A case report on a IV-degree thermal crush injury of right upper arm：The application of functional prosthesis implantation technology

Abstract Severe IV-degree thermal crush injury of limbs involved the subcutaneous fascia, muscle and bone, which may lead to amputation and has a great impact on the patient's quality of life. We can repair wounds with pedicle flaps or even free flaps, However, there are still huge challenges in bone defect of extremities and functional reconstruction. In recent years, with the development of functional prostheses, we have reconstructed limb functions in many patients helping them to complete their daily lives. We report a case where the right upper arm was injured by thermal crush, leading severe burns to the skin, fascia, muscle and bone. We applied a pedicled latissimus dorsi flap and a free anterolateral thigh flap to repair the wound, and realized the function of limb salvage and movement of the right upper arm by implanting 3D printed scapula, upper arm and elbow joint prostheses. This case illustrates that IV-degree burns involving bones have new technologies to repair and achieve mobility now.

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A Thin Anterolateral Thigh Free Flap for Severe Hand Burn Deformity

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i3.65 ◽

1970 ◽

Vol 1 (3) ◽

Author(s):

Parintosa Atmodiwirjo ◽

Dewi Aisiyah Mukarramah

Keyword(s):

Free Flap ◽

Burn Injury ◽

Hand Function ◽

Free Flaps ◽

Good Alternative ◽

Anterolateral Thigh Flap ◽

Right Hand ◽

Anterolateral Thigh ◽

Contracture Release ◽

The Right

Background: Hand is one of the most commonly involved areas in burn injury, resulting in contracture.1 Reconstruction of severe postburn hand deformity is very challenging. Because there is no adjacent skin laxity to allow for local flaps in the burned hand, distant or free flaps should be considered. 2 Application of the thin anterolateral thigh flap in hand reconstruction has become one of the most preferred options for resurfacing of soft-tissue defects after contracture release. 3 Other than closing the defect after contracture release, restoration of hand function is also essential.Patient and Methods: In 2010, a man, 37 years old presented with severe contracture on the right hand due to an explosive flame burn 1,5 years ago. On the right hand, there was hyperextension at the metacarpophalangeal (MCP) joint with flexion on the wrist and thumb abduction with hyperextension at the interphalangeal joint. Our goal is to reconstruct this severe hand burn deformity using thin ALT free flap with flap thickness 4 mm to achieved good hand contour.Results: The thin ALT free flap was vital, and 1-year follow-up gives good hand contours. Patient under rehabilitation therapy from 2 weeks postoperative to attain good functional hand.Summary: A thin anterolateral thigh free flap gives good alternative for resurfacing defect in reconstruction of burn hand than other fasciocutaneous flaps. The advantage are it provides the same color and texture, thin and pliable flap to form good hand contour.

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EDUKASI TERHADAP REMAJA DALAM PENINGKATAN PENGETAHUAN TENTANG PENGGUNAAN GAME DENGAN BIJAK

Jurnal Pemberdayaan Masyarakat Universitas Al Azhar Indonesia ◽

10.36722/jpm.v2i1.361 ◽

2020 ◽

Vol 2 (1) ◽

pp. 11

Author(s):

Ikhsan Fuady ◽

Rangga Saptya MP

Keyword(s):

Side Effects ◽

Violent Behavior ◽

Daily Lives ◽

Before And After ◽

Improper Use ◽

Effective Role ◽

Education And Outreach ◽

The Right ◽

Dedicated Team ◽

User Ratings

AbstrakPemanfaatan game dikalangan remaja memiliki peran yang efektif sebagai wadah untuk hiburan. Tetapi pemanfaatan game tidak tepat memiliki efek samping game terhadap kehidupan sehari hari remaja, mulai dari kurang bersosialIsasi hingga perilaku kekerasan dikalangan remaja. Penyuluhan terhadap remaja bertujuan untuk memberikan pemahaman kepada remaja tentang variasi game berdasarkan rating pengguna, maupun cerdas dalam manajemen penggunaan game dalam kehidupan remaja sehari hari. Pengetahuan remaja tentang varian/ragam game berdasarkan rating relatif rendah sebagaian besar pemengetahuannya tersebar pada kategori sangat rendah dan rendah yaitu sebesar 65 persen. Metode edukasi dan sosialisasi ini adalah dengan beberapa tahapan. Tahap pertaman tim pengabdian memberikan edukasi dan diskusi tentang beragam bentuk game, karakteristik, serta karakteristik pengguna game yang tepat. Selanjutnya beberapa permainan dan kuis untuk meingkatkan literasi remaja tentang pemanfaatan game secara bijak. Kegiatan penyuluhan ini mampu meningkatkan pemahaman para remaja dalam mengenali game yang baik digunakan, hal ini dapat dilihat dari peningkatan pengetahuan remaja relatif signifikan sebelum dan sesudah penyuluhan.Kata kunci: Edukasi, Game, Penyuluhan Abstract The use of games among teenagers has an effective role as a forum for entertainment. But the improper use of games has the side effects of games on the daily lives of adolescents, ranging from lack of socialization to violent behavior in adolescents. Counseling against adolescents aims to provide understanding to adolescents about the variety/variance of games based on user ratings, as well as being smart in managing game use in daily teenage life. Teenagers' knowledge about game variants/based on the rating is relatively low, most of the knowledge is spread in the very low and low categories, which is 65 percent. The method of education and outreach is by several stages. The first stage of the dedicated team provided education and discussion about various forms of games, characteristics, and characteristics of the right game user. Furthermore, some games and quizzes to improve teen literacy about game use wisely. This counseling activity can increase the understanding of teenagers in recognizing games that are well used, this can be seen from the relatively significant increase in adolescent knowledge before and after counseling.Keywords: Education, Games, Counseling

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AI and Migration Management

The Oxford Handbook of Ethics of AI ◽

10.1093/oxfordhb/9780190067397.013.49 ◽

2020 ◽

pp. 768-787

Author(s):

Petra Molnar

Keyword(s):

Human Rights ◽

New Technologies ◽

Forced Migration ◽

Fundamental Rights ◽

International Human Rights Law ◽

Privacy Rights ◽

International Regulation ◽

Development Technology ◽

And Migration ◽

The Right

This chapter focuses on how technologies used in the management of migration—such as automated decision-making in immigration and refugee applications and artificial intelligence (AI) lie detectors—impinge on human rights with little international regulation, arguing that this lack of regulation is deliberate, as states single out the migrant population as a viable testing ground for new technologies. Making migrants more trackable and intelligible justifies the use of more technology and data collection under the guide of national security, or even under tropes of humanitarianism and development. Technology is not inherently democratic, and human rights impacts are particularly important to consider in humanitarian and forced migration contexts. An international human rights law framework is particularly useful for codifying and recognizing potential harms, because technology and its development are inherently global and transnational. Ultimately, more oversight and issue specific accountability mechanisms are needed to safeguard fundamental rights of migrants, such as freedom from discrimination, privacy rights, and procedural justice safeguards, such as the right to a fair decision maker and the rights of appeal.

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Integration of 3D Printed Flexible Pressure Sensors into Physical Interfaces for Wearable Robots

Sensors ◽

10.3390/s21062157 ◽

2021 ◽

Vol 21 (6) ◽

pp. 2157

Author(s):

Kevin Langlois ◽

Ellen Roels ◽

Gabriël Van De Velde ◽

Cláudia Espadinha ◽

Christopher Van Vlerken ◽

...

Keyword(s):

Pressure Distribution ◽

Human Subjects ◽

Pressure Sensors ◽

Poor Performance ◽

Capacitive Pressure Sensor ◽

Upper Arm ◽

Seamless Integration ◽

Dynamic Task ◽

Wearable Robots ◽

3D Printed

Sensing pressure at the physical interface between the robot and the human has important implications for wearable robots. On the one hand, monitoring pressure distribution can give valuable benefits on the aspects of comfortability and safety of such devices. Additionally, on the other hand, they can be used as a rich sensory input to high level interaction controllers. However, a problem is that the commercial availability of this technology is mostly limited to either low-cost solutions with poor performance or expensive options, limiting the possibilities for iterative designs. As an alternative, in this manuscript we present a three-dimensional (3D) printed flexible capacitive pressure sensor that allows seamless integration for wearable robotic applications. The sensors are manufactured using additive manufacturing techniques, which provides benefits in terms of versatility of design and implementation. In this study, a characterization of the 3D printed sensors in a test-bench is presented after which the sensors are integrated in an upper arm interface. A human-in-the-loop calibration of the sensors is then shown, allowing to estimate the external force and pressure distribution that is acting on the upper arm of seven human subjects while performing a dynamic task. The validation of the method is achieved by means of a collaborative robot for precise force interaction measurements. The results indicate that the proposed sensors are a potential solution for further implementation in human–robot interfaces.

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Suprafascial Free Flaps: Classification and Comprehensive Review of the Literature

Craniomaxillofacial Trauma & Reconstruction Open ◽

10.1177/24727512211020574 ◽

2021 ◽

Vol 6 ◽

pp. 247275122110205

Author(s):

Sebastian Rios ◽

María Isabel Falguera-Uceda ◽

Alicia Dean ◽

Susana Heredero

Keyword(s):

Survival Rate ◽

Preoperative Planning ◽

Donor Site ◽

Free Flaps ◽

Donor Site Morbidity ◽

Anterolateral Thigh Flap ◽

Cochrane Library ◽

Review Of The Literature ◽

Comprehensive Review ◽

Search Terms

Study Design: Suprafascial free flaps have become common place in reconstructive surgery units. Nomenclature related to these flaps has not been uniform throughout the scientific literature, especially in regard to planes of dissection. This study is designed as a comprehensive review of the literature. Objectives: Our study highlights which flaps are used most frequently, their main indications, their survival rate, and how they have evolved in the last few decades as innovations have been introduced. Methods: A review of the literature was performed using keywords and Medical Subject Headings search terms. PubMed, Embase, and Cochrane Library were searched using the appropriate search terms. Data collected from each study included flap type, dissection plane, preoperative planning, area of reconstruction, as well as complications, donor-site morbidity and survival rate. Results: Seven hundred and fifty-five studies were found based on the search criteria. After full-text screening for inclusion and exclusion criteria 34 studies were included. A total of 1332 patients were comprised in these studies. The most common types of flaps used were superficial circumflex iliac perforator flap (SCIP), anterolateral thigh flap (ALT), and radial forearm flap. The most common areas of reconstruction were head & neck and limbs. There was no significant difference in survival rates between flaps that were raised in different planes of dissection. Conclusions: Based on the author’s review of the literature, suprafascial flaps are reliable, they have low donor site morbidity, and there is a wide selection available for harvest. The use of new technologies for preoperative planning, such as CT-Angiography and UHF ultrasound, have contributed to have more predictable results. We propose a standardized classification for these flaps, in order to create a uniform nomenclature for future reference.

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Teleworking: A New Reality Conditioned by the Right to Privacy

Laws ◽

10.3390/laws10030064 ◽

2021 ◽

Vol 10 (3) ◽

pp. 64

Author(s):

Carlos Arroyo-Abad

Keyword(s):

New Technologies ◽

Legal Framework ◽

Right To Privacy ◽

The Right To Privacy ◽

Work From Home ◽

Provision Of Services ◽

The Right

Faced with protecting the right to privacy and, with it, the inviolability of homes, the development of new technologies and the possibility of developing work from home has opened the door to a series of new conflicts that require us to provide a specific legal framework by which such situations can be addressed. In the Spanish case, we speak of Law 10/2021 from 9 July on remote working. The objective of this study is to assess the scope as well as the problems that this law generates during its application, regarding controlling the provision of services. However, we not only identify the incidental factors, but also provide a necessary reinterpretation of the right to privacy from the perspective of the inviolability of homes, especially when its current articulation may operate to the detriment of employees’ rights, as contradictory as this may seem.

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Embracing Industry 4.0: Empirical Insights from Malaysia

Informatics ◽

10.3390/informatics8020030 ◽

2021 ◽

Vol 8 (2) ◽

pp. 30

Author(s):

Mansoor Ahmed Soomro ◽

Mohd Hizam-Hanafiah ◽

Nor Liza Abdullah ◽

Mohd Helmi Ali ◽

Muhammad Shahar Jusoh

Keyword(s):

Industry 4.0 ◽

New Technologies ◽

Descriptive Study ◽

Digital Transformation ◽

Quantitative Approach ◽

Survey Questionnaire ◽

Digital Revolution ◽

Leadership Strategy ◽

The Right ◽

The Cost

Industry 4.0 revolution, with its cutting-edge technologies, is an enabler for businesses, particularly in reducing the cost and improving the productivity. However, a large number of organizations are still too in their infancy to leverage the true potential of Industry 4.0 and its technologies. This paper takes a quantitative approach to reveal key insights from the companies that have implemented Industry 4.0 technologies. For this purpose, 238 technology companies in Malaysia were studied through a survey questionnaire. As technology companies are usually the first in line to adopt new technologies, they can be studied better as leaders in adopting the latest technologies. The findings of this descriptive study surfaced an array of insights in terms of Industry 4.0 readiness, Industry 4.0 technologies, leadership, strategy, and innovation. This research paper contributes by providing 10 key empirical insights on Industry 4.0 that can be utilized by managers to pace up their efforts towards digital transformation, and can help the policymakers in drafting the right policy to drive the digital revolution.

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Laryngeal Cancer With Lung Metastases Showing Long-Term Complete Response and Delayed Immune-Related Adverse Event After Nivolumab Discontinuation

Ear Nose & Throat Journal ◽

10.1177/01455613211031025 ◽

2021 ◽

pp. 014556132110310

Author(s):

Takahito Kondo ◽

Munehide Nakatsugawa ◽

Mitsuru Okubo ◽

Hironori Nakamura ◽

Daisuke Yunaiyama ◽

...

Keyword(s):

Interstitial Pneumonia ◽

Laryngeal Cancer ◽

Lung Metastases ◽

Complete Response ◽

Cervical Lymph Node Metastasis ◽

Anterolateral Thigh Flap ◽

Drug Discontinuation ◽

Antibody Testing ◽

Extranodal Extension ◽

The Right

We report a case of laryngeal cancer with multiple lung metastases that maintained a complete response (CR) for 18 months after discontinuing nivolumab treatment, with colitis developing 5 months after drug discontinuation. A 65-year-old man was diagnosed with T3N2cM0 stage IVA right supraglottic squamous cell carcinoma that progressed after 1 course of TPF (cisplatin, docetaxel, and 5-fluorouracil) as induction chemotherapy. He underwent total laryngectomy, bilateral neck dissection, pharyngeal reconstruction with anterolateral thigh flap, and creation of a permanent tracheostoma; extranodal extension was detected in the right cervical lymph node metastasis, and the patient underwent adjuvant radiotherapy. Multiple lung metastases occurred during radiotherapy, and the patient was deemed platinum refractory; nivolumab treatment was thus initiated. The tumor proportion score for programmed death-ligand 1—evaluated via antibody testing of the laryngeal tumor—was <1. The patient received 240 mg/body nivolumab every 2 weeks; a computed tomography performed after course 16 of nivolumab treatment confirmed a CR. He exhibited grade 2 thyroid dysfunction, grade 1 interstitial pneumonia, and grade 2 colitis after 6, 7, and 14 months of receiving nivolumab, respectively; treatment was discontinued as despite maintaining a CR, interstitial pneumonia occurred twice. Colitis appeared 5 months after nivolumab discontinuation; nevertheless, a CR was maintained after 18 months.

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Normative Arm and Calf Blood Pressure Values in the Newborn

PEDIATRICS ◽

10.1542/peds.83.2.240 ◽

1989 ◽

Vol 83 (2) ◽

pp. 240-243

Author(s):

Myung K. Park ◽

Da-Hae Lee

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Mexican Americans ◽

Newborn Infants ◽

Coarctation Of The Aorta ◽

Upper Arm ◽

Mean Values ◽

The Right ◽

Diagnosis Of Hypertension ◽

Mean Heart Rate

Indirect BP measurement was obtained in the right upper arm in 219 healthy newborn infants with the Dinamap monitor and was compared with values obtained from the calf to establish normative BP values and to help establish a diagnosis of hypertension and coarctation of the aorta in the newborn. There were 174 Mexican-Americans (79.5%), 33 whites (15.0%), and 12 blacks (5.5%). The width of the BP cuff was selected to be 0.4 to 0.5 times the circumference of the extremities. Three supine position readings of BPs and heart rate were obtained from each site and were averaged for statistical analyses. Mean arm BP values (±SD) of the neonate less than 36 hours of age were 62.6±6.9/38.9± 5.7 mm Hg (48.0±6.2 mm Hg). Neonates older than 36 hours had slightly but significantly (P<.05) greater values (4 to 6 mm Hg) than did infants younger than 36 hours of age. Active neonates had values 6 to 10 mm Hg greater than quiet neonates (P<.05). BP values in the calf obtained with the same-sized cuff were almost identical with those obtained from the arm. Differences in consecutively obtained arm and calf BPs (arm values minus calf values) were 1.1±7.7 mm Hg systolic, -0.01 ± 6.2 mm Hg diastolic, and 0.9 ±6.9 mm Hg mean pressures. Mean heart rate (±SD) of neonates less than 36 hours of age was 129.4± 13.2 beats per minute and that of neonates older than 36 hours of age was 139.4± 14.1 beats per minute. These results show the following: (1) arm BPs and calf BPs using the same-sized cuff are almost identical with mean values of approximately 65/ 41 mm Hg (50 mm Hg) in neonates one to three days of age, (2) arm BP of 75/49 mm Hg (59 mm Hg) or greater is in the hypertensive range, and (3) calf BPs that are less than arm BPs by mean + 1 SD (6 to 9 mm Hg) necessitate a thorough investigation for coarctation of the aorta.

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The Relationship between Consistency of Propulsive Cycles and Maximum Angular Velocity during Wheelchair Racing

Journal of Applied Biomechanics ◽

10.1123/jab.24.3.280 ◽

2008 ◽

Vol 24 (3) ◽

pp. 280-287 ◽

Cited By ~ 6

Author(s):

Yong “Tai” Wang ◽

Konstantinos Dino Vrongistinos ◽

Dali Xu

Keyword(s):

Angular Velocity ◽

Upper Limb ◽

Wheelchair Propulsion ◽

Upper Arm ◽

Wheelchair Athletes ◽

Angular Velocities ◽

Limb Kinematics ◽

Analysis System ◽

The Right ◽

The Relationship

The purposes of this study were to examine the consistency of wheelchair athletes’ upper-limb kinematics in consecutive propulsive cycles and to investigate the relationship between the maximum angular velocities of the upper arm and forearm and the consistency of the upper-limb kinematical pattern. Eleven elite international wheelchair racers propelled their own chairs on a roller while performing maximum speeds during wheelchair propulsion. A Qualisys motion analysis system was used to film the wheelchair propulsive cycles. Six reflective markers placed on the right shoulder, elbow, wrist joints, metacarpal, wheel axis, and wheel were automatically digitized. The deviations in cycle time, upper-arm and forearm angles, and angular velocities among these propulsive cycles were analyzed. The results demonstrated that in the consecutive cycles of wheelchair propulsion the increased maximum angular velocity may lead to increased variability in the upper-limb angular kinematics. It is speculated that this increased variability may be important for the distribution of load on different upper-extremity muscles to avoid the fatigue during wheelchair racing.

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