Single Foot Research Articles

Vascular calcification score on plain radiographs of the feet as a predictor of peripheral arterial disease in patients with chronic kidney disease

The incidence of lower extremity amputation is increasing in patients with chronic kidney disease (CKD), but symptoms of peripheral arterial disease (PAD) in patients with CKD are uncommon. The aim of the current study was to assess the value of the vascular calcification (VC) score on plain radiographs of the feet for the prediction of PAD in patients with CKD. We recruited 102 patients with CKD (24 pre-dialysis, 58 hemodialysis [HD], and 20 peritoneal dialysis [PD]). We defined the VC score on the plain radiographs of the feet as follows: score 0, no calcification; score 1, the length of the VC is <5 cm in a single foot or <2 cm in both feet; and score 2, the length of the VC is >5 cm in a single foot or >2 cm in both feet. We evaluated the atherosclerotic calcified plaques of the femoral or popliteal artery with Doppler ultrasonography and compared it with the VC score. Patients with high VC scores showed more atherosclerotic calcified plaques in the femoral or popliteal artery (P < 0.01). The prevalence of PAD in patients with CKD was closely related with the VC score (P < 0.01). PAD was associated with diabetes, a higher hsCRP, and a lower total cholesterol level (P < 0.01). The VC score was a significant predictor of the presence of PAD (odds ratio: 6.66, P < 0.001). Asymptomatic CKD patients, including those on HD and PD, may have PAD and routine testing by plain radiographs of the feet followed by Doppler ultrasonography are of pivotal significance, especially if the patients are diabetic.

The Effects of Walking Speed on Multisegment Foot Kinematics in Adults

Multisegment foot models provide researchers more-detailed information regarding foot mechanics compared with single rigid body foot models. Previous work has shown that walking speed significantly affects sagittal plane ankle motion. It is important to distinguish changes in intersegment foot mechanics following treatment that are due to clinical intervention versus those due to walking speed alone. Foot and ankle kinematics were collected on 24 adults walking at 5 speeds. Significant differences were seen at the ankle using a single rigid body foot model, as well as at the hindfoot and forefoot using a multisegment foot model, with all motions exhibiting a shift toward plantar flexion and decreased stance time with increasing speed. When evaluating foot mechanics using a multisegment foot model across groups or conducting intrasubject comparison over time/treatments, it is imperative that walking speed be accounted for or controlled.

A comparison of multi-segment foot kinematics during level overground and treadmill walking

Previous work comparing treadmill and overground walking has focused on lower extremity motion and kinetics, with few identified differences. However, a comparison of multi-segment foot kinematics between these conditions has not been previously reported. Sagittal ankle motion using a single rigid body foot model and three-dimensional hindfoot and forefoot kinematics were compared during barefoot, level, overground walking at a self-selected speed and treadmill walking at a similar speed for 20 healthy adults. Slight differences were seen in ankle plantarflexion and hindfoot plantarflexion during first rocker, as well as peak forefoot eversion and abduction, however all changes were less than 3°, and most were within the day-to-day repeatability. These results indicate that foot mechanics as determined using a multi-segment foot model were similar between overground and treadmill walking at similar speeds in healthy adults. Treadmill protocols may provide a controlled method to analyze a patient's ability to adapt to walking at different speeds and surface slopes, which are encountered often during ambulation of daily living.

Randomised controlled trial of the effectiveness of using foot reflexology to improve quality of sleep amongst Taiwanese postpartum women

Objective to examine the effectiveness of using foot reflexology to improve sleep quality in postpartum women. Design and setting randomised controlled trial, conducted at two postpartum centres in northern Taiwan. Participants 65 postpartum women reporting poor quality of sleep were recruited from July 2007 to December 2007. Interventions participants were assigned randomly to either an intervention or a control group. Participants in both groups received the same care except for reflexology therapy. The intervention group received a single 30-minute foot reflexology session at the same time each evening for five consecutive days. Sessions were administered by a certified nurse reflexologist. Measures and findings the outcome measure was the Pittsburgh sleep quality index (PSQI), and this was performed at baseline and post test. Mean PQSI scores for both groups declined over time between baseline and post test. Using a generalised estimation equation to control several confounding variables, the changes in mean PSQI were found to be significantly lower in the intervention group ( β=−2.24, standard error=0.38, p<0.001) than in the control group. Conclusion an intervention involving foot reflexology in the postnatal period significantly improved the quality of sleep. Implications for practice midwives should evaluate maternal sleep quality and design early intervention programmes to improve quality of sleep in order to increase maternal biopsychosocial well-being. Midwives interested in complementary therapies should be encouraged to obtain training in reflexology and to apply it in clinical settings if it is allowed.

Field and Laboratory Tests Investigating Settlements of Foundations on Weathered Keuper Marl

Measured settlements of buildings on the weathered Keuper Marl appeared to be much smaller than calculated settlements, which were based on stiffness modulus from standard oedometer tests. Therefore, both special triaxial K 0-tests and oedometer tests were carried out for an accurate determination of stiffness moduli. Modulus obtained in the triaxial K 0-tests were at least two to three times the values obtained in the oedometer tests. To verify observations from the laboratory tests, the loads and the settlements of two single footings on weathered Keuper mudstone have been measured during construction of a building over 1 year. Also, a large scale footing load test with measurements of deformations were conducted on the weathered Keuper mudstone. The measured settlements of the two single footings and the tested foundation were compared with the settlements based on conventional calculations with moduli from oedometer tests and triaxial K 0-tests. Up to a foundation pressure of σv = 500 kN/m² the calculated settlement based on E S-modulus obtained from triaxial K 0-tests was found to correspond well to the measured deformation. For foundation pressure beyond 500 kN/m², the foundation response was highly non-linear and it could not be described any more with the linear-elastic model. Therefore the footing load test was also simulated by FEM analyses.

Unipedal standing exercise and hip bone mineral density in postmenopausal women: a randomized controlled trial

The aim of this study was to test the effect of unipedal standing exercise on bone mineral density (BMD) of the hip in postmenopausal women. Japanese postmenopausal women (n = 94) were assigned at random to an exercise or control group (no exercise). The 6-month exercise program consisted of standing on a single foot for 1 min per leg 3 times per day. BMD of the hip was measured by dual-energy X-ray absorptiometry. There was no significant difference in age and baseline hip BMD between the exercise group (n = 49) and control group (n = 45). Exercise did not improve hip BMD compared with the control group. Stepwise regression analysis identified old age as a significant determinant (p = 0.034) of increased hip total BMD at 6 months after exercise. In 31 participants aged >/=70 years, the exercise group (n = 20) showed significant increase in the values of hip BMD at the areas of total (p = 0.008), intertrochanteric (p = 0.023), and Ward's triangle (p = 0.032). The same parameters were decreased in the control group (n = 11). The percent changes in hip BMD of the exercise group were not significantly different from those of the control group either in the participants with low baseline hip total BMD (<80% of the young adult mean) or high baseline hip total BMD (> or =80% of the young adult mean). In conclusion, unipedal standing exercise for 6 months did not improve hip BMD in Japanese postmenopausal women. Effect of exercise on hip total BMD was age dependent. In participants aged > or =70 years, the exercise significantly increased hip total BMD.

Use of serial laminar tissue collection via biopsy in conscious healthy horses

To determine the feasibility of performing serial laminar and skin biopsies on sedated horses and whether sampling affected adjacent tissues. 6 horses. Laminar tissues were harvested via biopsy through the hoof wall from healthy conscious horses via sedation and regional anesthesia. Eight specimens were collected at 4 time points during 24 hours from a single foot. Laminar biopsy specimens were harvested with a 6-mm-diameter biopsy punch after burring through the horny corium to the stratum medium. Skin biopsy specimens were collected from an area proximal to the coronary band. All tissues were examined via light microscopy. Total RNA was extracted and quantified, and gene expression analysis was completed for 2 housekeeping genes and the inflammatory mediator cyclooxygenase-2. Laminar and skin biopsies yielded adequate specimens for histologic and gene expression evaluation. There was no extension of inflammation or detectable damage to adjacent tissues during the 24-hour period in either laminar or skin specimens as judged via histologic findings and cyclooxygenase-2 expression. Lameness and discomfort induced by the procedure were minimal. Laminar biopsy provided a satisfactory method of collecting laminar specimens and allowed serial sampling of individual horses.

Sirenomelia (Mermaid Syndrome): An Infant from Parents Who Used a Special Form of Snuff

We report the first case of a fetus with sirenomelia or mermaid syndrome, whose Afghanian parents were heavy user of a special form of snuff. The case was diagnosed as a mermaid syndrome but some of the features were common to both symmelia dipus and symmelia apus, for example, the single lower extremity had the normal femur, tibia and fibula, but the single foot was rotated medially. The digestive tube ended to a massive closed saclike structure and the anus was absence. The external genital organs were rudiment and the normal testes were undescended. Aorta was divided to branches, such that the external iliac arteries were very small in comparison to the internal iliac arteries. Inferior Vena cava was placed on to the left side of the aorta and unlike the majority of reported mermaid syndrome, the bladder was present. So, the researchers believe that the present case is a rare variant of the mermaid syndrome.

Cross‐linguistic differences in prosodic organization: Evidence from a repetition task.

The prosody of languages such as English and Spanish has been characterized as exhibiting different rhythmic organizations. English has been hypothesized to organize syllables into feet, with one stressed syllable per foot. Spanish is among the languages whose prosody has been hypothesized to not include the foot, despite the existence of lexical stress in Spanish. We tested the hypothesis that these potential differences in organization would lead to systematically different responses when speakers were asked to entrain a sequence of syllables with a metronome at an increasing rate, and that L1Spanish/L2English speakers would continue to exhibit the Spanish pattern in their English. Speakers of all three types were recorded producing a single repeated syllable, or a sequence of two alternating syllables, in time with a metronome, whose rate increased monotonically after a stabilization period. At slower speech rates, English speakers produced each word as a separate foot with a corresponding pitch accent, while at increased speech rates, two words were grouped together into a single iambic foot with one pitch accent. Spanish speakers and L1Spanish/L2English speakers are expected to shorten both vowels, employing a symmetric strategy (as opposed to the asymmetric strategy of English speakers) to keep pace with the metronome. [Work supported by NIH, NSF.]

Isoflurane Suppresses Stress-enhanced Fear Learning in a Rodent Model of Post–Traumatic Stress Disorder

A minority of patients who experience awareness and/or pain during surgery subsequently develop post-traumatic stress disorder. In a rodent model of post-traumatic stress disorder, stress-enhanced fear learning (SEFL), rats are preexposed to a stressor of 15 foot shocks. Subsequent exposure to a single foot shock produces an enhanced fear response. This effect is akin to sensitized reactions shown by some post-traumatic stress disorder patients to cues previously associated with the traumatic event. The authors studied the effect of isoflurane and nitrous oxide on SEFL. Rats were exposed to the inhaled anesthetic during or after a 15-foot shock stressor. Then, rats were given a single foot shock in a different environment. Their fear response was quantified in response to the 15-foot shock and single-foot shock environments. SEFL longevity was tested by placing a 90-day period between the 15 foot shocks and the single foot shock. In addition, the intensity of the foot shock was increased to evaluate treatment effectiveness. Increasing isoflurane concentrations decreased SEFL when given during, but not after, the stressor. At 0.40 minimum alveolar concentration (MAC), isoflurane given during the stressor blocked SEFL 90 days later. A threefold increase in the stressor intensity increased the isoflurane concentration required to block SEFL to no more than 0.67 MAC. As with isoflurane, nitrous oxide suppressed SEFL at a similar MAC fraction. These results suggest that sufficient concentrations (perhaps 0.67 MAC or less) of an inhaled anesthetic may prevent SEFL.

Orthotic fitting improves gait in a patient with generalized secondary dystonia

To determine whether an orthotic fitting improved gait in an adult patient presenting with generalized secondary dystonia. The patient had stance and gait disturbances associated with pain, ankle instability and fatigability. Clinical examination showed the presence of dystonia in the foot and ankle, along with equinovarus foot, mainly on the left side. The patient was fitted with a patellar tendon-bearing orthosis on the left side, orthopaedic shoes and plantar orthoses. The outcome of the treatment after 12 months was assessed on the basis of a physical examination and an instrumental gait assessment, using the GAITRite(R) system to analyse spatiotemporal parameters and force-plates to measure body weight distribution. The fitting resulted in a significant improvement in gait, reduced pain and ankle instability, decreased cadence, increased step length and single foot support time, and reduced asymmetry of the temporo-spatial patterns and body weight distribution. Patellar tendon-bearing orthoses and orthopaedic shoes could provide a good therapeutic approach for improving gait in patients with generalized secondary dystonia.

Real-time PCR strategy for rapid discrimination among main lymnaeid species from Argentina

Snails of the Family Lymnaeidae act as an intermediate hosts of Fasciola hepatica worldwide. The taxonomy of lymnaeid species is relevant for epidemiological studies and molecular strategies are increasingly used for that purpose. This work presents the first report of a real-time PCR approach used to identify the most important lymnaeid species in the Southern Cone of South America. Species discrimination is based on the sequence polymorphism located within the helix E10-1 of the variable region V2 of the 18S rRNA genes, which yields amplicons with clearly different melting temperatures. This procedure minimises the risk of carry-over contamination because it does not require post-PCR manipulations, and the whole protocol can be completed in less than 4 h with a single snail foot as starting material. This method was successfully carried out in a blind study that included a panel of 20 Galba truncatula, 5 Lymnaea viatrix, 5 Lymnaea diaphana and 5 Pseudosuccinea columella specimens from different endemic areas for fasciolosis. This molecular approach constitutes a key laboratory tool complementing ecological studies that ultimately will promote more efficient control strategies.

Avaliação radiológica do espaço articular na artrose do quadril: estudo comparativo em decúbito e ortostatismo

OBJETIVO: Comparar as alteracoes do espaco articular em pacientes com osteoartrose do quadril, por meio de estudo radiografico que inclui as posicoes em decubito dorsal e ortostatismo monopodalico. METODOS: A amostra do presente estudo consta de 74 radiografias. Metade das radiografias foram realizadas com os pacientes em decubito dorsal e a outra metade com os pacientes em ortostatismo monopodalico. Uma regua milimetrada e uma lente de aumento foram usadas para realizar as medicoes dos quadris. O espaco entre o acetabulo e a cabeca femoral (EACF) foi medido a partir de radiografias centradas no quadril. RESULTADOS: Comparando-se 74 radiografias com osteoartrose do quadril obtidas em decubito dorsal e ortostatismo monopodalico conclui-se que existe diferenca estatisticamente significativa entre as posicoes estudadas respectivamente de 1,47 para 1,12mm (p < 0,0001). A correlacao foi de 0,952 com p < 0,0001. O teste t-Student pareado para a amostra decubito dorsal e ortostatismo revelou intervalo de confianca de 0,2671 a 0,4302 com p < 0,0001 bicaudal. CONCLUSAO: As radiografias mensuradas em ortostatismo com apoio monopodalico avaliam melhor o verdadeiro espaco articular e o grau de artrose.

Experimental investigation of the system behaviour of a model three-legged jack-up on clay

Results from combined loading experiments dedicated to evaluating the capacity and stiffness of a single footing have significantly improved the understanding of the response of circular shallow foundations. However, due to experimental practicalities, little corroborative evidence is available to confirm predicted behaviour when multiple footings act within a structural system. This paper addresses this concern by presenting the results of a series of experimental tests on a three-legged model jack-up unit founded on soft, heavily overconsolidated clay. The model adopted geometric features representative of a large prototype rig by appropriately scaling leg height, leg separation and flexural stiffness, as well as the ‘spudcan’ footing diameter and profile. Pushover events were considered by subjecting the model jack-up to monotonic horizontal loading at hull level. By measuring loads and displacements at the hull and at each spudcan, the system behaviour of the jack-up could be analysed. Nine separate tests were performed, revealing how load orientation, leg length and preload ratio changed the system capacity and affected the load–displacement paths of the jack-up and spudcan system. The test results are compared with those derived from single spudcan experiments, and are interpreted within the combined load yield surface approach gaining acceptance within the offshore industry.

On Born's deformed reciprocal complex gravitational theory and noncommutative gravity

Born's reciprocal relativity in flat spacetimes is based on the principle of a maximal speed limit (speed of light) and a maximal proper force (which is also compatible with a maximal and minimal length duality) and where coordinates and momenta are unified on a single footing. We extend Born's theory to the case of curved spacetimes and construct a deformed Born reciprocal general relativity theory in curved spacetimes (without the need to introduce star products) as a local gauge theory of the deformed Quaplectic group that is given by the semi-direct product of U ( 1 , 3 ) with the deformed (noncommutative) Weyl–Heisenberg group corresponding to noncommutative generators [ Z a , Z b ] ≠ 0 . The Hermitian metric is complex-valued with symmetric and nonsymmetric components and there are two different complex-valued Hermitian Ricci tensors R μ ν , S μ ν . The deformed Born's reciprocal gravitational action linear in the Ricci scalars R , S with Torsion-squared terms and BF terms is presented. The plausible interpretation of Z μ = E μ a Z a as noncommuting p-brane background complex spacetime coordinates is discussed in the conclusion, where E μ a is the complex vielbein associated with the Hermitian metric G μ ν = g ( μ ν ) + i g [ μ ν ] = E μ a E ¯ ν b η a b . This could be one of the underlying reasons why string-theory involves gravity.

Initial experience with the Pascal photocoagulator: a pilot study of 75 procedures

Background:The Pascal is a semiautomated photocoagulator that delivers a pattern array of multiple burns in a rapid predetermined sequence with a single foot pedal depression. Each burn is reduced to...

A modified single-prolonged stress model for post-traumatic stress disorder

In the rat, single-prolonged stress (SPS) model produces a core symptom of post-traumatic stress disorder (PTSD), the enhanced fear response to the traumatic cue (conditioned fear response). This investigative tool is typically used for PTSD studies. However, whether SPS can produce another core symptom of PTSD, hyperarousal (the sensitized fear response in animal models), has not been evaluated. It is also not clear whether SPS can enhance both conditioned and sensitized fear responses after different incubation times. In this study, a single inescapable electric foot shock was given to rats immediately after SPS procedures (SPS&S). After different incubation times (1, 7 or 14 days), the conditioned or sensitized fear response was measured by re-exposing the stressed rats to the shock context or a neutral tone in a novel environment. Additionally, paroxetine, a selective serotonin reuptake inhibitor (SSRI) was administered after SPS&S for 14 days to test its potential preventive effect on PTSD-like symptoms. We observed that conditioned fear persisted and sensitized fear increased with ongoing incubation times after SPS&S. Early rapid intervention with paroxetine after SPS&S ameliorated PTSD-like symptoms in both fear responses and anxiety behaviors. Our data suggests that this modified SPS&S model may be both novel and predictably mimic the clinical characteristics of PTSD better than other investigative paradigms.

The relationship of reduced peripheral nerve function and diabetes with physical performance in older white and black adults: the Health, Aging, and Body Composition (Health ABC) study.

OBJECTIVE—Poor peripheral nerve function is prevalent in diabetes and older populations, and it has great potential to contribute to poor physical performance.RESEARCH DESIGN AND METHODS—Cross-sectional analyses were done for the Health, Aging, and Body Composition (Health ABC) Study participants (n = 2,364; 48% men; 38% black; aged 73–82 years). Sensory and motor peripheral nerve function in legs/feet was assessed by 10- and 1.4-g monofilament perception, vibration detection, and peroneal motor nerve conduction amplitude and velocity. The Health ABC lower-extremity performance battery was a supplemented version of the Established Populations for the Epidemiologic Studies of the Elderly battery (chair stands, standing balance, and 6-m walk), adding increased stand duration, single foot stand, and narrow walk.RESULTS—Diabetic participants had fewer chair stands (0.34 vs. 0.36 stands/s), shorter standing balance time (0.69 vs. 0.75 ratio), slower usual walking speed (1.11 vs. 1.14 m/s), slower narrow walking speed (0.80 vs. 0.90 m/s), and lower performance battery score (6.43 vs. 6.93) (all P < 0.05). Peripheral nerve function was associated with each physical performance measure independently. After addition of peripheral nerve function in fully adjusted models, diabetes remained significantly related to a lower performance battery score and slower narrow walking speed but not to chair stands, standing balance, or usual walking speed.CONCLUSIONS—Poor peripheral nerve function accounts for a portion of worse physical performance in diabetes and may be directly associated with physical performance in older diabetic and nondiabetic adults. The impact of peripheral nerve function on incident disability should be evaluated in older adults.

Performance Evaluation of a Strengthened Building Considering the Soil-Structure Interaction

In this article, performance evaluations of a 3D building strengthened by additional shear-walls are presented as a case study by considering the foundation effects. Soil-structure interaction is included in the nonlinear static analysis of the building and performance evaluations are made according to Chs. 6 and 8 of FEMA440. Different foundation types such as mat foundation, continuous or single footings are considered in the analysis. Tensionless elastic-plastic Winkler soil model is used for soil behavior. Non-linear push-over analysis and performance evaluations are obtained by SAP2000 computer package. Elastic-plastic Winkler soil behavior is represented by equivalent frame elements subjected only to axial forces and equivalent axial stiffness is defined for these elements. Mat foundation and footings are idealized as linear-elastic thick shell elements in the analysis. Performance evaluations and comparisons for the strengthened building are given in detail for different foundation types.

Tarsal and Metatarsal Bone Mineral Density Measurement Using Volumetric Quantitative Computed Tomography

A new method for measuring bone mineral density (BMD) of the tarsal and metatarsals is described using volumetric quantitative computed tomography (VQCT) in subjects with diabetes mellitus and peripheral neuropathy. VQCT images of a single foot were acquired twice from eight subjects (mean age 51 [11 SD], seven males, one female). The cortical shells of the seven tarsal and five metatarsal bones were identified and semiautomatically segmented from adjacent bones. Volume and BMD of each bone were measured separately from the two acquired scans for each subject. Whole-bone semiautomatic segmentation measurement errors were determined as the root mean square coefficient of variation for the volume and BMD of 0.8% and 0.9%, respectively. In addition to the whole-bone segmentation methods, we performed atlas-based partitioning of subregions within the second metatarsal for all subjects, from which the volumes and BMDs were obtained for each subregion. The subregion measurement BMD errors (root mean square coefficient of variation) within the shaft, proximal end, and distal end were shown to vary by approximately 1% between the two scans of each subject. The new methods demonstrated large variations in BMDs between the 12 bones of the foot within a subject and between subjects, and between subregions within the second metatarsal. These methods can provide an important outcome measure for clinical research trials investigating the effects of interventions, aging, or disease progression on bone loss, or gain, in individual foot bones.