The feet cannot perform tasks as quickly and with as much dexterity as the hands. However, due to the heavy workload placed on the hands, there is potential for the feet to replace or assist the hands. In order to use the feet more effectively, this study aims to find ways to increase the speed and accuracy of directly touching a touchpad with the feet while in a seated position. The study investigates the effects of three factors: the slope of the touchpad, the direction of foot movement, and the touch area of the foot used. Regarding the direction of foot movement, the study found that the most effective direction for both accuracy and speed was at a 30-degree angle to the right when the front of the right foot was set at 0 degrees. The 0-degree and 60-degree angles showed similar efficiencies, but were lower than the 30-degree angle. The study also found that using the big toe as the touch area resulted in the best speed, accuracy, and subjective satisfaction. The index toe was the second-best option, while using the ball of the foot was the least accurate and slowest option. Lastly, using an slope angle of 15 degrees for the touchpad was found to increase work efficiency compared to using a 7-degree slope angle. These findings can serve as guidelines for designing foot interfaces.

Foot drop is a common disability in post-stroke patients and represents a challenge for the clinician. To date, Ankle Foot Orthosis (AFO) combined with conventional rehabilitation is the gold standard of rehabilitation management. AFO has a palliative mechanical action without actively restoring the associated neural function. Functional Electrical Stimulation (FES), consisting in stimulation of the peroneal nerve pathway, represents an alternative approach. By providing a FES device (Bioness L-300, BIONESS, USA) for 6 months to a post-stroke 22-year-old woman with a foot drop, our goal was to quantify its potential benefit on walking capacity. Gait parameters and the temporal evolution of the speed were collected with a specific connected sole device (Feet Me®) during the 10-meter walking, the Time Up and Go, and the 6-minute walking tests with AFO, FES or without any device (NO). As a result, the walking speed changes on 10-meters were clinically significant with an increase from baseline to 6 months in AFO and FES conditions (+0.14m-1 and +0.36m-1), without any changes in NO condition. In addition, speed decreased at about 4-minutes of the 6-minute walking test in NO and AFO conditions, while speed increased in FES conditions at baseline and after 1, 3 and 6 months. Monitoring gait speed in an endurance test after an ecological rehabilitation training program helps to examine walking performance in post-stroke patients and to propose a specific rehabilitation program depending on a fatigue threshold.

Background: To compare the clinical efficacy of Japas osteotomy of the middle foot and first metatarsal sequence osteotomy in treating children with cavovarus foot deformity. Methods: A retrospective analysis was performed on the clinical effect of cavovarus foot surgery from January 2012 to January 2019. Thirty light and medium cavovarus foot cases underwent osteotomy based on soft tissue release. Among them, 16 cases of 22 feet underwent first metatarsal sequence osteotomy, and 14 cases of 21 feet underwent middle foot Japas osteotomy. Ankle-posterior foot (Wicart) scoring system was used to evaluate the good and good rates of the two surgical methods. X-ray films were taken before and after the last follow-up in a standing weight-bearing position, and Meary Angle, Hibb Angle, and Pitch Angle were measured to compare the clinical efficacy of the two surgical methods in correcting the light and medium-cavovarus foot deformity.Results: (1) All patients were followed up for an average of 30 months. There was no significant difference in Meary, Hibb, and Pitch Angle between first metatarsal osteotomy and middle foot Japas osteotomy before surgery, indicating that the severity of malformation was similar between the two groups. (2) The Meary, Hibb, and Pitch Angle of the last follow-up were compared between the two groups (P>0.05), which showed no statistical significance, indicating that the two surgical methods had similar effects on cavovarus deformity correction. (3) At the most recent follow-up, there was no statistically significant difference between the two groups regarding the percentage of patients who achieved an excellent or good Wicart score; for the first metatarsal osteotomy group, the rate was 87%, and for the Japas osteotomy group was 90%; the Fisher test p>0.05 indicates that the postoperative excellent and good rates of the two treatments are comparable.II (4) Comparison of operation time and intraoperative blood loss between the two groups, P<0.05, showed statistically significant differences, indicating that the first metatarsal osteotomy had obvious advantages over Japas osteotomy operation time and intraoperative blood loss. Conclusions: There is no significant difference in postoperative efficacy between first metatarsal osteotomy and Japas osteotomy for light and medium-cavovarus with the apex of the deformity located at the medial cuneus or navicular cuneiform joint. However, the intraoperative blood loss and operative time of first metatarsal osteotomy are superior to Japas osteotomy of the middle foot, and the trauma to children is less. Therefore, the first metatarsal osteotomy can be considered a surgical procedure.

Aims: Multidisciplinary diabetic foot clinics have been shown to be an effective therapeutic model for reducing major amputations and mortality rates. The aim of this article is to assess the economic impact of the implementation of a multidisciplinary diabetic foot clinic in a hospital in Barcelona, Spain. Methods: Observational cost-benefit study of all subjects with diabetes admitted with the diagnosis of a major amputation due to diabetic foot from 2010 to 2020. Direct and indirect costs were compared before and after the introduction of the multidisciplinary diabetic foot clinic. Results: The individual cost per patient with diabetic foot was €14,768 before the implementation of the unit. After the implementation of the clinic, the expected cost was reduced to €5,985 due to a 40% reduction in the probability of hospitalization. Overall, the implementation of the clinic resulted in cost savings per patient valued at €8,783, of which, €7,165 are related to hospital benefits. Conclusion: The results of this analysis contributes to the evidence suggesting that multidisciplinary diabetic foot clinics are cost-effective, by demonstrating that they have a positive impact on patient health while also reducing the utilization of healthcare resources.

Management of diabetic foot ulcers (DFUs) presents challenges to even the most experienced wound care providers. Because of the chronic, non-healing nature of many DFUs, advances in the treatment and care of this disease process are particularly relevant. This case study aims to report the efficacy of the application of dehydrated amniotic membrane allograft (DAMA) to a diabetic foot ulcer. The patient in this study is a 44-year-old male who presented with an aggressive infection on his right foot, which resulted in an open wound of 18 months duration. This patient received weekly applications of dual-layer DAMA over seven weeks. Upon examination at the initial application, the wound was classified as a Wagner grade 3 with necrosis of the underlying muscle. Upon inspection at the final visit, the wound was closed entirely. The results that were shown include improvements in the size, depth, edges, necrotic tissue amount, and epithelization of the wound. This case study demonstrates that the ap-plication of DAMA has the potential to augment the body’s natural DFU healing response; however, future nonrandomized and randomized controlled trials are needed to establish its efficacy further.

The Coronavirus disease 2019 (COVID-19) pandemic is clearly taking a firmer grip on South Africa and more podiatrists will face the potential transmission of SARS-CoV-2. Government response was swift with the implementation of a travel ban, strict national lockdown as well as social distancing and hygiene protocols in line with international health regulations. Co-morbidities such as tuberculosis and HIV/AIDS, endemic to South Africa, are considered a dangerous combination with COVID-19, making many South Africans vulnerable to contracting the COVID-19. Patients with diabetes as well as the aged are vulnerable, both in terms of potential combined complications and challenges in continuity in foot care. The demands of the pandemic may outstrip the ability of the health systems to cope. Should this time arrive, all healthcare practitioners, including podiatrists, would have to step in and take on a role beyond their scope of practice in order to ensure that the healthcare system does not get overwhelmed. It is important for podiatrists to keep abreast with the developments around the COVID-19, in order that they may institute appropriate clinical practice which will ensure maximum protection for themselves, staff and patients as well as providing quality foot health care.

The cavovarus deformity is characterized by a pathologic longitudinal arch elevation caused by a severe hindfoot varus and forefoot equinus deformity. This disorder includes multiple anomalies and therapies and affects 25% of the population. Cavus feet usually indicate neurologic illness, which affects sensory and motor nerves. Clinical and radiological evaluations are needed to establish each patient's optimum therapy. Failure to identify a neurologic illness may lead to inappropriate surgical treatment, recurrence, and reconstructive failure. In progressive anomalies, surgical procedures must be performed quickly in a phased protocol to prevent the malalignment from worsening. Soft tissue surgeries, osteotomies, and arthrodesis are surgical options for patients. To aid and lead practitioners in selecting the most appropriate therapy for their patients daily, we have included the most common therapeutic options currently available in this article.

We hypothesized that biofilm production occurs on stainless steel when incubated with tissue specimens in thioglycolate broth media (TBM). In a diabetic foot infection (DFI) cohort, applying the Kirschner wire and conventional methods were more sensitive than applying only the latter (CI 90%; 0.167 versus 0.375).

Colours act as stimuli capable of inducing physiological and psychological responses, impacting on human life by influencing behaviour, cognition and emotion. Designers frequently draw upon colour association cues in designing products, packaging and marketing materials to exploit the reported human reactions to them. To date, clinicians and foot orthoses manufacturers appear to have given little thought to how the colour of foot orthoses may have impact within the broader context of a biopsychosocial model of healthcare. Here we examine research regarding colour perception and association and provide rationale for how the use of colour in foot orthoses therapy might be better exploited to improve patient outcomes and to form a focus for future research.

Background: Diabetic foot ulcers are an increasingly common complex problem and are associated with a very considerable health care burden. Diabetic foot ulcer with Alcaligenes faecalis infection is rarely reported in the literature. We report a case series of diabetic foot ulcer with Alcaligenes faecalis infection treated at our facility. Methods: We conducted a retrospective analysis of all patients with diabetic foot ulcer with Alcaligenes faecalis infection seen from January 2014 to April 2019. We analyzed the clinical characteristics, ulcer lesion classification, comorbidities, prior intravenous antibiotic use within three months, wound culture, antibiotics sensitivity test, and clinical outcomes of these patients. Results: Eight cases of diabetic foot ulcer with Alcaligenes faecalis infection were seen in five males and three females. The mean age was 54.6 years. All patients had other comorbidities, and all ulcer lesions were of chronic duration ( more than 14 days ). All wound cultures revealed polymicrobial infection, with two cases of diabetic foot with extensive-drug resistant Alcaligenes faecalis infection found in 2019. All patients needed intravenous antibiotic therapy and surgical interventions for the chronic ulcer lesion. The wound failed to heal in three patients. Conclusions: All diabetic foot ulcers with Alcaligenes faecalis infection were of chronic duration ( more than 14 days ) and had polymicrobial infection. Extensive-drug resistant Alcaligenes faecalis emerged in 2019. Definitive antibiotic therapy is necessary for all infected wounds and should be based on both the culture results and susceptibility data. All patients will need appropriate wound care, and most will need rapid surgical intervention for an optimal outcome.

People with diabetic foot frequently exhibit poor gait and balance. However, there is no review to inform digital biomarkers of poor gait and balance related to diabetic foot, measurable by wearables outside traditional gait laboratories. Such information could assist in designing remote patient monitoring platform to track changes in gait and balance dysfunction among people with diabetic foot for timely referral and intervention. Accordingly, we conducted a web-based review using PubMed. Our search was limited to human subjects and English-written papers published in peer-reviewed journals. We identified 20 papers in this review. We found preliminary evidence of digital biomarkers of gait and balance dysfunction in people with diabetic foot, measured by wearables, such as slow gait speed, large gait variability, unstable gait initiation, and large body sway. However, due to heterogeneities in included papers in terms of study design, movement tasks, and small sample size, more studies are recommended to confirm this preliminary evidence. Additionally, based on our review, we recommend establishing appropriate strategies to successfully implement wearable-based assessment into clinical practice for diabetic foot care.

We investigated the radioclinical outcomes of naviculectomy and limited/tailored soft-tissue releases in a short series of ambulatory children with complex/intractable congenital vertical talus subsets namely neglected, multiple operated and recurrent patients. We postulated that this technique will yield satisfactory radioclinical outcomes and minimal complications because it avoids extensive surgical release/trauma that is otherwise classically recommended for complex congenital vertical talus (CVT). The cohort consisted of five -four boys, one girl- complex CVT children with neglected, multiple operated and/or recurrent subsets. Patients were included if manipulative casting techniques were deemed unlikely to produce a plantigrade foot. Patients underwent naviculectomy with variable on-demand limited soft tissue releases. Two patients had bilateral affection and two had a non-idiopathic aetiology. The mean age was 5.2 years (4 to 6.25) and mean follow-up was 2.3 years (1 to 3). We reported satisfactory outcomes as per foot posture, function, overall parent satisfaction including pain and radiography per lateral views of talar-axis-first metatarsal base angle on the short/intermediate term. Whereas manipulative casting is unlikely to yield lasting outcomes in ambulatory children with complex subsets of CVT, extensive surgical soft-tissue releases have unfavourable long-term complications. As a substitute, naviculectomy as a form of resection arthroplasty created a practical and affordable third way between manipulative casting with minimally invasive surgery and the extensive surgical soft tissue releases on the short/intermediate term.

(1) Background: Foot strike pattern and cadence are two important variables that are related to sport performance and injury risks; the objective of this study is to analyse the foot strike pattern and cadence of the male elite athlete that participated in the Tokyo Olympic Games marathon. (2) Methods: Two independent researchers analysed the foot strike pattern of the first 51 participants in the 5km, and the cadence of the finalists in three different segments of the race. Descriptive statistics were presented for the main variables of this study. A repeated measures ANOVA was used to study the differences in cadence between different sections of the race (p&lt;0.05). (3) Results: Average of the cadence of the eight finalists was 185.5 steps per minute (SD ± 5.1). No differences between sections of the race were found. The more most common foot strike pattern was midfoot strike pattern, followed by rearfoot strike pattern, and forefoot strike pattern. The results of cadence are in line with previous studies that analysed elite athletes, with the values being higher than other research involving recreational runners. (4) Conclusions: elite marathon runners mostly run with a running non-rearfoot strike pattern and a cadence of over 185 steps per minute.

A position sensing glove, called SmartScan, that creates a 3D virtual model of a real object is presented. The data from the glove is processed by a volume minimization algorithm to validate the position sensor data. This allows only data from the object’s surface to be retained. The data validation algorithm allows the user to progressively improve an image by repeatedly moving their hand over the object. In addition, the user can choose their own balance between feature resolution and invalid data rejection. The SmartScan glove is tested on a foot model and is shown to be robust against motion artifacts, and has a mean accuracy of 2.9 mm (compared to a 3D model generated from optical imaging) without calibration.

Objective: To evaluate two different DECT postprocessing protocols for detection of MSU deposits in foot tendons of cadavers with verification by polarizing light microscopy as gold standard.Material and Methods: A total of 40 embalmed cadavers (15 male; 25 female; median age, 82 years; mean, 80 years; range, 52 - 99; SD ± 10.9) underwent DECT to assess MSU deposits in foot tendons.Two postprocessing DECT protocols with different Hounsfield unit (HU) thresholds 150/500 (=established) versus 120/500 (= modified) HU were applied to dual source acquisition with 80 kV for tube A and 140 kV for tube B.Six fresh cadavers (4 male; 2 female; median age, 78; mean, 78,5; range 61 - 95 ) were examined by DECT. Tendon dissection of 2/6 fresh cadavers with positive DECT 120 and negative DECT 150 studies were used to verify MSU deposits by polarizing light microscopy.Results: The tibialis anterior tendon was found positive in 57.5%/100% (DECT 150/120), peroneus tendon in 35%/100%, achilles tendon in 25%/90%, flexor halluces longus tendon in 10%/100%, and tibialis posterior tendon in 12.5%/97.5%. DECT 120 resulted in increased tendon MSU deposit detection, when DECT 150 was negative, with an overall agreement between DECT 150 and DECT 120 of 80 % (P = 0.013). Polarizing light microscope confirmed MSU deposits detected only by DECT 120 in tibialis anterior, achilles, flexor halluces longus and peroneal tendons.Conclusion: The DECT 120 protocol showed a higher sensitivity when compared to DECT 150.

Background. To prospectively evaluate the reliability of a portable optical scanner compared to the water displacement technique for volumetric measurements of the foot and ankle, and to compare the acquisition time associated with these two methods. Methods. Foot volume was measured in 29 healthy volunteers (58 feet, 24 female/5 male) by a 3D scanner (UPOD-S 3D Laser Full-Foot Scanner ®) and by water-displacement volumetry. Measurements were performed on both feet, up to a height of 10 cm above the ground. The acquisition time for each method was evaluated. Kolmogorov-Smirnov test, Lin's Concordance Correlation Coefficient, and a Student’s t-test were performed. Results: Mean foot volume was 869.7+/-165.1cm3 (3D scanner) versus 867.9+/-155.4cm3 (water-displacement volumetry) (p <10-5). Concordance of measurements was 0.93, indicative of a high correlation between the two techniques. Volumes were 47.8 cm3 lower when using the 3D scanner versus water volumetry. After statistically correcting this underestimation, the concordance was improved (0.98, residual bias = -0.03 +/- 35.1 cm3). Mean examination time was 4.2 +/-1.7 min (3D optical scanner) versus 11.1 +/-2.9 min (water volumeter) (p<10-4). Conclusion: Ankle/foot volumetric measurements performed using this portable 3D scanner are reliable and fast, and can be used in clinical practice and research.

(1) Background: High blood pressure is one of the symptoms of stroke, the Self Care Deficit theory by Dorothea Orem focuses on a person's ability to care for himself independently so that the ability to maintain his health and well-being is achieved. There are currently 600 million hypertensive patients worldwide, of which 3 million die every year. Uncontrolled high blood pressure can lead to a 7-fold increase in the chances of stroke. The existence of this condition can be minimized in patients through several innovative interventions, one of which is foot massage. This study aims to determine the effectiveness of stretching and foot massage with lavender oil in stabilizing high blood pressure in stroke patients.(2) Methods: The method used in this research is descriptive. The subjects of this case study were selected according to the inclusion and exclusion criteria of the journal Evidence-Based. Subjects included intervention patients and control patients. Foot massage therapy with lavender oil is done 2 times a day for 10-15 minutes using the effleurage technique after showering in the morning and evening. Stretching is done 2 times a day every 10-15 minutes.(3) Results: The results of the analysis showed that there was a change in blood pressure after the application of stretching and foot massage with lavender oil. From the initial examination, the results showed that the blood pressure of 170/100 mmHg decreased to 140/90 mmHg and the pain scale decreased from 4 to 0.

Foot and Mouth Disease (FMD) is a viral disease, widespread and highly contagious affecting mainly cloven-hoofed domestic and wild animals. FMD can lead to high economic losses due to reduction in animals’ production such as drop of milk production, loss of body weight and high mortality rate in young ruminants. Sixteen nasal swabs and epithelial tissues were collected from animals showing typical clinical signs of FMD during the last FMD outbreak in Libya in 2018-2019. Blood samples, swabs and epithelial tissues impressions on Flinders Technology Associates (FTA) cards were shipped to the FMD Reference laboratory in Brescia, Italy, and tested for the detection of FMD viruses. Nucleic acids were extracted from the FTA cards and molecular testing of the examined FTA cards confirmed that the FMD virus circulating in Libya was serotype O. Sequencing analysis of the FMD virus VP1 gene confirmed that FMD virus strain was serotype O/East Africa 3 (O/EA-3) topotype. The phylogenetic of the VP-1 gene of the FMD virus showed very high nucleotide identity (99.8%) between the virus circulating in Libya and the Algerian FMD virus strains isolated in Algeria on 2018 and 2019.

The choice of antibiotic regimens to use in patients presenting with diabetic foot osteomyelitis and their duration differs according to the situation. Antibiotics play a more important role in the medical option where no infected bone has been resected while their role is reduced but not negligible in the case of surgical options. Some studies have reported the presence of biofilm structures in bone samples taken from patients with diabetic foot osteomyelitis which raises the question of the place of anti-biofilm antibiotic regimens in this setting. During the last two decades, clinical studies have suggested a potential benefit for anti-biofilm antibiotics, mainly rifampicin against staphylococci and fluoroquinolones against gram-negative bacilli. No data from randomized controlled studies have however been reported so far. The present work provides a summary of the available data on the question of the place of anti-biofilm antibiotics for the treatment of diabetic foot osteomyelitis but also the potential limitations of such treatments.

Carbon farming is a capable strategy for more sustainable production of food and other related products. It seeks to produce the diverse array of natural farming methods and marketable products simultaneously. In agroforestry system, carbon sequestration is done by incorporating carbon dioxide (CO2) into plant biomass via photosynthesis. Carbon is, thus, stored in reserves of above-ground biomass, such as timber or branches, and below-ground biomass such as roots, or organic carbon in the soil. In addition to the significance of carbon sequestration in climate change mitigation, soil organic carbon (SOC) is an imperative indicator for the soil health as well as fertility. The change in SOC can explain whether the land use pattern degrades or improves the soil fertility. SOC, found in the soil in the form of soil organic matter (SOM), helps to improve soil health either directly or indirectly. Its direct consequence is related to the process of mineralization. Further, agroforestry is highly capable of generating huge amounts of bio-mass. In fact, agroforestry is believed to be particularly suitable for replenishment of SOC. Therefore, efforts should be made to convince farmers for their resource-use efficiency and soil conserving ability in order to get maximum benefits out of agriculture. According to food and agriculture organization (FAO,) agriculture, forestry, and other land use practices account for 24% of global greenhouse gas (GHG) emissions, and total global livestock emissions of 7.1 gigatons of CO2-equivalent per year, representing 14.5% of total anthropogenic GHG emissions. Agroforestry system that deliberately integrates trees and crops with livestock in the agricultural production could potentially increase carbon sequestration and decrease GHG emission from the terrestrial ecosystems, thus, helping in global climatic change mitigation. This study, therefore, aimed at clarification about carbon farming, modifications in carbon cycle and carbon sequestration during agricultural development in addition to benefits of agroforestry.

Since 2015, outbreaks of foot-and-mouth disease (FMD) in the Middle East have been caused by a new emerging viral lineage, A/ASIA/G-VII. In-vitro vaccine matching data indicated that this virus poorly matched (low r1-value) with vaccines that were being used in the region as well as most other commercially available vaccines. The aim of this study was to assess the performance of two candidate vaccines against challenge with a representative field virus from the A/ASIA/G-VII lineage. The results from an initial full dose protection study provided encouraging data for the A/MAY/97 vaccine, while the A22/IRQ/64 vaccine only protected 2/7 vaccinated animals. In view of these promising results, this vaccine was tested in a potency test (PD50) experiment in which 5 cattle were vaccinated with a full dose, 5 cattle with a 1/3 dose and 5 cattle with a 1/9 dose of vaccine. Vaccines were prepared as would be done during an emergency vaccination campaign using a double oil emulsion adjuvant. At 21 days post vaccination these vaccinated cattle and 3 control cattle were subsequently challenged intradermolingually with a field isolate from the A/ASIA/G-VII lineage. All cattle from the full vaccine dose, 4 cattle from the 1/3 vaccine dose and 2 cattle from the 1/9 vaccine dose were clinically protected against challenge with FMDV A/ASIA/G-VII, resulting in a heterologous potency of 6.5 PD50/dose. These data support previous studies showing that a high potency emergency vaccine can protect against clinical disease when challenged with a heterologous strain of the same serotype. Not only the r1-value of the vaccine, but also the homologous potency of a vaccine should be taken into account when advising vaccines to control an outbreak.

An impaired healing response underlies diabetic foot wounds chronicity, frequently translating in amputation, disability, and early mortality. In addition, diabetics frequently suffer of the underappreciated episode of post-epithelization ulcer recurrence. Recurrence epidemiological data are alarmingly high; so that the ulcer is considered in “remission” and not healed for the time it remains epithelialized. Recurrence may result from the conspiracy of behavioral and biological factors. Although the damaging role of behavioral, clinical predisposing factors is undebatable, the role of endogenous biological signalers that prime the residual scar tissue to recurrence has remained elusive. We propose that ulcer recurrence is deeply impinged by chronic hyperglycemia and its downstream biological effectors, which originate epigenetic drivers that enforce abnormal pathologic phenotypes to dermal fibroblasts, and keratinocytes as memory cells. Hyperglycemia-derived cytotoxic reactants accumulate and modify dermal proteins, reduce scar tissue mechanical tolerance, and disrupt fibroblasts-secretory activity. Accordingly, the combination of epigenetic and local and systemic cytotoxic signalers, induce the onset of “at-risk phenotypes” as premature skin cells aging, dysmetabolism, inflammatory, pro-degradative, and oxidative programs that may ultimately converge to scar cells demise. Unfortunately, post epithelialization recurrence rates data are missing in clinical studies of accepted ulcer healing therapies during follow-up periods. Intra-ulcer infiltration of epidermal growth factor exhibits the most consistent remission data with the lowest recurrences during 12-month follow-up. Recurrence data should be regarded as a valuable clinical endpoint during the investigational period for each emergent healing candidate.

In diabetic foot infections (DFI), the clinically virulence of skin commensals are generally pre-sumed to be of low virulence. In this single-center study, we divided the wound isolates into two groups: skin commensals (coagulase-negative staphylococci, micrococci, corynebacteria, cutibacteria); and, pyogenicpathogenic pathogens, and followed the patients for ≥ 6 months. In this retrospective study among 1,018 DFI episodes (392 [39%] with osteomyelitis), we identified skin commensals as the sole culture isolates (without accompanying pyogenicpathogenic patho-gens) in 54 cases (5%). After treatment (antibiotic therapy [median of 20 days], hyperbaric oxy-gen in 98 cases [10%]), 251 episodes (25%) were clinical failures. Group comparisons between those growing only skin commensals and controls found no difference in clinical failure (17% vs 24 %, p=0.23) or microbiological recurrence (11% vs 17 %, p=0.23). The skin commensals were mostly treated with non-beta-lactam oral antibiotics. In multivariate logistic regression analysis, isolation of only skin commensals was not associated with failure (odds ratio 0.4, 95% confi-dence interval 0.1-3.8). Clinicians might wish to consider these isolates as potential pathogens when selecting a targeted antibiotic regimen, which may equally base on oral non-beta-lactam antibiotic agents susceptible to the corresponding skin pathogens.

BACKGROUND: diabetic foot ulcers (DFU) represent the main cause of major amputations and hospitalizations in diabetic patients. Aim of this study was to assess safety and cost-efficacy of intramuscular injection of peripheral blood mononuclear cells (PBMNCs), in diabetic patients with no-option chronic limb-threatening ischemia (CLTI) and small artery disease (SAD). METHODS: a retrospective study was carried out on a series of types 2 diabetic patients with DFU grade Texas 3 and no-option CLTI and SAD. All patients had undergone at least a previous revascularization and were allocated in a surgery waiting-list for major amputation. The principal endpoint evaluated at 90 days was a composite of TcPO2 values at the first toe ≥30 mmHg and/or TcPO2 increase of at least 50% from baseline and/or ulcer healing. Secondary endpoint were individual components of the primary endpoint, any serious and non-serious adverse events, direct costs at one year. RESULTS: the composite endpoint was achieved in 9 patients (60.0 %); one patient (6.7%) healed within 90 days and 26.7% and 46.7% showed TcPO2 ≥30 mmHg and a TcPO2 increase of at least 50% at 90 days, respectively. At 1-year, three (20.0%) patients underwent a major amputation (all diagnosed SAD grade III). One patient died after seven months, and seven patients (46.7%) healed. The overall median and mean cost per patient were 8,238±7,798€ and 4,426[3,798;8,262]€, respectively. CONCLUSIONS: the use of PBMNCs implants in no-option CLTI diabetic patients with SAD seems to be of help in reducing the risk of major amputation.

Vaccination is one of the best approaches to control and eradicate foot-and-mouth disease (FMD). To achieve this goal, vaccines with inactivated FMD virus antigen in suitable adjuvants are being used in addition with other control measures. However, only a limited number of vaccine strains are commercially available which often have a restricted spectrum of activity against the different FMD virus strains in circulation. As a result, when new strains emerge, it is important to measure the efficacy of the current vaccine strains against these new variants. This is important for countries where FMD is endemic but also for countries that hold an FMD vaccine bank to be prepared for emergency vaccination. The emergence and spread of the O/ME-SA/Ind-2001 lineage of viruses posed a serious threat to countries which had OIE-endorsed FMD control plans and had not reported FMD for many years. In vitro vaccine matching results showed a poor match (r1-value &lt;0.3) to the more widely used vaccine strain O Manisa and less protection in a challenge test. This paper describes the use of O3039 vaccine strain as an alternative either alone or in combination with the O Manisa vaccine strain with virulent challenge by a O/ME-SA/Ind-2001d sub-lineage virus from Algeria (O/ALG/3/2014). The experiment included challenge at 7 days post vaccination (to study protection and emergency use) and 21 days post vaccination (as would be done in standard potency studies). The results indicated that the O3039 vaccine strain alone as well as the combination with O Manisa is effective against this strain of the O/ME-SA/Ind/2001d lineage offering protection from clinical disease even after 7 days post vaccination and with reduction in viraemia and virus excretion.

MicroRNAs (miRNAs) are small endogenous RNAs that regulate gene expression post-transcriptionally by targeting either the 3′ untranslated or coding regions of genes. They have been reported to play key roles in a wide range of biological processes. The recent remarkable developments of transcriptomics technologies, especially next-generation sequencing technologies and advanced bioinformatics tools, allow more in-depth exploration of messenger RNAs (mRNAs) and non-coding RNAs (ncRNAs) including miRNAs. These technologies have offered great opportunities for a deeper exploration of miRNA involvement in farm animal diseases, as well as livestock productivity and welfare. In this review, we provide an overview of the current knowledge of miRNA roles in farm animal diseases with a particular focus on diseases of economic importance. In addition, we discuss the steps and future perspectives of using miRNAs as biomarkers and molecular therapy for livestock disease management as well as the challenges and opportunities for understanding the regulatory mechanisms of miRNAs related to disease pathogenesis.

We describe a recently developed approach to quantify welfare loss in animals, the Cumulative Pain metric. It combines the two most relevant dimensions of negative affective experiences: intensity and duration. The metric enables estimating the time individuals spend in negative affective states of a physical or psychological nature (operationally referred to simply as ‘pain’) of different intensities as the result of one or more challenges (e.g., diseases, injuries, deprivations). A new notation protocol (the Pain-Track) is used in which the duration of the experience is represented along the horizontal axis and intensity is represented by four categories in the vertical axis. Pain experiences are partitioned into temporal segments, where hypotheses for the experienced duration and intensity are proposed based on existing welfare indicators (e.g., neurophysiological, behavioral, anatomical, evolutionary). This structure forces transparency about assumptions and uncertainties, highlights knowledge gaps, and enables estimates to be continuously adjusted. Because the Cumulative Pain metric is based on parameters with a broadly common biological meaning, it provides the much needed interoperability among assessments of animal welfare. It enables comparing the impact of practices and living conditions, policies and interventions, and the calculation of welfare footprints of animal-sourced products using a universal measurement unit.

The present work aims to characterize the mechanical behavior of a new composite material for the conservation and development of the vast historical and architectural heritage that is particularly vulnerable to environmental and seismic actions. The new composite consists of natural hydraulic lime (NHL) -based mortar, reinforced by sisal short fibers randomly oriented in the mortar matrix. The NHL-based mortar ensures the chemical-physical compatibility with the original feature of the historical masonry structures (mostly in stone and clay) aiming to pursue both the effectiveness and durability of the intervention. The use of vegetable fibers (i.e. the sisal one) is an exciting challenge for the construction industry since they require a lower degree of industrialization for their processing, and therefore, their costs are also low, as compared to the most common synthetic/metal fibers. Beams of sisal-composite sizing 160x40x40 mm3 with a central notch are tested in three-point bending, aiming to evaluate both their bending strength and fracture energy. Also, tensile tests and compressive tests were performed on the composite samples, while water retention test and slump test were performed on the fresh mix. Finally, the tensile tests on the Sisal strand were carried out to evaluate the tensile strength of both strand and wire. A final comparison with unreinforced mortar specimens shows that the proposed composite ensures great workability and good performances in term of ductility and strength and it can be considered a promising alternative to the classic fiber-reinforcing systems.

Foot-and-mouth disease virus (FMDV) causes the highly contagious foot-and-mouth disease, which is characterized by the appearance of vesicles in and around the mouth and feet of cloven-hoofed animals. BHK21 cells are the cell line of choice for the propagation of FMDV for vaccine production world-wide but vary in their susceptibility for different FMDV strains. Previous studies showed that the FMDV resistance of a certain BHK cell line can be overcome by using a closely related but permissive cell line for the pre-adaptation of the virus, but the adapted strains were found to harbor several capsid mutations. In this study, these adaptive mutations were introduced into the original Asia-1 Shamir isolate individually or in combination to create a panel of 17 Asia-1 mutants by reverse genetics and examine the effects of the mutations on receptor usage, viral growth, immunogenicity and stability. A single amino acid exchange from glutamic acid to lysine at position 202 in VP1 turned out to be of major importance for productive infection of the suspension cell line BHK-2P. In consequence, two traditionally passage-derived strains and two recombinant viruses with a minimum set of mutations were tested in vivo. While the passaged-derived viruses showed a reduced particle stability, the genetically modified viruses were more stable but did not confer a protective immune response against the original virus isolate.

Safe sample transport is of great importance for infectious diseases diagnostics. Various treatments and buffers are used to inactivate pathogens in diagnostic samples. At the same time, adequate sample preservation, particularly of nucleic acids, is essential to allow an accurate laboratory diagnosis. For viruses with single-stranded RNA genomes of positive polarity, such as foot-and-mouth disease virus (FMDV), however, naked full-length viral RNA can itself be infectious. In order to assess the risk of infection from inactivated FMDV samples, two animal experiments were performed. In the first trial, six cattle were injected with FMDV RNA (isolate A22/IRQ/24/64) into the tongue epithelium. All animals developed clinical disease within two days and FMDV was reisolated from serum and saliva samples. In the second trial, another group of six cattle was exposed to FMDV RNA by instilling it on the tongue and spraying it into the nose. The animals were observed for 10 days after exposure. All animals remained clinically unremarkable and virus isolation as well as FMDV genome detection in serum and saliva were negative. No transfection reagent was used for any of the animal inoculations. In conclusion, cattle can be infected by injection with naked FMDV RNA, but not by non-invasive exposure to the RNA. Inactivated FMDV samples that contain full-length viral RNA carry only a negligible risk of infecting animals.