Search Results (1,271)

This article presents the design and detailed characterization of a new supersonic wind tunnel at the Aerospace Laboratory for Lasers, ElectroMagnetics, and Optics of Texas A&M University, tailored for optical diagnostic development and sub-scale fundamental compressible fluid dynamics research. A Ludwieg tube tunnel architecture was selected due to its robustness, versatility, and low operational costs. The tunnel consists of a 50-foot-long driver tube constructed from modular Tri-Clamp spools, a Mach 4 nozzle with 3 in. exit diameter configured as a free jet, and a fast-acting valve with 14 ms opening time for high-duty-cycle operation. Such construction proved to be a robust, compact, and affordable solution for academic applications. Characterization methods consisted of simultaneous high-speed dot-schlieren, total and static pressure measurements, and femtosecond laser electronic excitation tagging. Average flow velocity for the first steady-state test time was measured via FLEET at (668.0 ± 5.7) m/s. The Mach number was calculated based on the angles of the attached oblique shocks formed near the 30° cone model. Calculated Mach number was repeatable from run to run and had small oscillations near the average value of 3.96 ± 0.03. Based on the simultaneously measured velocity and Mach number, the static temperature was calculated to be between (68.6 ± 0.3) K and (66.3 ± 0.3) K throughout the 400 ms test time, completely defining the thermodynamic state of the generated freestream flow. Full article

Background: The origin of hallux abducto valgus (HAV) is considered to be multifactorial; however, evidence regarding the factors involved in its development is scattered and often contradictory. Understanding the factors that contribute to the onset of HAV is crucial for informing both prevention and clinical management strategies. This review aims to explore the etiological factors associated with the development of HAV. Methods: A literature search was conducted in PubMed, Embase, Web of Science and Scopus. The search included observational studies that investigated etiological or risk factors related to the development of HAV. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklists, and the level of evidence was classified according to the Oxford Centre for Evidence-Based Medicine (OCEBM). Results: A total of 36 observational studies (20 cross-sectional and 16 case–control) were included, involving 14,500 participants, predominantly females. Genetic evidence indicated strong familial aggregation and variants in collagen- and extracellular matrix-related genes as potential hereditary determinants. The most consistent biomechanical factors were first-ray hypermobility, abnormal foot pronation and reduced activity of the abductor hallucis muscle. Additionally, female sex, older age and prolonged use of narrow or inadequate footwear were identified as recurring predictive variables. Overall, the findings support a complex etiological model based on the interaction of intrinsic and extrinsic factors. Conclusions: The development of HAV appears to be determined by the interaction of genetic, structural and biomechanical factors that alter first-ray stability and forefoot function. Current evidence supports a multifactorial etiological model with a strong hereditary component and higher susceptibility in women. Longitudinal studies employing standardized methods are needed to establish causal relationships and quantify the relative contribution of each factor. Full article

Human locomotion relies on a proximal–distal organization of joint mechanical work that adapts to task constraints, such as those imposed by inclined walking. In individuals with transtibial amputation, loss of the biological ankle disrupts this organization, leading to proximal alterations and inter-limb asymmetries. Active mechatronic prosthetic feet have been developed within a biomechanical biomimicry framework to restore distal positive mechanical work. This exploratory study quantified the effects of an active mechatronic prosthetic foot on joint mechanical work during inclined walking. Four individuals with transtibial amputation performed instrumented treadmill walking at −3°, 0°, and +3° using their habitual passive foot and a powered foot. Positive and negative mechanical work at the ankle, knee, and hip were computed using inverse dynamics and compared with a normative reference database (n = 20). The powered foot induced modest, task-dependent modifications, mainly at the ankle and knee. In downhill walking, it promoted a more symmetrical redistribution of negative mechanical work, particularly at the knee, suggesting a partial reduction in contralateral overload. In uphill walking, distal assistance increased prosthetic-side positive work, reflecting slope-dependent reallocation rather than normalization. Although a multivariate deviation score indicated reduced deviation under the powered condition, full convergence toward the asymptomatic organization was not achieved. Full article

Venothromboembolic (VTE) events are considered rare complications following foot and ankle surgery. Most instances of VTE following surgical procedures occur in particularly high-risk patient populations; therefore, VTE prophylactic anticoagulation is initiated based on risk/benefit stratification for each individual patient undergoing foot and ankle surgery. We present a case report on a 40-year-old male who underwent isolated Lisfranc ligament repair and subsequently developed an acute saddle pulmonary embolism and deep vein thrombosis 1 month postoperatively. The patient was on prophylactic Lovenox, yet still developed a life-threatening complication. The patient was found to be on a selective estrogen receptor modulator for the off-label treatment of male infertility. This medication, surgical intervention, and a period of non-weight bearing are believed to be contributory to the patient’s relatively increased hypercoagulable state. This case depicts a rare complication of foot and ankle surgery and highlights the importance of VTE prophylaxis during the postoperative period. Full article

Background/Objectives: As a treatment, fluoropyrimidines are often associated with early moderate-to-severe toxicity. Although pre-emptive DPYD genotyping enables genotype-guided dosing, significant adverse events still occur in patients classified as DPYD wild-type (WT). The aim of this study was to identify DPYD variants and evaluate the contributions of TYMS, ENOSF1, CDH4, and CDA variants to fluoropyrimidine toxicity. Methods: A total of 256 European ancestry patients (aged ≥ 18 years, had completed ≥6 cycles of chemotherapy, and were WT for the DPYD variants routinely tested for) underwent genotyping for TYMS, ENOSF1, CDH4, and CDA variants, and full DPYD exon sequencing was performed in 56 of these patients. Toxicity was defined as fluoropyrimidine-related adverse events requiring a dose reduction. Multivariable models were adjusted for sex, fluoropyrimidine type, and the Charlson Comorbidity Index, and time-to-event was assessed using the Kaplan–Meier/Cox proportional hazards models. Results: A subgroup of 117 patients experienced toxicity requiring a dose reduction. The most frequent events were asthenia, gastrointestinal toxicity, hand–foot syndrome, and haematological toxicity. The ENOSF1 rs2612091 C allele was associated with fluoropyrimidine withdrawal and a shorter time to dose reduction. In the patients treated with 5-fluorouracil, TYMS rs11280056 was associated with toxicity. DPYD exon sequencing identified thirteen variants, nine of which were more prevalent in the toxicity group. These included a canonical splice site (c.150+1G>A) and a stop-gained (c.1863G>A) variant, which is predicted to result in loss of function. Conclusions: In real-world practice, despite undergoing standard DPYD genotyping, DPYD WT patients receiving a full dose of fluoropyrimidines develop clinically relevant toxicity. The presence of rare DPYD variants and associated genes (ENOSF1 and TYMS) suggests that broader, prospectively validated pharmacogenetic strategies may improve toxicity prevention. Full article

This paper presents a mobile application to encourage sustainable travel in urban areas as a proof-of-concept for user-centred sustainable urban transport. The app provides real-time route evaluation based on the environmental impact of different transport modes and local sensor monitoring feedback. Its core feature is an ecological route assessment using life cycle assessment calculations. Users receive quantitative feedback on their carbon footprint and a mobility score ranging from one (worst, red) to five (best, green). Providing both ecological and time-based navigation assessments, the app generates a comprehensive ecological footprint based on individual behaviour, raising awareness of United Nations climate targets. To increase its appeal, the app integrates a quest model offering vouchers from local partners (e.g., half-priced coffee) and competitions (e.g., complete the most journeys under 5 km by bike or on foot per week). A user-centred development process involving multiple test groups and a physical mock-up has been used to optimize the user interface, concept, and gamification elements. The app will be extended to include location-based quests and interactive chat quizzes. The project addresses key aspects of sustainable individual mobility and could be adapted for other cities, universities, or regions. Full article

Diabetes mellitus (DM) is highly prevalent among patients undergoing foot and ankle surgery and is associated with substantially increased perioperative and postoperative risk. This narrative review synthesizes the current literature on optimization of DM patients undergoing foot and ankle surgery. Complications of chronic hyperglycemia, including neuropathy and peripheral vascular disease, make the foot and ankle particularly vulnerable to ulceration, infection, and deformity, contributing to high rates of both operations and postoperative complications such as surgical site infection and readmission. Glycemic control and obesity are modifiable predictors of surgical outcomes and represent key targets for preoperative optimization. Lifestyle modification and pharmacologic therapy play central roles in DM optimization. Traditional agents such as metformin, sulfonylureas, thiazolidinediones, and dipeptidyl peptidase-4 inhibitors remain foundational therapies, while newer therapies such as sodium–glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 (GLP-1) agonists offer meaningful improvements to glycemic control and weight loss. Pharmacologic regimens must be individualized, and many agents require careful perioperative management. Despite advances in medical therapy, high-quality evidence specific to foot and ankle surgery remains limited. Future research should focus on developing procedure- and agent-specific guidelines to reduce the substantial clinical and economic burden of DM in foot and ankle surgical patients. Full article

Background: Diabetic foot infections (DFIs) are a major cause of hospitalization, limb loss, and mortality among patients with diabetic foot ulcers (DFUs). This study evaluated the risk of developing DFIs among patients with newly diagnosed DFUs across insurance categories. Methods: Adults ≥18 years with a new DFU diagnosis were identified in the PearlDiver insurance claims database (2010–2020) using validated ICD-9/10 codes. Insurance status at the index DFU was categorized as Medicaid, Medicare, commercial, or self-pay. Propensity score matching (1:3) based on age, sex, Charlson Comorbidity Index, and major comorbidities was used to compare Medicaid vs. non-Medicaid patients. Results: Among 258,122 patients with new DFUs, 20,638 (8.0%) were Medicaid beneficiaries. Medicaid patients were younger (50.1 ± 10.2 vs. 60.6 ± 12.1 years, p < 0.001) but had similar comorbidity burden compared with commercially insured and Medicare patients. In matched analysis post-matching, Medicaid insurance was independently associated with higher odds of DFI-related hospitalization within 12 months (aOR 1.18, 95% CI 1.14–1.24) and major amputation at 3 years (aOR 1.72, 95% CI 1.39–2.13). Higher CCI, chronic kidney disease, congestive heart failure, COPD, and peripheral vascular disease also predicted adverse outcomes. Conclusions: Medicaid insurance was independently associated with increased risks of DFI and major amputation among patients with newly diagnosed DFUs. These findings highlight infection as a potentially modifiable pathway driving limb loss and emphasize the need to improve early ulcer evaluation and infection management for Medicaid beneficiaries. Full article

The growing demand for functional and value-added foods has prompted interest in integrating nutrient-rich ingredients and novel encapsulated systems into traditional pasta products. This study aimed to develop and optimize a ravioli dough formulated with elephant foot yam flour (EFYF), wheat flour (WF) and amaranth flour (AF) using mixture design in response surface methodology and to create an innovative filling using encapsulated edible pearls produced from okra mucilage and moringa leaf powder through ionotropic gelation. The pearls and ravioli dough were analyzed for physicochemical, textural, color and nutritional characteristics. Cooked ravioli was investigated for cooking quality and sensory attributes. The optimized dough formulation (46.67 g EFYF, 43.32 g WF, 10 g AF) exhibited desirable hardness (4.64 ± 0.28 N), chewiness (0.40 ± 0.02 N), nutritional, physicochemical and color attributes. The edible pearls demonstrated moderate moisture content (21.18 ± 0.26%), high protein (26.25 ± 0.02%), crude fiber (2.60 ± 0.01%), dietary fiber (8.60 ± 0.52%), high ash content (14 ± 0.62%) and soft gel-like texture. The cooked ravioli showed a cooking time of 8 ± 1 min, high water absorption capacity (209.9 ± 0.34%), minimal solid loss (1.30 ± 0.21%) and favorable sensory scores across appearance, taste, texture and overall acceptability. The study concludes that incorporating encapsulated pearls and nutrient-dense flours can produce a functional, nutritionally enriched ravioli with good technological performance and consumer appeal. Full article

One of the most common and severe complications of diabetes mellitus is diabetic foot, making early detection a public health priority. Infrared thermography is a promising noninvasive technique for identifying abnormal thermal patterns associated with inflammation, neuropathy, angiopathy, and tissue damage. This technique involves acquiring infrared radiation emitted by the skin and processing it to generate thermal maps that reflect underlying physiological changes. However, the reliability of thermographic assessments depends on strict technical conditions, including sensor performance, environmental control, and reproducible measurements. Despite its advantages, the clinical adoption of thermography is limited by the absence of standardized acquisition protocols and the influence of external and physiological factors on temperature measurements. Addressing these challenges is essential to ensure the accurate interpretation and validation of results. Recent advances, such as the incorporation of artificial intelligence algorithms and the development of portable, low-cost devices, offer new opportunities to enhance thermography’s applicability in clinical settings and home monitoring. Full article

This study was designed to evaluate the genetic parameters of growth, meat yield and foot color in Pacific abalone (Haliotis discus hannai) to support the development of a quality-oriented breeding program. Using data from 141 pedigreed full-sib families, heritabilities and genetic correlations among these traits were estimated. The results indicated that shell length at varying ages (0.45–0.71) and total wet weight (0.48) exhibited moderate-to-high heritabilities, suggesting substantial potential for genetic improvement in growth traits. The heritabilities for foot color (0.26) and meat weight (0.31) were moderate and statistically significant (p < 0.05), whereas the heritability for meat yield (0.14) was low and not statistically significant (p > 0.05). Strong positive genetic correlations were observed between shell length and total wet weight at harvest (0.90), as well as between total wet weight and meat weight at harvest (0.92). In contrast, the genetic correlations between total wet weight and foot color, and between total wet weight and meat yield, were low and not statistically significant (p > 0.05). These findings suggest that direct selection can effectively improve the growth and meat weight of Pacific abalone. However, improving foot color and meat yield may require independent or multi-trait selection approaches. Overall, this study provides crucial data for formulating a comprehensive breeding strategy that integrates both production efficiency and product quality in Pacific abalone aquaculture. Full article

Background: The aim of the study was to examine the relationship between body weight (weight category groups) and the ability to maintain balance in conditions of restricted field of vision and support area in female wrestlers. Methods: The study involved female wrestlers (n = 34), who were divided into three weight categories. The Romberg test was performer using a freeSTEP STANDARD stabilometric platform. The analysed stabilometric parameters measuring the range of centre-of-pressure (CoP) deviation included total path length (PL) of foot pressure on the ground. Results: The postural stability of female wrestlers was determined by their position, the quality of visual information, the limitation of the support base, and their weight category. As visual information and the support base were limited (when standing on one leg), the deviation of the centre of gravity increased (right leg: f² = 0.293, p < 0.005). Lightweight competitors showed the biggest body deviations in the ‘standing with both feet and eyes open’ position compared to the middleweight and heavyweight categories (eyes open EO f² = 0.233, p < 0.05; eyes closed EC f² = 0.217, p < 0.05). The differences between the tests with eyes open and closed were statistically significant only in the lightweight category. Conclusions: Balance training on the right leg with eyes open can be a sensitive diagnostic test, highlighting differences in stability levels between weight groups. It indicates the need to develop stability while eliminating visual compensation in order to compensate for these differences in competitive sports. Full article

The increasing need for lightweight, personalized, and sustainable orthopedic braces has motivated the development of bamboo fiber (BF)-reinforced polylactic acid (PLA) composites. In this study, BF/PLA composites were prepared by melt blending. The effects of polybutylene adipate terephthalate (PBAT) toughener, BF content, and a silane coupling agent on the mechanical properties were evaluated, along with their suitability for 3D printing foot braces. The results showed that at a PLA/PBAT mass ratio of 85/15 and a bamboo fiber content of 10 wt.%, the impact strength of the composite reached 7.7 kJ/m². Silane treatment of BF further improved the impact strength, with a maximum value of 11.3 kJ/m² achieved at a silane/BF mass ratio of 2/98. The optimized composite exhibited good printability across nozzle temperatures of 190–210 °C. Printing speed significantly influenced the process; a speed of 35 mm/s enabled successful fabrication of the foot brace, whereas higher or lower speeds led to model collapse due to overheating or cracking caused by insufficient interlayer adhesion. This study successfully developed a bamboo fiber-reinforced PLA composite suitable for 3D printing of orthopedic braces and identified the optimal 3D printing process parameters. Full article

Background: Diabetes-related foot complications are among the most common complications in individuals with type 2 diabetes mellitus. The prevention of foot problems that are at risk of developing because of type 2 diabetes mellitus should be addressed within the framework of preventive approaches prior to treatment. The aim of this study was to evaluate protective sensation in people with type 2 diabetes mellitus who have not been diagnosed with early diabetes-related foot complications and to investigate the effects of protective sensation on peripheral muscle strength, balance, and functional capacity. Methods: This study included 42 volunteer patients (56.71 ± 7.59 years) who were followed up with a diagnosis of type 2 diabetes mellitus and met the inclusion criteria. Individuals were evaluated prospectively and via face-to-face interviews. Light-touch, vibration, and discrimination sense was evaluated to determine protective sensation. Peripheral muscle strength (quadriceps femoris, biceps brachii, and hand grip) was measured and a 6 min walking test for functional capacity and balance evaluation were performed. Spearman correlation analysis was conducted using SPSS Statistics 21.0 for data analysis. Results: At least one of the components of protective sensation was moderately correlated with peripheral muscle strength, functional capacity, and balance scores. Reduced protective sensation was also observed in individuals with type 2 diabetes mellitus without neuropathy. Conclusions: In type 2 diabetes mellitus patients, decreases in light-touch, vibration, and discrimination sense are moderately associated with parameters of peripheral muscle strength, functional capacity, and balance. In patients with type 2 diabetes mellitus, early foot sole sensory examination may prevent the development of neuropathy and support clinicians in early diagnosis. Full article

Background: Flatfoot is an alteration of the normal structure of the foot, characterized by a partial or total reduction of the medial longitudinal plantar arch, valgus deformity of the heel, and abduction of the forefoot. While treatments often include strengthening of the intrinsic foot muscles, evidence of its efficacy in adults with flatfoot remains limited. Objectives: The main objective of this review was to evaluate the effects of strengthening the plantar intrinsic muscles in adults with flatfoot. Methods: Searches were conducted in PubMed, Embase, Cochrane, PEDro, and Web of Science databases up to October 2023. The review protocol was developed and followed according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies included were those published on intrinsic muscle strengthening in adult populations. A qualitative synthesis of all included articles was performed, along with a quantitative sub-analysis of randomized controlled trials and a critical methodological assessment. Results: Eleven studies involving a total of 374 participants were selected. Most studies identified the “short foot exercise” as the optimal exercise for isolating and training the plantar intrinsic foot muscles. The most commonly analyzed variables were the Foot Posture Index and the Navicular Drop Test. Conclusions: Strengthening the plantar intrinsic muscles enhances the height of the medial longitudinal arch, improves hindfoot posture and balance, and increases hallux abductor muscle activity. This strengthening, whether achieved through short foot exercises alone or in combination with other techniques, is effective in treating adult flatfoot. Current literature suggests that a duration of 4–6 weeks may be sufficient to achieve beneficial outcomes. Full article