Short Leg Research Articles

BET 2: Tubular bandage, plaster or aircast boot for avulsion fractures of the base of the fifth metatarsal?

A shortcut review was carried out to investigate whether avulsion fractures of the base of the fifth metatarsal were best treated with tubular bandage, a walking boot or a short...

The impact of urban road network morphology on pedestrian wayfinding behaviour

During wayfinding pedestrians do not always choose the shortest available route. Instead, route choices are guided by several well-known wayfinding strategies or heuristics. These heuristics minimize cognitive effort and usually lead to satisfactory route choices. Our previous study evaluated the costs of four well-known pedestrian wayfinding heuristics and their variation across nine network morphologies. It was observed that the variation in the cost of these wayfinding heuristics increased with an increase in the irregularity of the network, indicating that people may opt for more diverse heuristics while walking through relatively regular networks, and may prefer specific heuristics in the relatively irregular ones. The study presented here aims to investigate this claim by comparing simulated routes with observed pedestrian trajectories in Beijing and Melbourne, two cities at opposite ends of the regularity spectrum. We found that the values of mean route length and mean Network Hausdorff Distance for walking trips made in Melbourne were consistently lesser than the corresponding values obtained in Beijing. Also, across both the cities, we found that while there was minimal variation in the popularity of heuristics overall, in cases where different heuristics produced dissimilar routes, the shortest leg first strategy and the least angle strategy were more popular.

FEATURES OF APPLICATION OF BIOPREPARATIONS FOR CULTIVATION OF OYSTER MUSHROOMS ON STRAW SUBSTRATE

The world’s population consumes a significant amount of mushrooms each year. Beginners in mushroom growing are considered to be the Chinese, who at the beginning of our era learned to grow different species of basidiomycetes. Today, Ukraine has a significant potential for the development of mushroom growing: there are the necessary raw materials for substrates and still unoccupied premises. Research institutions preserve a unique collection of high-yielding strains, and specialized laboratories produce high-quality seed mycelium. The article is devoted to the study of the influence of biologicals on the productivity of oyster mushrooms of the common strain K-12 during intensive cultivation on a straw substrate. Based on research, it is established that the use of biologicals as an adjunct to the substrate affects the growth processes of the fungus. Biometric indicators of fruit body weight with the use of azotophyte or phytocyde exceeded the indicators of fruit body weight grown on the substrate, where the biological product was not used by 2,0 g, and the diameter of the cap was inferior to 2,0 and 6,0 mm, respectively. Fungi obtained on the substrate without the use of the biological product were characterized by a shorter leg length compared to the variant using azotophyte by 3,0 mm, and exceeded the test value by 4 mm using phytocyde. From the use of azotophyte or phytocide, the diameter of the stem of the fruiting body decreases to 12,0-15,0 mm. Carrying out of timely agrotechnical actions promotes reception of a qualitative harvest of fruit bodies of an oyster mushroom. Before harvesting, the fruiting bodies were characterized by a typical shape and inherent color of the cap and were in technical maturity. The cap of the fruit body did not crack, was not damaged by pests, and its humidity was 65,0-68,0 %. The activity of the bacteria Azotobacter chroococcum and Bacillus subtilis has an effect on the productivity of strain K-12, they stimulate the formation of more primordia. With the use of Azotophyte or Phytocide, the yield increases by 22,0 and 18,0 %. The total yield of oyster mushroom consists of two waves of fruiting. The yield of the first wave of fruiting is 2,3 times higher than the yield of the second wave of fruiting. The use of Azotophyte helps to increase the yield of the first wave of fruiting fungus by 2,2 kg / 100 kg of substrate, and phytocide – by 1,8 kg / 100 kg of substrate. The use of Azotophyte or Phytocyde as an additive to the substrate is economically advantageous: the net profit increases by 32 and 24 %, and the level of profitability - by 1,2-1,1 times, respectively.

Distrofia torácica asfixiante o Síndrome de Jeune

La distrofia torácica asfixiante (DTA), también denominada Síndrome de Jeune, es una enfermedad genética autosómica recesiva, cuya causa se desconoce en muchos casos. Sin embargo, se han identificado mutaciones en al menos 11 distintos genes.[1,2] Su frecuencia se estima en 1:130000 recién nacidos vivos.[3] La afección clínica se manifiesta en los huesos, principalmente en el tórax y las costillas. El tórax pequeño y las costillas cortas, son causa de la cavidad torácica, característicamente en “forma de campana” que, restringe el crecimiento y la expansión de los pulmones, lo que causa dificultad respiratoria.[3,4] La forma letal de este síndrome se debe a insuficiencia respiratoria secundaria a la hipoplasia pulmonar y al estrechamiento de la caja torácica.[4] La DTA se puede asociar también con brazos y piernas cortas, formas inusuales de los huesos pélvicos, dedos adicionales de pies o manos y problemas renales, cardíacos, hepáticos y oculares.[1,2,3] El objetivo es reportar un caso clínico de la forma letal de DTA.

Limb length discrepancy and gait parameters of amateur football players in Lagos State, Nigeria.

Football is a widely played sport globally. Limb length discrepancies have been found to be common among football players and these may lead to abnormal gait. The purpose of this study was to determine the relationship between limb length discrepancy (LLD) and gait parameters of amateur football players in Lagos State, Nigeria. Eighty-nine amateur football players participated in the cross-sectional study. They were recruited from different stadia in Lagos State. Limb length and gait parameters were measured using tape and footprint measurements. The prevalence of real limb length discrepancy among the participants was 75% (n = 67). The results of this study showed that the right leg was the shorter leg in 60% (n = 53) of the participants. There was no significant correlation between gait parameters and limb length measurement. Although limb length discrepancy is common among amateur football players in Lagos State, the relationship between limb length and gait parameters is weak.

Early Outcomes of an Anterior Ankle Fusion Plating System with rhPDGF-BB Beta Tricalcium Phosphate Graft

Category:Ankle; Ankle ArthritisIntroduction/Purpose:Ankle fusion offers a reliable and effective treatment for end-stage ankle arthritis. Biomechanical studies have shown that plating systems may offer an advantage to ankle fusion patients with significant bone loss, bone deformity, or osteoporotic bone by providing a stiffer construct. One potential downside to plating systems is that they have been associated with soft tissue irritation due to their profile height. The objective of this case series was to assess the early patient clinical and radiographic outcomes of an anatomically designed, lower profile anterior ankle fusion plate used in combination with an autograft alternative, recombinant human protein derived growth factor (rhPDGF-BB).Methods:All ankle fusions performed between May 2018 and August 2019 at two centers were retrospectively evaluated. All patients received an anatomically designed, low profile anterior ankle fusion plate (ORTHOLOC 3Di, Wright Medical Group, Memphis, Tennessee, USA) through an anterior surgical approach. All patients also received rhPDGF-BB as part of the surgical procedure. Patients were non-weight bearing for 6 to 8 weeks in a splint or short leg cast, before transitioning to protected partial weight bearing for another 6 to 8 weeks. Patient demographics, time to radiographic fusion, length of follow-up, and adverse events were collected as part of the review.Results:There were 20 patients (12 male, 8 female) included in the analysis. The average age was 60.9 years (range, 42-90) and the average BMI was 31.6 kg/m2 (range, 21-52). There were eight diabetics, four smokers, and two patients who had preoperative ulcers. The average follow-up time was 7.8 months (range, 3-18). The fusion rate was 90%, with two nonunions. One nonunion patient was an obese, diabetic, neuropathic, smoker with a preoperative ulcer and a previous ankle fracture. She was treated with a bone stimulator and showed increased bony consolidation. The second nonunion patient was a neuropathic, diabetic who had previous hindfoot Charcot reconstruction. Her nonunion was stable and fibrous, which allowed her to ambulate pain free without bracing or assistive devices.Conclusion:This case series presents the first clinical results for this anatomically designed anterior ankle fusion plate. Outcomes were positive with a 90% fusion rate despite being used in a series of patients with a high incidence of risk factors and comorbidities. Additional complications were minor as related to wound healing. Further study is needed to confirm these promising initial results.

Compression Wrapping for Calcaneal Fractures after Extensile Lateral Approach: Results of a Retrospective Study

Category:TraumaIntroduction/Purpose:Displaced intraarticular calcaneus fractures comprise the majority of all calcaneus fractures. Many are indicated for open reduction and internal fixation (ORIF) through an extensile lateral approach (ELA). Unfortunately, this approach has reported complication rates of up to 32%. Improved edema management may reduce the incidence of complications. While compression wrapping has been shown to reduce wound complications in ankle arthroplasty, it has not been well studied in lower extremity trauma. This study aimed to evaluate the benefit of compression wrapping in calcaneus fractures treated surgically with an ELA.Methods:This study included 19 patients from 2015-2018 who underwent ORIF of closed intra-articular calcaneal fractures via an ELA by two surgeons. Demographics, comorbidities, fracture characteristics, and time to surgery were recorded. Following surgery, the extremity was initially immobilized in a short leg splint with transition to serial compression wrappings on postoperative day two. Wrappings involved application of multi-layered cotton cast padding and short stretch elastic bandages to the extremity in a distal to proximal fashion. Wraps were replaced every three days by trained physiotherapists until the two- week postoperative visit. The primary outcome was development of a wound complication. A minor complication was defined as wound appearance prompting initiation of oral or IV antibiotics or local wound care. A major complication was defined as development of flap necrosis or return to the OR for debridement.Results:Mean age was 47.7 years. 3 patients (15.7%) were diabetic, and 7 patients (36.8%) were smokers. Mean BMI was 26.9 kg/m2 (SD 4.4). Mean time to surgery was 11.4 days from injury (SD 6.93). The rate of minor soft tissue complication was 4/19 (26.3%); 2 patients required oral antibiotics only, 1 local wound care only, and 1 both antibiotics and local wound care. The rate of major complication was 2/19 (10.5%), with 1 patient requiring a return to OR and another requiring both a return to the OR and IV antibiotics. Of those patients, 1 was noncompliant with the protocol. All patients progressed to eventual soft tissue healing.Statistical analysis identified diabetes as a risk factor for any complication (p=0.02, relative risk 5.3).Conclusion:Compression wrapping resulted in a low incidence of major soft tissue complications in calcaneus fractures treated with an extensile lateral approach. Compression wrapping is an effective method of post-operative soft tissue management for calcaneal fractures, and may have further applications for similar high energy foot and ankle fractures. Further studies are warranted to determine whether this novel wound care technique is superior to standard post-operative wound care.

Conservative versus Surgical Treatment for the Fifth Metatarsal Diaphyseal Fractures: A Retrospective Comparative Study

Category:Midfoot/Forefoot; TraumaIntroduction/Purpose:The fifth metatarsal fracture is the most common metatarsal fracture accounting for 56-68% of all metatarsals. Most of the previous studies have focused on fractures of the proximal fifth metatarsal. Whereas the current evidence has still remained controversial regarding appropriate treatment for the fifth metatarsal diaphyseal fracture. To date, there has been no comparative study between nonsurgical and surgical management in such fractures. The purpose of this study was to compare the outcomes and complications following conservative versus surgical treatment for displaced diaphyseal fractures of the fifth metatarsal bone. The primary outcome was time to union. Secondary outcomes were functional outcome scores (SF-36 and FAAM), VAS, time to return to activities of daily living (ADL), sports activities as well as complications.Methods:A retrospective study with prospective outcomes measurement was performed by reviewing charts and collecting data between January 2016 and December 2018. We included patients aged 18 or over, diagnosed with closed isolated fracture of the fifth metatarsal diaphyseal bone, all fractures had more than 2 mm of displacement in any planes of radiographs (AP, oblique, lateral), treated within 3 weeks after injury, minimal follow-up time of 6 months. Exclusion criteria were previous history of ipsilateral fifth metatarsal diaphyseal bone, pathological or stress fracture, proximal fifth metatarsal fracture, underlying diabetes, neuropathy, inability to walk such as cerebrovascular disease. All patients in surgical group were treated with ORIF with plate and screws. Postoperatively, early ROM exercise and heel weight bearing in walking boot were instructed. Whereas, patients in conservative group were immobilized with short leg cast in first six weeks and subsequently changed to walking boot or hard- soled shoes.Results:There were forty-five patients enrolled in the study, twenty patients treated with ORIF and twenty-five patients treated with casting. No significant differences were demonstrated with regard to demographic data. The mean union time of ORIF group was 8.7+-1.8 weeks, which was significantly shorter than the casting group (16.0 +- 4.18 weeks) (p<0.001). There was a significant improvement of functional outcomes (SF-36, FAAM) in both groups (p<0.001) but no statistically significant difference between two groups (p>0.05). An average time to return to ADL was significantly faster in ORIF group (8.6+-3.1 weeks) (p<0.001). The overall complications in casting group were significantly higher (28%,p<0.05) including painful malunion (3 patients, 12%), delayed union (2 patients, 8%) and persistent pain from CRPS (2 patients, 8%).Conclusion:Both casting and ORIF demonstrated significant improvement of functional outcomes compared to pre-operative status as measured with VAS, SF-36, and FAAM. Even though there was no significant difference of functional outcomes between two groups. ORIF group had significantly faster union time, time to return to ADL, and lesser in overall complications. The authors prefer early surgical treatment in fractures with more than 2 mm displacement, active, high-demand patients. However, randomized controlled trials with longer follow-up would be required.

Smart Beta Made Smart

We construct tradable proxies of on-paper long-short risk factors using combinations of large and liquid mutual funds and ETFs, based on their holdings, for both retail and institutional investors. Using a novel proprietary dataset, we are able to account for the ETF shorting fees in constructing the short leg of the factors. In contrast with the recent literature, we find that investors are able to harvest the SMB and part of the HML risk premia, although MOM and RMW remain hard to replicate, with institutional investors outperforming retails. Our results have implications for the benchmarks that should be used to evaluate portfolio managers.

Effects of High-Dose Vitamin D Supplementation on Phase Angle and Physical Function in Patients with Prostate Cancer on ADT

Purpose Androgen deprivation therapy (ADT) is commonly used to treat patients with advanced prostate cancer but is associated with functional decline. Bioelectrical impedance analysis (BIA)-derived phase angle may reflect frailty and functional decline in cancer patients. High-dose vitamin D supplementation may improve phase angle values and physical function. Methods We conducted an exploratory analysis from a phase II randomized controlled trial investigating the efficacy of high-dose vitamin D supplementation in prostate cancer patients (age ≥ 60 yrs). Fifty-nine patients were randomized to high-dose vitamin D (600 IU/day plus 50,000 IU/week) or low-dose: RDA for vitamin D (600 IU/day plus placebo weekly) for 24 weeks. Phase angle was measured by BIA. Physical function measures included handgrip strength, 6-minute walk test, Short Performance Physical Battery and leg extension. All testing was completed at baseline, week 12 and week 24. Results Phase angle values were wider over the entire study in the high-dose vitamin D arm indicating healthier muscle cells. The low-dose vitamin D arm had phase angle values consistent with frailty cutoffs in older men (<5.7°). Conclusion Patients in the high-dose vitamin D arm experienced wider phase angle values over the course of the study which may indicate less frailty. ClinicalTrials.gov ID: NCT02064946.

When Equity Factors Drop Their Shorts

Although factor premiums originate in both long and short legs of factor portfolios, we found that (1) most added value comes from the long legs, (2) the long legs offer more diversification than the short legs, and (3) the performance of the short legs is generally subsumed by that of the long legs. These results are robust over size, time, and markets and cannot be attributed to differences in tail risk. We also found that the claim that the value and low-risk factors are subsumed by the new (post-2015) Fama–French factors does not hold for the long legs of these factors.

Non-weightbearing imaging and standard knee radiographs are inferior to formal alignment radiographs for calculating coronal alignment of the knee

IntroductionRealignment knee osteotomy relies on accurate preoperative assessment of coronal alignment. Weightbearing (WB) ‘long-leg’ (LL) radiographs are the accepted gold-standard investigation, though in practice standard knee radiographs (short leg; SL) and non-weightbearing (NWB) cross-sectional imaging such as computed tomography (CT) scanograms have been used. We compare the accuracy of SL and NWB radiographs to formal LL alignment radiographs. MethodsA prospectively maintained osteotomy database was reviewed to identify the study population. All patients underwent standardised weightbearing long-leg alignment radiographs. The series was screened consecutively until 30 patients who also underwent WB SL radiographs (‘WB cohort’), and 30 with NWB SL (‘NWB cohort’) radiographs, were identified. Anatomic tibiofemoral angle was calculated by independent reviewers using a validated technique from both radiographs and contrasted. Results60 patients were identified as outlined in the study protocol. There were no differences in baseline demographics. Coronal alignment calculated from SL and LL radiographs differed significantly (median difference 2.1°, p < 0.001). Alignment values from weightbearing SL radiographs demonstrated markedly greater agreement with LL values than those from NWB radiographs (intraclass correlation coefficient 0.878 vs 0.657), with the NWB cohort also exhibiting greater outlier and extreme outlier incidence. ConclusionOur data adds to the growing evidence that SL radiographs are inadequate in the interpretation of knee alignment. In addition, we demonstrate that NWB radiographs (and by extension other NWB modalities such CT scanograms) demonstrate poorer agreement to gold-standard than WB methods. Coronal alignment of the knee cannot be reliably measured from non-weightbearing imaging modalities. Implications for practiceThough potentially useful as an adjunct, non-weightbearing cross-sectional imaging and standard knee radiographs should not be used as a proxy for formal weightbearing long-leg radiographs in osteotomy planning.

Outcomes of Short Versus Long Leg Casts for Childhood Accidental Spiral Tibial CAST Fractures.

The objective of the current study was to analyze the outcomes of short versus long leg casts in the treatment of childhood accidental spiral tibial (CAST) fractures. A retrospective review was performed of medical records at a single tertiary children's hospital from 2009 to 2014 of children with distal, spiral tibial fractures (CAST fractures). The following points were documented for each patient: sex, laterality of fracture, age at presentation, type of cast, length of time in cast, use of a controlled ankle motion boot after cast removal, suspicion for abuse, and complications including skin irritation, skin breakdown, infection, compartment syndrome, fracture displacement, and gait disturbances. A total of 21 patients with an age range of 12 to 62 months were found to have CAST fractures as confirmed by x-ray. Fourteen were treated with short leg casts, whereas 7 were treated with long leg casts. Both groups healed with equal outcomes, and there was no documented suspicion for abuse in any case. A short leg walking cast seems to be an effective and safe method of treatment for CAST fractures and could be considered as potentially preferable to long leg casts because of the added benefits of increased mobility and function. Follow-up to this preliminary study is warranted to better elucidate any differences in benefit between these treatment options, and clinical judgment should be used when considering immobilization options.

Echoes from the past – the identity of Sundathelphusa picta (von Martens, 1868) and descriptions of two new species of freshwater crab (Crustacea, Brachyura, Gecarcinucidae, Sundathelphusa) from Luzon Island, the Philippines

The poorly known Philippine freshwater crab, Sundathelphusa picta (von Martens, 1868) from Luzon Island is re-described and re-illustrated, using type material as well as other specimens sampled from near its type locality. Two similar congeners from Luzon, S. uva sp. nov. and S. angelito sp. nov., from the provinces of Bataan and Rizal, respectively, are described as new. These three species are united by their relatively small size, rounded and dome-shaped carapaces, proportionately short ambulatory legs, and stout male first gonopods. They are distinguished from each other by a suite of morphological characters, particularly of the carapace, male pleon and gonopods.

Physical characteristics of the Uyghurs: anthropometric data from Kashgar

Before the Sui and Tang Dynasties, the Mediterranean type of the European race had been the main ethnic type of the ancient inhabitants of Kashgar. After moving westward to Xinjiang, the Uyghurs of the North Asian Mongolian race started to have long-term integration with other ethnic groups and gradually formed the Uyghurs. At present, the ethnographic characteristics of Uyghur have been a concern for a while. In this study, 560 subjects (273 males and 287 females) were selected and measured using anthropometric methods in Kashgar, the region most representative of the Uyghurs. The study showed that Uyghur individuals have obvious Eurasian characteristics, with South Asian and North Asian features also being identified in this region. However, East Asian type features were rarer in the Uyghur. According to physical characteristics indexes, Kashgar Uyghur males and females are of medium height and heavier weight; with rounder, taller heads and narrower faces that are mesorrhine; they are also wider in chest and shoulder with relatively long trunks. Males have medium head breadth and leg length whereas females possess narrow head breadth and shorter leg length. Among the 13 ethnic groups in China, Uyghur males were found to have a medium nasal root length and extraocular angle as well as reduced Mongolian fold and concave nose. Meanwhile, it is common for Uyghur females to have a high external eye angle, medium concave nose and dorsal rate, a high round ear lobe rate and low nasal base upturn rate. The Uyghur in southern Xinjiang are closer to the East Asian type than the Uyghur in northern Xinjiang. The head and nose features of Uyghur in southern Xinjiang are more similar to those from Mongolia. In case of facial features, the northern Uyghur and Mongolian are relatively close. There is a high incidence of wrinkles on the upper eyelids presented in Uyghur adults, with some people having Mongolian folds, a higher possibility of outer corners than inner corners, and mostly brown eye color. Together this suggests that Uyghur adults have the basic characteristics of the Mongolian race. Uyghur and East Asian ethnic groups are relatively close in face breadth, head length, morphological facial height and head breadth. Due to the fact that Uyghur individuals have rounder and taller heads accompanied by relatively long upper bodies and short legs, they can be considered to have the basic characteristics of an Oriental population. Both the Asian Oriental ethnic group features and Eurasian population characteristics are found in the Uyghur group in terms of their physical type. Among the various types in East Asia, Uyghur adults are closer to the East Asian type, while having certain characteristics of the South Asian and North Asian type. The physical characteristics of the Uyghur may potentially reflect the historical process of multi-ethnic integration.

Studies on neotropical Phasmatodea XXI: Sigaruphasma, a new genus of Hesperophasmatini Bradley &amp; Galil, 1977, from Hispaniola with the descriptions of two new species (Phasmatodea: Cladomorphinae)

The new Hesperophasmatini–genus Sigaruphasma gen. nov. from Hispaniola is described and illustrated. It is remarkable for violating several of the previously stated diagnostic features of the tribe Hesperophasmatini Bradley and Galil, 1977. It is well characterized by the cylindrical, cigar–like body of females, proportionally very short legs, strongly broadened profemora of females, lacking sensory–areas on the probasisternum and profurcasternum as well as the smooth egg–capsule. Two new species are described from the Dominican Republic, both from the males, females and eggs. S. bouladoui sp. nov. occurs in the eastern portion of Hispaniola (Monseñor Nouel, San Cristóbal, San José de Ocoa and Samaná provinces) and has fully winged males. S. armatum sp. nov. occurs in the southern and southeastern Dominican Republic (Barahona, La Vega, San José de Ocoa, Elías Piña, Santiago provinces) and has apterous males with a strong body spination. Both species show a remarkable range of intraspecific variability and polymorphism, which is described and illustrated.

The critical two dimensional Ising model on right-triangle-shaped square lattices

Using the bond-propagation algorithm, we study the critical Ising model on the square lattice with the shape of right triangle and free boundaries. The length of short leg is N and that of long leg is M. The aspect ratio between the two legs ρ=M∕N is fixed. For six ratios: ρ=1,2,3,4,8,16, the critical free energy density, internal energy density and specific heat on the lattices with 30≤N≤600 are calculated. Based on these accurate data, we determine exact expansions of the critical free energy, internal energy, and specific heat. With these expansions, we extract the bulk, surface, and corner parts of the free energy, internal energy, and specific heat. The corner term in free energy density proportional to lnN is consistent to the conformal field theory in the accuracy of 10−10 at the least. It is found that the edge terms in the internal energy proportional to lnN related to the hypotenuse are the same for ρ=1,2,3,4,8,16, i.e. this term is geometry independent. However the edge terms in the specific heat proportional to lnN are geometry dependent, i.e. they are different for different ρ. The corner terms in the internal energy and specific heat are also obtained.

Adverse To Converse

Toe Pain--- Cross-Country HISTORY: A 12 year-old female cross country runner presented to the pediatric sports medicine clinic with 3 months of right second toe pain. Initially, the pain started after stubbing her toe. She developed a constant dull ache that was present at rest and worsened with prolonged walking and during cross country. She noted that her symptoms gradually worsened with time, and she was having no improvement with rest, icing and anti-inflammatories. PHYSICAL EXAMINATION: Overlying skin with no rashes or lesions. Tenderness along the plantar surface of her right second metatarsophalangeal (MTP) joint. ROM was limited in both passive and active flexion and extension of the affected joint. Sensation was intact, and strength with flexion and extension of the toe was normal, however there was significant pain with testing. MT squeeze test was negative. Varus and valgus stress to MTP joint elicited no laxity, and “drawer test” of MTP joint showed mild instability. DIFFERENTIAL DIAGNOSIS: 1. Sprain of plantar plate 2. Metatarsal fracture/stress fracture 3. Osteochondrosis of the metatarsal head 4. Metatarsalgia 5. Lisfranc injury 6. Intermetatarsal neuroma TEST RESULTS: X-ray R foot: --- Flattening of the second metatarsal head. MRI R foot without contrast: --- Flattening/collapse of the 2nd metatarsal head/distal epiphysis with prominent marrow edema of the 2nd metatarsal head and neck. Mild MTP joint space narrowing. FINAL/WORKING DIAGNOSIS: Osteochondrosis of the metatarsal head (Freiberg Disease) - Stage 4 TREATMENT AND OUTCOMES: 1. Placed in short leg walking boot with protected weight-bearing, ice 1-2 times daily, Foot/Ankle Surgery consultation with discussion of conservative care vs surgical (chondral drilling and/or chondroplasty). Patient opted for conservative care. 2. At 4-week follow-up, patient’s pain significantly reduced. Continued walking boot additional 4 weeks with transition into stiff-soled shoe. 3. At 8-weeks post treatment, follow-up MRI showed no progression of disease. Clinically with almost complete resolution of pain. 4. By 10 weeks, transitioned into a custom foot orthotic with added support to float 2nd MTP joint. Restrictions included low impact sports only with plan for repeat MRI at 6 months.

Lottery Preference and Anomalies

We construct a lottery factor based on 13 commonly used lottery proxies, and show that the lottery factor significantly improves explanatory power of prominent factor models. We find that anomaly returns are significantly stronger among stocks with high lottery features and are mainly driven by the short leg of lottery stocks. The effect of the lottery feature on anomalies is not driven by financial distress or investor sentiment, and instead is related to investors being reluctant to short sell stocks with high lottery features due to potentially high upside risk.

Analysis on the Mechanical Stability of the Leg Joints in UHV Transmission Tower

Transmission line pole tower, whose safety and reliability will directly affect the safe and stable operation of the entire transmission line, is a rod-shaped and tower-shaped structure that supports overhead transmission line conductors and ground lines and maintains a certain distance between them and the ground. Moreover, the stress stability of the leg structure joints in UHV transmission towers is mainly analyzed in the paper. With the help of the finite element analysis software, taking the arrangement of the long and short legs in the actual structure of the tower as an example, the influence of different angles of the tower on the bending moment is compared and analyzed under the condition that the main material slenderness ratio is the same. Meanwhile, in order to eliminate the influence of horizontal force on the height of different tower legs, only the bending moment generated by the structural system at the tower legs under axial pressure is considered to continuously improve the stability and reliability of the line pole tower structure, so that the power safety can be guaranteed to a large extent.