bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hammertoe Correction with Wire Fixation of Varying Length
Authors: Mayolo Patrick , Kress Kristin L. , Kang Paul , Jaffe David E. 
Published: January 2022

Category: Midfoot/Forefoot; Lesser Toes Introduction/Purpose: Hammertoe deformities are commonly encountered and frequently require surgical intervention for pain relief and shoewear accommodation. Various techniques exist for surgical management, but proximal interphalangeal (PIP) joint fusion with Kirschner (K) -wire fixation remains an inexpensive, popular treatment. The decision to place a K wire that spans the metatarsophalangeal (MTP) joint versus only fixating the digit through the proximal phalanx is entirely dependent on provider preference and situational context. This study was performed to evaluate the effect of length of wire fixation on clinical outcomes after hammertoe reconstruction. Methods: A retrospective review of all hammertoe reconstructions by a single fellowship trained foot and ankle surgeon from 2017-2021 was performed. Hammertoe reconstructions involved PIP arthrodesis with double wire fixation and other supplemental balancing procedures as indicated. Pins were routinely removed at between 5-6 weeks and protected heel weightbearing was generally advised. Wire length was chosen at the discretion of the surgeon intraoperatively. Patients were excluded if no radiographic follow-up was available after pin removal. Patient outcomes were evaluated with radiographs and clinic notes to assess pin length, pin complications/breakage, return to the OR, MTP congruency, and PIP union rate. A logistic regression was performed to determine the odds ratio for digit congruency and non-union status. Results: 88 toes (45 patients) underwent hammertoe reconstruction with K wire fixation. Of these toes, 47 had wires that spanned the MTP and 41 that did not. There were 65 congruent MTP joints and 23 incongruent joints. 16 of the incongruent joints were pinned across the MTP while 31 in the congruent group were pinned. One toe in the MTP group required return to the OR for removal of a broken wire, compared to zero in the phalanx group (p=1.0). No pins broke in the phalanx group, compared to 3 in the MTP group (p=0.25). One toe in the proximal phalanx group had their pins pull out early but no return to the OR was needed. There were 26 (63.4%) PIP radiographic nonunions, compared to 21 (44.7%) in the MTP group (p=0.12). Conclusion: Wire failure was a rare occurrence in either group. Breakage only occurred in the MTP group, but only required one surgical intervention for removal. Pinning the MTP may allow for improved deformity correction and increased stability of the hammertoe reconstruction. Pin breakage can occur, but it may be of little clinical significance. The increased stability and control of MTP correction may be worth the potential risk of pin breakage. Pin breakage may be avoided potentially by using thicker wires, earlier removal, and protected weightbearing.
Changes in Plantar Forces and Pressures During Functional Movement with an Intrepid Dynamic Exoskeletal Orthosis Brace
Authors: Meeker James E. , Weiss Jason , Thompson Austin R. , Feng Jing 
Published: January 2022

Category: Ankle; Ankle Arthritis; Midfoot/Forefoot; Trauma Introduction/Purpose: Non-surgical interventions such as bracing using ankle foot orthoses (AFO) aim to assist, restore and redirect weightbearing forces with immobility in mind. We identified a custom carbon fiber specific energy storing AFO that was created to improve functional performance in veterans after limb salvage procedures. While being evaluated exclusively in a veteran population, the Intrepid Dynamic Exoskeletal Orthosis (IDEO) has also been indicated to be a conservative treatment option for veterans with posttraumatic osteoarthritis of the tibiotalar and subtalar joints. To evaluate the off-loading properties of the IDEO brace in a civilian population with osteoarthritis of the ankle. Methods: Eight civilian patients 18-years or older who were prescribed an IDEO brace by a single surgeon participated in the study. Foot pressure data were recorded using Tekscan F-Scan system, an ultra-thin, in-shoe sensor that provides force and pressure information. Participants were instructed to walk at a self-selected pace along a 20 meter walkway under three conditions. Using F-Scan Research software, the stances were identified and averaged. Then, the forefoot and heel areas were identified. Next, the maximal force, force*time integral (FTI), maximal contact area, maximal contact pressure, pressure*time integral (PTI), and center of force (COF) excursion were calculated. One-way ANOVA with repeated measures was performed to detect effects of the condition (three levels: Without, Under and Over). Pairwise comparison with least significant difference (equivalent to no adjustments) was performed to detect difference among the conditions. Results: Compared to the Without condition, the Under condition showed higher pressure in both the heel and the forefoot areas (especially in the forefoot) in most subjects; COF excursion was increased in some subjects. Compare to the Without condition, the Over condition showed reduced pressure in both the heel and the forefoot areas (especially in the forefoot) in most subjects. The statistical results below only included the involved side of the six subjects who were tested in all three conditions. Table 1 showed the results of one-way ANOVA with repeated measures of the six subjects. Conclusion: The results of this study showed that the IDEO is effective in improving gait function and relieving forefoot pressure in the civilian population. IDEO generated force (and thus power), especially in the forefoot area in late stance, to provide more push-off power and propel the body moving forward. While acting as a functional foot, the IDEO reduced force by 66% and reduced pressure by 49% in the forefoot area, which helped to relieve pain. IDEO creates functional foot by storing power in the early stance and release power in late stance.
Clinical Outcomes of Nano Arthroscopy in the Office Setting for the Treatment of Posterior Ankle Impingement
Authors: Mercer Nathaniel P. , Samsonov Alan , Dankert John , Delmonte Rick J. , Stornebrink Tobias , Gianakos Arianna L. , Kerkhoffs Gino , Kennedy John G. , Dahmen Jari 
Published: January 2022

Category: Ankle; Arthroscopy Introduction/Purpose: The hypothesis of the current study was that IONA in the treatment of posterior ankle impingement would provide the patient with a unique experience of their pathology and facilitate their rapid recovery through an awareness of their own condition and that using IONA would accelerate recovery to sports-specific activities compared to standard arthroscopic procedures. Methods: This was a retrospective cohort study investigating patients who underwent IONA for posterior ankle impingement between 2019 and 2020. Clinical outcomes were evaluated using the following methods preoperatively and at final follow-up: The Foot and Ankle Outcome Scores (FAOS) and Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference and Pain Intensity domains. A five-point Likert scale regarding patient satisfaction was evaluated at final follow-up. Wilcoxon signed-rank test was performed to compare preoperative and postoperative outcome scores. Results: Ten patients were included in this study, which included 4 males and 6 females with a mean age of 41.9 +- 15.5 years (range, 24-66 years) and a mean body mass index (BMI) of 28.3 +- 6.3 kg/m2 (range, 17.1 - 39.9). The mean follow-up time was 13.3 +- 2.9 months (range, 11-17 months). The mean PROMIS Pain Intensity T-score significantly decreased from 57.5 +- 8.4 preoperatively to 49.5 +- 5.5 at final follow-up (p<0.001). The mean PROMIS Pain Interference T-score decreased from 69.0 +- 5.8 preoperatively to 63.1 +- 5.8 at final follow-up (p<0.001). There were 7 patients who participated in sports activity prior to the IONA-arthroscopy procedure. Of those, 7 patients (100%) returned to their sports activities. The median time to return to sports was 4.1 weeks (range, 1 to 14 weeks). Lastly, 10 patients (100%) expressed willingness to undergo the same procedure again. Conclusion: The current study demonstrates that IONA treatment of posterior ankle impingement results in significant pain reduction, a low complication rate and excellent patient-reported outcomes with high rates of return to work/sport. Additionally, IONA for posterior ankle impingement leads to high patient satisfaction with a significant willingness to undergo the same procedure again.
Outcomes of Endoscopic Treatment for Plantar Fasciitis: A Systematic Review
Authors: Mercer Nathaniel P. , Ward Leona , Hoberman Alexander , Cronin Joseph J. , Hurley Eoghan T. , Kennedy John G. 
Published: January 2022

Category: Other Introduction/Purpose: Endoscopic plantar fascia release (EPFR) is an established operative treatment for recalcitrant plantar fasciitis. The purpose of this systematic review is to provide a comprehensive review on the outcomes of endoscopic plantar fascia release in the treatment of plantar fasciitis at mid- and long-term follow-up. Methods: A systematic review was performed using, MEDLINE, EMBASE, and Cochrane library databases in May 2020 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies included were evaluated with regards to the level of evidence (LOE) and quality of evidence (QoE) using the Coleman methodological score. Clinical outcomes and complications were also evaluated. Results: Twenty-five studies including 729 feet were included in this systematic review with a mean follow-up of 25.1 months. 18 papers used the American Orthopaedic Foot & Ankle Society (AOFAS) score. The weighted mean preoperative AOFAS score was 55.6 and the postoperative score was 89.6 out of 100. The total number of patients who had complications was 117 of 729 (16.1%). The most common complication was a recurrence of pain experienced by 6.5% of patients (47 of 117). Conclusion: Endoscopic plantar fascia release provides good clinical and functional outcomes in patients with refractory plantar fasciitis. However, this procedure is associated with a moderately high complication rate.
The Infected Diabetic Foot: A Microbiological Analysis
Authors: Waldecker Ute 
Published: January 2022

Category: Basic Sciences/Biologics; Diabetes Introduction/Purpose: Diabetic foot infections show increasing prevalence. Their therapy is time consuming and expensive. Standardized antibiotic treatments do not exist. Suboptimal antibiotic therapy increases the morbidity of the patient. The aim of the study was to evaluate the dominating bacterial colonization in the diabetic foot. Furthermore we evaluated the changes of the colonization during surgical and antibiotic treatment and the efficiency of the therapy. Methods: The study included 100 patients with a diabetic foot syndrome and a pedal ulcer. Ulcers were classified according to Wagner Classification. HbA1c, CRP and patients BMI were documented. All patients underwent an angiologic investigation with arterial doppler ultrasonography and TcpO2 measurement. An MRI of the affected foot was performed to rule out osteomyelitis. All patients underwent surgical and antibiotic treatment. Surgery included debridement, abscess drainage, VAK therapy, bony resection, minor amputation, resection arthroplasty, Helal osteotomies. Osteomyelitis was pathologically verified. Microbiological results of superficial and deep smears, which were taken during the surgical therapy were analyzed. The antibiotic treatment was adapted to the bacterial resistance. Results: The duration of antibiotic treatment varied from 1 to 136 days (Mean:19.6 days, SD:17.3 ). The mean number of surgical interventions was 2.6. The dominating initial antibiotic treatment was Clindamycin/ Cefuroxim (48%) followed by Clindamycin (11%),Cefuroxim (7%), Clindamycin/ Ciprofloxacin (6%), Tazobactam (3%). The dominating bacteria were gram +. The difference of the percentage distribution compared to the gram- bacteria was statistically significant. The only significant percentage change of the antibiotic treatment was seen after the first surgical intervention, when the initial antibiotic treatment was significantly more effective against gram - bacteria. A change of the antibiotic treatment was seen with 1. Clindamycin / Ciprofloxacin in 66%, 2. Tazobactam in 67%, 3.Clindamycin in 36% and Clindamycin/ Cefuroxim in 35%. Conclusion: The dominating bacteria of the infected diabetic feet were gram +. The initial i.v. antibiotic treatment with Clindamycin/ Cefuroxim was effective in 66%. An optimization of the initial antibiotic treatment with greater focus on the gram + bacteria seems to be necessary.
Early intestinal microbial features are associated with CD4 T-cell recovery after allogeneic hematopoietic transplant
Authors: Miltiadous Oriana , Waters Nicholas R. , Andrlová Hana , Dai Anqi , Nguyen Chi L. , Burgos da Silva Marina , Lindner Sarah , Slingerland John , Giardina Paul , Clurman Annelie , Armijo Gabriel K. , Gomes Antonio L. C. , Lakkaraja Madhavi , Maslak Peter , Scordo Michael , Shouval Roni , Staffas Anna , O’Reilly Richard , Taur Ying , Prockop Susan , Boelens Jaap Jan , Giralt Sergio , Perales Miguel-Angel , Devlin Sean M. , Peled Jonathan U. , Markey Kate A. , van den Brink Marcel R. M. 
Published: January 2022

AbstractLow intestinal microbial diversity is associated with poor outcomes after allogeneic hematopoietic cell transplantation (HCT). Using 16S rRNA sequencing of 2067 stool samples and flow cytometry data from 2370 peripheral blood samples drawn from 894 patients who underwent allogeneic HCT, we have linked features of the early post-HCT microbiome with subsequent immune cell recovery. We examined lymphocyte recovery and microbiota features in recipients of both unmodified and CD34-selected allografts. We observed that fecal microbial diversity was an independent predictor of CD4 T-cell count 3 months after HCT in recipients of a CD34-selected allograft, who are dependent on de novo lymphopoiesis for their immune recovery. In multivariate models using clinical factors and microbiota features, we consistently observed that increased fecal relative abundance of genus Staphylococcus during the early posttransplant period was associated with worse CD4 T-cell recovery. Our observations suggest that the intestinal bacteria, or the factors they produce, can affect early lymphopoiesis and the homeostasis of allograft-derived T cells after transplantation.
Genome insights into the pharmaceutical and plant growth promoting features of the novel species Nocardia alni sp. nov
Authors: Nouioui Imen , Ha Sung-min , Baek Inwoo , Chun Jongsik , Goodfellow Michael 
Published: January 2022

AbstractBackgroundRecent studies highlighted the biosynthetic potential of nocardiae to produce diverse novel natural products comparable to that ofStreptomyces, thereby making them an attractive source of new drug leads. Many of the 119Nocardiavalidly named species were isolated from natural habitats but little is known about the diversity and the potential of the endophytic nocardiae of root nodule of actinorhizal plants.ResultsThe taxonomic status of an actinobacterium strain, designated ncl2T, was established in a genome-based polyphasic study. The strain was Gram-stain-positive, produced substrate and aerial hyphae that fragmented into coccoid and rod-like elements and showed chemotaxonomic properties that were also typical of the genusNocardia. It formed a distinct branch in theNocardia16S rRNA gene tree and was most closely related to the type strains ofNocardia nova(98.6%),Nocardia jiangxiensis(98.4%),Nocardia miyuensis(97.8%) andNocardia vaccinii(97.7%). A comparison of the draft genome sequence generated for the isolate with the whole genome sequences of its closest phylogenetic neighbours showed that it was most closely related to theN. jiangxiensis, N. miyuensisandN. vacciniistrains, a result underpinned by average nucleotide identity and digital DNA-DNA hybridization data. Corresponding taxogenomic data, including those from a pan-genome sequence analysis showed that strain ncl2Twas most closely related toN. vacciniiDSM 43285T. A combination of genomic, genotypic and phenotypic data distinguished these strains from one another. Consequently, it is proposed that strain ncl2T(= DSM 110931T= CECT 30122T) represents a new species within the genusNocardia, namelyNocardia alnisp. nov. The genomes of theN. alniandN. vacciniistrains contained 36 and 29 natural product-biosynthetic gene clusters, respectively, many of which were predicted to encode for a broad range of novel specialised products, notably antibiotics. Genome mining of theN. alnistrain and the type strains of its closest phylogenetic neighbours revealed the presence of genes associated with direct and indirect mechanisms that promote plant growth. The core genomes of these strains mainly consisted of genes involved in amino acid transport and metabolism, energy production and conversion and transcription.ConclusionsOur genome-based taxonomic study showed that isolate ncl2Tformed a new centre of evolutionary variation within the genusNocardia.This novel endophytic strain contained natural product biosynthetic gene clusters predicted to synthesize novel specialised products, notably antibiotics and genes associated with the expression of plant growth promoting compounds.
Transcriptional and physiological data revealed cold tolerance in a photo-thermo sensitive genic male sterile line Yu17S
Authors: Pan Xiaoxue , Guan Ling , Lei Kairong , Li Jingyong , Zhang Xianwei 
Published: January 2022

AbstractBackgroundRice is highly sensitive to chilling stress during the seedling stage. However, the adaptable photo-thermo sensitive genic male sterile (PTGMS) rice line, Yu17S, exhibits tolerance to low temperatures. Currently, the molecular characteristics of Yu17S are unclear.ResultsTo evaluate the molecular mechanisms behind cold responses in rice seedlings, a comparative transcriptome analysis was performed in Yu17S during seedling development under normal temperature and low temperature conditions. In total, 9317 differentially expressed genes were detected. Gene ontology and pathway analyses revealed that these genes were involved mostly in photosynthesis, carotenoid biosynthesis, carbohydrate metabolism and plant hormone signal transduction. An integrated analysis of specific pathways combined with physiological data indicated that rice seedlings improved the performance of photosystem II when exposed to cold conditions. Genes involved in starch degradation and sucrose metabolism were activated in rice plants exposed to cold stress treatments, which was accompanied by the accumulation of soluble sugar, trehalose, raffinose and galactinol. Furthermore, chilling stress induced the expression of phytoene desaturase, 15-cis-ζ-carotene isomerase, ζ-carotene desaturase, carotenoid isomerase and β-carotene hydroxylase; this was coupled with the activation of carotenoid synthase activity and increases in abscisic acid (ABA) levels in rice seedlings.ConclusionsOur results suggest that Yu17S exhibited better tolerance to cold stress with the activation of carotenoid synthase activity and increasing of ABA levels, and as well as the expression of photosynthesis-related genes under cold condition in rice seedlings.
Community perspective on family medicine and family physician in Saudi Arabia 2020
Authors: Murad Manal Abdulaziz , Kheimi Rawan Maatouk , Toras Mohammed Majdi , Alem Rahaf Hussain , Aljuaid Atheer Meshal , Alobaidan Jafar Naji , Binishaq Hebah Yousef , Asiri Abdulrahman Ahmed , Sagga Manar Khalid 
Published: January 2022

AbstractBackgroundDespite the importance and advantages of family medicine, it has poorly developed in Arab communities when compared to other medical specialties. Therefore, in this study, we aim to investigate the perception of the Saudi population about family medicine and physicians.Materials and methodsA cross-sectional study was carried out using a self-administered structured online survey tool through the Google Forms platform. The online questionnaire was distributed to all Saudi Arabia’s residents aged more than 15 years. A predesigned questionnaire was used and included items collecting data about participants’ sociodemographic characteristics, awareness/knowledge, and experience/attitudes.ResultsA total of 6974 valid participants were included in the current study, where the age group 25–35 years (37.1%) and 51.7% of them were females. Out of the included participants, 81.3% (n = 5671) did not report any chronic illnesses, while the other 18.7% (n = 1303) did. The mean awareness and knowledge score for all participants was 9.57 ± 3.39 (out of 20 possible points), while the mean experience and attitude score for all participants was 10.15 ± 2.58 (out of 16 possible points). Patients’ perceptions, whether awareness and knowledge or experience and attitude scores, were significantly correlated (P-value < 0.001) to chronic illness status, being a healthcare worker, job, marital status, and gender factors. Moreover, experience and attitude score was additionally correlated to residence region (P-value = 0.034) and participants’ nationality (P-value< 0.001).ConclusionGeneral population in Saudi Arabia were aware about the importance of family physicians and they trust them. The identified predictors should be considered when trying to increase public awareness and enhance the experience with family physicians.
A randomized clinical trial on the effect of foot reflexology performed in the fourth stage of labor on uterine afterpain
Authors: Sharifi Neda , Bahri Narjes , Hadizadeh-Talasaz Fatemeh , Azizi Hoda , Nezami Hossein , Tohidinik Hamid Reza 
Published: January 2022

Abstract
Background
Uterine afterpains are among the most prevalent complaints after natural vaginal delivery. Non-pharmacological treatment modalities to relieve afterpains are an important care priority. This study was conducted to investigate the effect of foot reflexology in the fourth stage of labor on afterpains in multiparous women.

Methods
This single-blind, randomized, clinical trial recruited 80 eligible pregnant women presenting to Allameh Bohlool Hospital in Gonabad and 17-Shahrivar Hospital in Mashhad, Iran, in 2019. In the first and second hours postpartum, the reflexology group received 10 min of general massage and specific reflexology massage on each foot on the uterine, pituitary, and solar plexus points. The control group received 10 min of general massage, and then rotational massage on a neutral point on the lateral side of the heel. The pain was measured every hour up to 4 h postpartum using a visual analogue scale. The collected data were analyzed in SPSS-16 software at a significance level of P < 0.05.

Results
The median of the afterpain score in the first hour (P = 0.05) and second hour (P = 0.274) postpartum did not differ significantly between the two groups, but this score was lower in the reflexology group at the third hour (P < 0.001) and fourth hour (P < 0.001) postpartum. The mean total afterpain score in the 4 h postpartum was significantly lower in the reflexology group (P < 0.001).

Conclusion
The results revealed that foot reflexology in the fourth stage of labor has positive effects on relief from uterine afterpain. Reflexology is therefore recommended as a measure to reduce postpartum uterine afterpains.