pads. Almost half of the students were frequently using cell phones for texting, out of them 132 (44%) texted less than 50 messages per day. Another 96 (32%) did texting between 50–100 texts. Out of 300 students who filled the questionnaire 125 (42%) students were experiencing pain in the thumb/wrist. Finkelstein test when done on students almost half (n=149) showed positive results. It was noted that as frequency of mobile phone usage increased progressively more and more people showed positive Finkelstein Test (p value 0.000). Conclusion: the result of the study concluded that almost half of the students use their mobile phones for texting more than 50 S.M.S per day and because of their mobile key pads and high speed of texting they experienced pain and weakness over the base of the thumb/wrist which shows the De Quervain’s positive in that students and there is a positive association between the thumb pain and frequent text messaging. PMID:24932451

Remote vibrotactile noise improves light touch sensation in stroke survivors’ fingertips via stochastic resonance

PubMed Central

2013-01-01

Background and purpose Stroke rehabilitation does not often integrate both sensory and motor recovery. While subthreshold noise was shown to enhance sensory signal detection at the site of noise application, having a noise-generating device at the fingertip to enhance fingertip sensation and potentially enhance dexterity for stroke survivors is impractical, since the device would interfere with object manipulation. This study determined if remote application of subthreshold vibrotactile noise (away from the fingertips) improves fingertip tactile sensation with potential to enhance dexterity for stroke survivors. Methods Index finger and thumb pad sensation was measured for ten stroke survivors with fingertip sensory deficit using the Semmes-Weinstein Monofilament and Two-Point Discrimination Tests. Sensation scores were measured with noise applied at one of three intensities (40%, 60%, 80% of the sensory threshold) to one of four locations of the paretic upper extremity (dorsal hand proximal to the index finger knuckle, dorsal hand proximal to the thumb knuckle, dorsal wrist, volar wrist) in a random order, as well as without noise at beginning (Pre) and end (Post) of the testing session. Results Vibrotactile noise of all intensities and locations instantaneously and significantly improved Monofilament scores of the index fingertip and thumb tip (p < .01). No significant effect of the noise was seen for the Two-Point Discrimination Test scores. Conclusions Remote application of subthreshold (imperceptible) vibrotactile noise at the wrist and dorsal hand instantaneously improved stroke survivors’ light touch sensation, independent of noise location and intensity. Vibrotactile noise at the wrist and dorsal hand may have enhanced the fingertips’ light touch sensation via stochastic resonance and interneuronal connections. While long-term benefits of noise in stroke patients warrants further investigation, this result demonstrates potential that a wearable device applying vibrotactile noise at the wrist could enhance sensation and grip ability without interfering with object manipulation in everyday tasks. PMID:24112371

Sonographic appearance of the flexor tendon, volar plate, and A1 pulley with respect to the severity of trigger finger.

PubMed

Sato, Junko; Ishii, Yoshinori; Noguchi, Hideo; Takeda, Mitsuhiro

2012-10-01

To evaluate trigger digits with sonography to determine morphological changes in the A1 pulley, flexor tendon, and volar plate in relation to the severity of triggering. We evaluated 67 trigger digits and graded them into 1 of 4 groups. We compared the groups according to severity and to contralateral fingers, which served as controls. The thickness of the flexor tendons under the A1 pulley was proportional to the severity of triggering. The anteroposterior thickness of the flexor tendon increased significantly among the grades exhibiting triggering regardless of the affected digit. However, in digits other than the thumb, tendon thickness increased even in the absence of active triggering. Thickening tended to be greater with finger flexion. The A1 pulley exhibited the greatest thickness and the volar plate exhibited significant thickening in the group that exhibited continuous triggering that was easily reduced with active extension (grade III). The flexor tendon thickened significantly before patients experienced triggering except in the thumb. In the thumb, the flexor tendon and A1 pulley thickened significantly only after patients exhibited triggering. Thickening of the volar plate appears to have an important role in continuous triggering. Although most clinicians can easily determine the severity of a trigger digit by clinical examination, ultrasound might be helpful for objectively understanding the severity and response to treatment, by examining the thickness of the flexor tendon and A1 pulley. In particular, sonographic measurement of the A1 pulley might be useful in judging the progression of trigger finger severity. In cases where a Doppler signal is detected inside the A1 pulley, more conservative therapies might be worth considering before surgery. Diagnostic ΙΙΙ. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

[Therapeutic effect observation of chronic knee joint pain assisted with the central-square needling technique of the thumb-tack needles].

PubMed

Yang, Yang; Qi, Si; Liu, Mengyue; Zhao, Yu; Li, Ning

2017-10-12

To compare the differences in the clinical therapeutic effects on chronic knee joint pain between the combination of the central-square needling technique of thumb-tack needles with the routine therapy of acupuncture, moxibustion and tuina and the routine therapy of acupuncture, moxibustion and tuina . One hundred and twenty patients of chronic knee joint pain were randomized into an observation group and a control group, 60 cases in each one. In the control group, the routine therapy of acupuncture, moxibustion and tuina was adopted. In the observation group, at the end of treatment with the routine therapy of acupuncture, moxibustion and tuina , the subcutaneous embedding therapy was followed with four thumb-tack needles at the sites 1 to 1.5 cm above, below and bilateral to the main point ( ashi point) separately, and the needles were retained for 24 h to 48 h. The treatment was given once every two days, three times a week, totally 6 times in two weeks; and the follow-up visit was done for 3 months in patients of the two groups. The visual analogue scale (VAS) score before and after each treatment, Lequesne index score before treatment and at the end of follow-up and the case numbers of proactive use of painkillers or receiving acupuncture treatment in the follow-up stage were compared and observed in the patients of the two groups. The VAS score was reduced gradually after treatment in the patients of the two groups. The differences were significant statistically after the second treatment as compared with those before the treatment in the two groups (all P <0.05), in which, the improvements in VAS scores after the third treatment in the observation group were more obvious than those in the control group (all P <0.05). At the end of follow-up visit, Lequesne index scores were all improved as compared with those before treatment in the two groups (both P <0.05) and the improvements were similar between the two groups ( P >0.05). In the follow-up stage, there were 0 case in the observation group and 9 cases in the control group in terms of proactive use of painkillers ( P <0.05). There were 5 cases in the observation group and 1 case in the control group receiving acupuncture treatment again ( P >0.05). The acupuncture scheme in assistance with the central-square needling technique of thumb-tack needles obviously relieves chronic knee joint pain, much better sustains the analgesic effects of acupuncture and improves patient compliance.

Describing Soils: Calibration Tool for Teaching Soil Rupture Resistance

ERIC Educational Resources Information Center

Seybold, C. A.; Harms, D. S.; Grossman, R. B.

2009-01-01

Rupture resistance is a measure of the strength of a soil to withstand an applied stress or resist deformation. In soil survey, during routine soil descriptions, rupture resistance is described for each horizon or layer in the soil profile. The lower portion of the rupture resistance classes are assigned based on rupture between thumb and…

Rep. Bill Nelson inside a personal rescue sphere

NASA Image and Video Library

1985-09-25

U.S. Representative Bill Nelson (D.,Florida) gives a thumbs up signal from inside a small ball called a personal rescue sphere (PRS). The PRS is not part of STS 61-C hardware, but serves to evaluate a subject's reaction to close quarters. The photo was taken through a visor on the 39-inch diameter fabric rescue sphere.

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

fleet type from 1992-2014 Last update August 2016 View Graph Graph Download Data Generated_thumb20160830 Trend of S&FP AFV acquisitions by fuel type from 1992-2015 Last update August 2016 View Graph Graph transactions from 1997-2014 Last update August 2016 View Graph Graph Download Data Biofuelsatlas BioFuels Atlas

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

-1paywcu Last update August 2014 View Graph Graph Download Data State & Alt Fuel Providers -kgi9ks Trend of S&FP AFV acquisitions by fleet type from 1992-2014 Last update August 2016 View Graph -2015 Last update August 2016 View Graph Graph Download Data Generated_thumb20160907-12999-119sgvk

Introduction to Exploring Our Bodies

ERIC Educational Resources Information Center

Early Childhood Today, 2006

2006-01-01

The body is probably one of a child's first science experiments. Young children are curious about their own bodies and how they work. They love to explore how they move (and do not move), the sounds they makes, how they look, how different textures feel on their skin, even how it tastes when they suck their thumb. Activities suggested in this…

Lighting Control Systems

DTIC Science & Technology

2004-02-26

Shorter payback periods After 19 Cost Benefit of Powerlink Rule of Thumb for Powerlink: Powerlink becomes more cost effective beyond 16 controlled...web enabled control (and management software) Increase in level of integration between building systems Increase in new features, functions, benefits ...focus on reducing run-time via Scheduling, Sensing, Switching Growing focus on payback Direct energy cost (with demand) Additional maintenance benefits

Assessing the Short-Term Effects on Output of Changes in Federal Fiscal Policies (Working Paper Series)

DTIC Science & Technology

2012-05-01

and to gauge how changes in business and consumer behavior may affect multipliers. In the simplified forms of such models, increases in government...or rule-of-thumb consumers). Research on consumer behavior has found that the spending of some households tends to vary one-for-one with income

Radiolabeled Microsphere Technique in Conscious Subjects during Acceleration Exposures on the USAFSAM Centrifuge.

DTIC Science & Technology

1980-03-01

function even though the pump is pumping air into the blood manifold. R-2 is secured to the plate with two thumb screws, and when the syringes are...the scapula . The animals were allowed 2-4 weeks of surgical recovery before the acceleration studies were performed. Experimental Protocol--On the day

Lift as You Climb: A Profile of President Mary Vosevich

ERIC Educational Resources Information Center

Blumenthal, Anita

2012-01-01

"My thumb got me into this!" declares the new APPA President Mary Vosevich when asked how she entered the field of educational facilities management. It was 1984, and Vosevich, a Midwest native, was working at Monsanto in St. Louis as a research biologist, having earned her B.S. in horticulture/agriculture from the University of…

Sample Size Requirements for Structural Equation Models: An Evaluation of Power, Bias, and Solution Propriety

ERIC Educational Resources Information Center

Wolf, Erika J.; Harrington, Kelly M.; Clark, Shaunna L.; Miller, Mark W.

2013-01-01

Determining sample size requirements for structural equation modeling (SEM) is a challenge often faced by investigators, peer reviewers, and grant writers. Recent years have seen a large increase in SEMs in the behavioral science literature, but consideration of sample size requirements for applied SEMs often relies on outdated rules-of-thumb.…

Training Your Faculty about Copyright When the Lawyer Isn't Looking

ERIC Educational Resources Information Center

Tobin, Thomas J.

2014-01-01

Administrators in higher-education institutions are faced with an often-conflicting landscape of laws, court cases, adopted practices, rules of thumb, and folk wisdom related to copyright concerns on their campuses. Ask any ten faculty member and receive ten different responses about what constitutes fair use, who owns content created for courses,…

Preterite/Imperfect Half-Truths: Problems with Spanish Textbook Rules for Usage.

ERIC Educational Resources Information Center

Frantzen, Diana

1995-01-01

Preterite/Imperfect (PI) usage is one of the hardest grammatical features of Spanish to learn. Some of the blame lies with misleading textbook explanations. A discussion of problematic P/I textbook explanations shows why the presentation of a more reliable set of principles is a preferable alternative to questionable rules of thumb. (18…

Sometimes the Customer "Isn't" Always Right: Problem Solving with Parents

ERIC Educational Resources Information Center

Stephens, Karen

2004-01-01

Relationships become so close in early childhood programs that many parents describe early childhood staff as their children's "extended family." And yet, no matter how genuine attachments are, there still remains the fact that parents are, in fact, the school's paying customers. When money is exchanged in the U.S., the typical rule of thumb for…

The Practical Art of Redesigning Teacher Education: Teacher Education Reform at Washington University, 1970-1975.

ERIC Educational Resources Information Center

Tom, Alan R.

1988-01-01

This article proposes rules of thumb about the teacher education design process. The rules are grounded in the attempts at reforming teacher education at Washington University in the early 1970s, at a time during which a year-long, field-based alternative to the traditional elementary program was operated. (IAH)

The Proper Sequence for Correcting Correlation Coefficients for Range Restriction and Unreliability.

ERIC Educational Resources Information Center

Stauffer, Joseph M.; Mendoza, Jorge L.

2001-01-01

Uses classical test theory to show that it is the nature of the range restriction, rather than the nature of the available reliability coefficient, that determines the sequence for applying corrections for range restriction and unreliability. Shows how the common rule of thumb for choosing the sequence is tenable only when the correction does not…

A Model-Based Approach to Predicting Graduate-Level Performance Using Indicators of Undergraduate-Level Performance

ERIC Educational Resources Information Center

Zimmermann, Judith; Brodersen, Kay H.; Heinimann, Hans R.; Buhmann, Joachim M.

2015-01-01

The graduate admissions process is crucial for controlling the quality of higher education, yet, rules-of-thumb and domain-specific experiences often dominate evidence-based approaches. The goal of the present study is to dissect the predictive power of undergraduate performance indicators and their aggregates. We analyze 81 variables in 171…

STS-51 Discovery crew during post-landing at KSC

NASA Image and Video Library

1993-09-22

STS051-S-161 (22 Sept 1993) --- Thumbs up from all five crew members signal the successful completion of almost ten full days in space. Backdropped against Discovery -- their in-space "home" for the flight -- are, left to right, astronauts Daniel W. Bursch, William F. Readdy, Frank L. Culbertson Jr., James H. Newman and Carl E. Walz.

Green Thumbs: A Kid's Activity Guide to Indoor and Outdoor Gardening.

ERIC Educational Resources Information Center

Carlson, Laurie

This guide contains indoor and outdoor gardening activities for children. The activities teach children how plants live and grow; how the weather, temperature, and seasons affect all living things; how living things come out of seeds and soil; how the birds, earthworms, bees, and toads help in the garden; and how the whole environment works…

Students, Parents Give Thumbs-Up to Flipped Classroom

ERIC Educational Resources Information Center

Pearson, George

2012-01-01

The Flipped Classroom isn't for everyone, but it's been well received by Math and Biology students and their parents at Okanagan Mission Secondary School (OKM) in Kelowna, B.C., and was strongly supported by the OKM principal, Scott Mclean. As teacher Graham Johnson noted in his personal account of his first year using the Flipped Classroom…

Fermilab | About Fermilab | Photo and Video Gallery

Science.gov Websites

LHC Dark matter and dark energy ADMX Muons More fundamental particles and forces Theory Scientific society Particle Physics 101 Science of matter, energy, space and time How particle physics discovery rarely interact with matter. thumb Med-Res Hi-Res A view of Fermilab's MINERvA detector with the MINOS

Culbertson tests cosmonaut space suit in Soyuz trainer

NASA Image and Video Library

2000-02-16

JSC2000-01440 (14 December 1999) --- Using both thumbs to signal success, astronaut Frank L. Culbertson. Jr., emerges from a training session in the nearby Soyuz trainer. Culbertson, currently visiting the Gagarin Cosmonaut Training Center in Russia, is in training as commander for Expedition Three. He was named to that position in September of this year.

STS-124 crew members as they prepare for their T-38 flight to KSC

NASA Image and Video Library

2008-05-06

JSC2008-E-038930 (6 May 2008) --- Astronaut Mike Fossum, STS-124 mission specialist, photographed in the rear station of a NASA T-38 trainer jet, gives a "thumbs-up" signal as he prepares for a flight from Ellington Field near NASA's Johnson Space Center to Kennedy Space Center, Florida.

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

-24960-10gn0o4 Annual Percent Growth of Vehicles in Operation Generated_thumb20160914-24960-10gn0o4 Last Annual Percent Growth of Vehicles in Operation 2010-2011 2011-2012 2012-2013 2013-2014 2014-2015 CNG States of America. Electric drive trains (EVs, Hydrogen, PHEVs and HEVs) experienced the greatest growth

Positioning Techniques to Reduce the Occurrence of DeQuervain's Tendonitis in Nursing Mothers

ERIC Educational Resources Information Center

Virzi, Alison

2010-01-01

DeQuervain's tendonitis is an inflammation of two tendons: the extensor pollicis brevis and the abductor pollicis longus as they cross in the first dorsal compartment of the wrist. Symptoms include pain, swelling along the radial aspect of the wrist, and a decrease in thumb motion. A positive Finkelstein's test at examination is seen. Frequently…

An Exploration of Administrative Heuristics in the United States and the United Kingdom

ERIC Educational Resources Information Center

English, Fenwick W.; Bolton, Cheryl L.

2008-01-01

This article is a report on a study of the use of heuristics, shortcuts, and rules of thumb by middle-line managers in institutions of higher education in the United States and the United Kingdom. Using a nonprobability convenience sample, the coinvestigators interviewed 13 middle-line managers over 5 months from eight institutions. The results…

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

acquisitions by fleet type from 1992-2014 Last update August 2016 View Graph Graph Download Data -m8i0e0 Trend of S&FP AFV acquisitions by fuel type from 1992-2015 Last update August 2016 View Graph transactions from 1997-2014 Last update August 2016 View Graph Graph Download Data Generated_thumb20160907

Relationship between Health Literacy and Self-Directed Learning Readiness of Older Adults

ERIC Educational Resources Information Center

Dennis, Robin Justice

2017-01-01

The primary purpose of this study was to determine if the health literacy level of older adults, age 65 and older, and the self-directed learning readiness score were correlated. After data cleaning, the number of cases was below the recommended rule of thumb. Deletion of cases indicated by the analyst of the self-directed learning readiness score…

Assisting People with Disabilities Improves Their Collaborative Pointing Efficiency through the Use of the Mouse Scroll Wheel

ERIC Educational Resources Information Center

Shih, Ching-Hsiang

2013-01-01

This study provided that people with multiple disabilities can have a collaborative working chance in computer operations through an Enhanced Multiple Cursor Dynamic Pointing Assistive Program (EMCDPAP, a new kind of software that replaces the standard mouse driver, changes a mouse wheel into a thumb/finger poke detector, and manages mouse…

Isolated symmetrical brachymetacarpia of the thumb--case report.

PubMed

Suresh, S S; Abraham, Raju; Ravi, Pullanikattil

2009-12-01

The authors report a case of isolated symmetrical metacarpia of the first metacarpal in a 33-year-old serving soldier. The patient was totally unaware of the deformity, which was found incidentally while radiographs were done for the wrist to rule out scaphoid fracture. To the best of our knowledge, there have been no similar reports in the English literature before.

How Do You Act Intelligently When You Don't Know What You Are Doing?

ERIC Educational Resources Information Center

Levinson, Eliot; Grohe, Barbara

2001-01-01

Presents basic questions for schools to consider in deciding between late and early adoption of new curriculum systems. Outlines rules of thumb for setting up contracts for new Web-based technologies. Suggests that good planning in the initial stages will ameliorate most of the problems that can occur. Concludes with two additional guidelines:…

How Long Should a Training Program Be? A Field Study of "Rules-of-Thumb"

ERIC Educational Resources Information Center

Cole, Nina

2008-01-01

Purpose: This study aims to examine the question of how long a behavioral skills training program should be in order to result in measurable behavioral change. Design/methodology/approach: An empirical field study was conducted to compare two different lengths of time for a managerial skills training program aimed at achieving behavioral change.…

Rediscovering the Kernels of Truth in the Urban Legends of the Freshman Composition Classroom

ERIC Educational Resources Information Center

Lovoy, Thomas

2004-01-01

English teachers, as well as teachers within other disciplines, often boil down abstract principles to easily explainable bullet points. Students often pick up and retain these points but fail to grasp the broader contexts that make them relevant. It is therefore sometimes helpful to revisit some of the more common of these "rules of thumb" to…

Mean, Median, and Skew: Correcting a Textbook Rule

ERIC Educational Resources Information Center

von Hippel, Paul T.

2005-01-01

Many textbooks teach a rule of thumb stating that the mean is right of the median under right skew, and left of the median under left skew. This rule fails with surprising frequency. It can fail in multimodal distributions, or in distributions where one tail is long but the other is heavy. Most commonly, though, the rule fails in discrete…

jsc2002e08143

NASA Image and Video Library

2002-03-01

JSC2002-E-08143 (1 March 2002) --- Astronaut Charles O. Hobaugh, seated at the Spacecraft Communicator (CAPCOM) console in the Shuttle Flight Control Room of the Johnson Space Center's Mission Control Center, gives a thumbs up signal, obviously connected to improving weather at the launch site for the Space Shuttle Columbia several hundred miles away in Florida. Astronaut William A. Oefelein is partially obscured in the background.