Design and Calibration of Pinch Force Measurement Using Strain Gauge for Post-Stroke Patients

Two fingers strength is an indicative measurement of pinch impairment. Conventionally, Fugl Meyer Upper Extremity Assessment (FMA-UE) is the primary standard to measure pinch strength of post-stroke survivors. In literature, the evaluation method performed by the therapist is subjective and exposed to inter-rater and intra-rater reliabilities. Recently, force-sensing resistors were implemented to measure two fingers force, but these sensors are subjected to nonlinearity, high hysteresis, and voltage drift. This paper presents a design of pinch force measurement based on the strain gauge. The pinch sensor was calibrated within a range of between 0 N to 50 N over a pinching length of 20 mm with a linearity error of 0.0123% and hysteresis of 0.513% during the loading and unloading process. The voltage drift has an average of 0.24% over 20 minutes. The pinch force measurement system reveals an objective pinch force measurements in evaluating the rehabilitation progress of post-stroke patients

Impact of Total Salpingectomy Versus Tubal Conservation During Abdominal Hysterectomy on Ovarian Function

Background: Hysterectomy is one of the most common surgeries in women worldwide. It is applied for the treatment of various problems, such as pelvic pain, menstrual problems, tumors, and other related diseases. Objective: The aim of this work was to preservation of ovarian function as long as possible to decrease manifestation of menopause in hysterectomized patients. Patients and Methods: The study was case control study included 58 patients attendant in outpatient clinic of Obstetrics and Gynecology department, Zagazig University Hospital, and Banha Teaching Hospital during the period from April 2017 to October 2018. All patients were scheduled to total abdominal hysterectomy without oophorectomy due to benign uterine disease. Patients was classified into two groups randomly: Group 1: included odd number of patients 29 was subjected to total abdominal hysterectomy with bilateral complete excision of the tubes. Group II: included an even numbers of patients (n =29) for whom the classical approach of hysterectomy was performed. Results: There was no significant difference between groups regarding Operation, time Hospital stay and Bleeding. Also regarding number of antral follicle post operatively. While these are significant differences between Ovary size distributions between studied groups at different times. Conclusions: It could be concluded that salpingostomy with abdominal hysterectomy is a safe and convenient treatment that does not have a deleterious effect on ovarian reserve

Workplace Violence Against Doctors in Khartoum State, Sudan, 2020

Background: Workplace violence against healthcare workers and especially doctors are now clearly taken as a rapidly rising health problem in Sudan with great political and legal concerns. The current study was aimed at exploring the prevalence of verbal and physical workplace violence, the major factors associated with it, and its consequences reported by medical staff in Khartoum, Sudan government hospitals in 2020. Methods: This cross-sectional study utilized self-administered questionnaires to collect data on aspects of workplace violence against doctors working in the government hospitals of Khartoum, Sudan. A nine-item self-reported workplace violence scale was used. An online survey of self-reported work-related violence exposure during the preceding 12 months was sent to conveniently selected doctors. In total, 387 doctors completed the questionnaire in 2020. Data were analyzed using the SPSS version 26. Results: One hundred and ninety five (50%) respondents reported they were victims of violence in the previous 12 months; 92% of them experienced nonphysical violence; while female doctors were more likely to experience this type of violence (67%), younger respondents <30 years of age were more likely to encounter violent episodes. Results show an association between exposure to physical violence and working at an emergency department. The assailants were mostly males in the age group of 19–35 years (70.2%), most of them were under no influence (60.8%). Conclusion: Approximately one in every two doctors had experienced some degree of violence, either physical or nonphysical or both, and it was negatively reflected on their psychological status as well as their work performance

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Quantification of the Therapist’s Gentle Pull for Pinch Strength Testing Based on FMA and MMT: An Experimental Study with Healthy Subjects

Static pinch strength against a therapist’s gentle pull is evaluated using the pincer grasp component of the Fugl Meyer Assessment (FMA) to assess pinch impairment after stroke. In the pincer grasp component, therapists applied a gentle pull to distinguish between a score of 1 (moderate pinch impairment) and a score of 2 (no pinch impairment). The gentle pull is described as a resistance equivalent to a manual muscle test (MMT) score 4/5. The accepted use of “gentle” as a qualitative description for the pull results is a non-standardized subjective interpretation. The goal of this paper was to determine the quantitative value of the gentle pull applied by the therapists as in their clinical practice using a pinch–pull gripping system. The FMA protocol was used to standardize the body and fingers positions of three occupational therapists who were then instructed to apply a gentle pull of 4/5 MMT using their thumb and index fingers (in a tip-to-tip pinch). The results show that the therapists exerted a mean gentle pull (4/5 MMT score) of 6.34 ± 0.98 N with high reliability and acceptable repeatability. In investigating the ability of healthy subjects to resist the gentle pull, 50 adult male volunteers were instructed to pinch the pincer object and resist a dynamic loading exerted by the pinch–pull gripping system as much as possible to the moment the pincer object slips away. The results show that all subjects were able to exert a pulling force higher than the quantitative value of the gentle pull

Robust position encoding and velocity deduction for real time water level monitoring

Precision Farming is concept that emphasis on optimization of input for maximum output. In rice production, Precision Farming has been gradually implemented to improve the rate of production. One of the activities is in the management of water usage, for better sustainability. Otherwise an uncontrolled water management leads to excessive use and in the long run may cause the soil to be damped and too soft for machinery to travel without sinking. Motivated by the problems related to irrigated water management for rice production, this research was conducted as a proposed method to measure the level of water, deducing the rate of rising, and at the same time establishing a wireless connectivity for possible use of remote monitoring. Specifically, this research presents a proposed technique for linear motion parameters measurement system. The measurement system contains linescan transducer with built in illumination system, grating scale, and ultrasonic sensor. Once the linescan transducer scans the grating scale optically, the displacement of the transducer is measured based on pixel differential method. However, if the time of the travelling is known, then it is possible to deduce the velocity and the acceleration of the transducer movement. Additionally, an ultrasonic sensor is added to the transducer to provide the initial position in proximity. The design of the linescan transducer basically included the illumination source and the division of grating scale. The accuracy of the measurements were compared to white and infrared lights. Then, the comparison was based on three scale divisions which are 0.5 mm, 1 mm, and 2 mm. Finally, the accuracy was also compared to different travelling ranges of motion. Moreover, the linescan transducer measurements were evaluated comparatively to reference devices. Two ZigBee modules were incorporated into the device, which allowed remote data communication between the transducer to a monitoring station. The wireless connection was tested over different transmission distances with a view to inform the accuracy of the measurements through ZigBee technology. The linescan module had low errors, if the grating scale division was 2 mm and the used illumination was infrared LEDs. In this case, the average error was 0.9% and the standard deviation was 11.63 mm over travelling range of 500 mm. However, after adding an ultrasonic sensor to the transducer, the integration of linescan sensor and ultrasonic sensor could measure the displacement over 1 meter with average error of 1.18% and standard deviation of 783 mm. The remote monitoring system could successfully send the data over different transmission distances (1.5m-10m) based in ZigBee modules. As a result, the output of this research is a contribution to knowledge in novel, robust, and simplified method for measurement of displacement, velocity, and acceleration of object in linear horizontal motion

Quantification of gentle pull using pinch-pull gripping system based on fugl meyer and manual muscle test protocols for rehabilitation

Fugl Meyer Assessment (FMA) and Manual Muscle Test (MMT) protocols are widely used in post-stroke rehabilitation assessment. In the protocol related to pinch function evaluation, the patients are required to pinch a pincer object and the therapists would apply some resistance equivalent to 4/5 score of MMT to distinguish between subjects whom is fully recovered and yet to recover. The resistance applied by the therapist using 4/5 MMT is also described as applying gentle pull in FMA protocol. Subject’s ability or inability to pinch and resist the gentle pull would lead to either score 1 (not recovered) or score 2 (recovered). However, the gentle pull (4/5 MMT) is subjective which may result in intra-rater and inter-rater variations. In this study, the gentle pull is determined quantitatively using a developed pinch-pull gripping system. The pinch-pull gripping system consists of a customized pinch force load cell measuring the pinch force, pulling force load cell measuring the pulling force, linear actuator applying the automatic pull, and displacement sensor to track the pinch slip. In determining the quantitative value of gentle pull, four therapists were recruited at Universiti Putra Malaysia Teaching Hospital and instructed to pinch a pincer object and exert a gentle pull equivalent to 4/5 MMT as they would apply in clinical practice. The results showed that the quantitative value of the therapist’s gentle pull is 6.59±0.94 N. In order to investigate if this gentle pull force is able to distinguish the normal volunteers, fifty normal volunteers representing score 2 were recruited and their pulling forces were measured and compared with the quantitative value of the gentle pull. The volunteers were instructed to pinch the pincer object and resist the automatic pull of the linear actuator as much as possible before the pincer object slips away from their fingers. The results show that the normal volunteers exerted mean pulling forces at slip away of 14.84±3.57 N and 13±2.72 N for right and left hands, respectively. This indicates that the normal volunteers attributed to score 2 is able to resist the gentle pull exerted by the therapist. Furthermore, the amount of gentle pull applied by the therapists is indeed suitable and that the pinch-pull gripping system is able to measure the pulling force accurately. The results also show that despite the volunteers exhibiting a small slip displacement, they could still resist the increase in the pulling force up to slip away. Thus, the presence of slip displacement prior to slip away is inadequate to judge the subject’s ability to resist the gentle pull. In rehabilitation, the pinch-pull gripping system can be used to evaluate the recovery of pinch function. In order to achieve a full recovery, the patient should be able to pinch the pincer object and resist the 6.59 N pull exerted by the pinchpull gripping system

Design and Calibration of Pinch Force Measurement Using Strain Gauge for Post-Stroke Patients

Two fingers strength is an indicative measurement of pinch impairment. Conventionally, Fugl Meyer Upper Extremity Assessment (FMA-UE) is the primary standard to measure pinch strength of post-stroke survivors. In literature, the evaluation method performed by the therapist is subjective and exposed to inter-rater and intra-rater reliabilities. Recently, force-sensing resistors were implemented to measure two fingers force, but these sensors are subjected to nonlinearity, high hysteresis, and voltage drift. This paper presents a design of pinch force measurement based on the strain gauge. The pinch sensor was calibrated within a range of between 0 N to 50 N over a pinching length of 20 mm with a linearity error of 0.0123% and hysteresis of 0.513% during the loading and unloading process. The voltage drift has an average of 0.24% over 20 minutes. The pinch force measurement system reveals an objective pinch force measurements in evaluating the rehabilitation progress of post-stroke patients

Precise positioning based on pixel differential in linear optical sensor array

Precision farming emphasis on the efficient use of resources for optimizing the output. In the production of paddy, measurement of water level and the rate of rising are important factors. Sensing techniques suffer from some restrictions which restrict obtaining high accuracy and high resolution measurements such as noise of electrical sensor, sensing clear response, potential error, and environmental effects. This paper presents a non-contact method to measure position in linear motion. Moreover, this work is going to be background and concept for water level measuring syste

An Automated Data Acquisition System for Pinch Grip Assessment Based on Fugl Meyer Protocol: A Feasibility Study

The Upper Extremity Fugl Meyer Assessment (UE-FMA) is the most comprehensive assessment for pinch impairment after stroke. The pinch test of UE-FMA is manually performed by pulling a pincer object away from the patient’s fingers while providing a visual observation that results in a subjective assessment. In this study, an automated data acquisition system that consists of a linear electric actuator applying automatic pulling to the customized pincer object held by the volunteer was developed. The pinch force was measured such that a strain gauge was placed on the pincer object while pulling force was measured using pulling force load cell connected in between the linear electric actuator and customized pincer object. The pincer object’s slip onset was detected using a displacement slip sensor. The mean pinch and pulling force values at the slip onset were 12.17 and 6.25 N for right hands, while mean pinch and pulling force values were 11.67 and 5.92 N for left hands of 50 healthy volunteers, respectively. Based on the paired t-test, there is no significant difference between right and left hands. The automated data acquisition system can objectively apply a pulling force, detect the slip onset, and measure the pinch and pulling forces