Outcome evaluation and cost-effectiveness analysis for an integrated multidisciplinary diabetic limb salvage program: a combined observational and simulation study.

Introduction: To compare the clinical outcomes and healthcare utilization of patients enrolled in the multidisciplinary Diabetic Foot in Primary and Tertiary (DEFINITE) Care program with a matched historical cohort and estimate the program's long-term cost-effectiveness using simulation.

Research Design And Methods: This study consisted of two components: a 1-year observational outcome evaluation and a long-term simulation-based cost-effectiveness analysis (CEA). We conducted an observational study to analyze 2798 patients with diabetic foot ulcers (DFUs) enrolled in the program between June 2020 and June 2021 (DEFINITE Care group) and 5462 patients with DFUs from June 2016 to December 2017 as historical controls.

Investigating Nonadherence in an Integrated Diabetic Limb Salvage Programme: Reasons, Associated Factors, and Impacts on Care Outcomes.

Adherence to treatment plans is crucial for patients with diabetic foot ulcers (DFUs) to achieve positive outcomes. With limited understanding of nonadherence and its impacts on care outcomes, this study aimed to explore the reasons and factors associated with nonadherence in an integrated diabetic limb salvage (DLS) programme and evaluate its effects on care outcomes. This study included 2798 DFU patients who were enrolled in an integrated DLS programme across multiple institutions in central and northern Singapore from 2020 to 2021.

Evaluation of measurements for tracheal hypoplasia in French bulldogs.

Tracheal narrowing may increase airflow resistance, resulting in clinical manifestations associated with brachycephalic obstructive airway syndrome (BOAS). When diagnosing tracheal hypoplasia, established values are based on measurements established for English bulldogs or non-specific "bulldog" breeds. The objective of this study was to investigate tracheal diameter ratios in French bulldogs to gain a better understanding of what would constitute tracheal hypoplasia in this breed.

Reasonable Risk Ratio of Palate Surgery: A New Critical Analysis.

Objective.: A new critical complication risk analysis, the reasonable risk ratio (RRR or R) for palate surgeries in obstructive sleep apnea patients.

Methods.

Computed tomography findings of nasal cryptococcosis in Australia (2008-2020): 12 dogs and 9 cats.

Objective: To describe the CT findings of Australian dogs and cats with nasal cryptococcosis over a 12-year period.

Animals: 12 dogs and 9 cats diagnosed with nasal cryptococcosis from 2008 through 2020.

Methods: CT findings were compared among enrolled cases from Australian veterinary referral centers.

Rapid Access From Primary Care to a Multidisciplinary Clinic at Tertiary Care Improves Clinical Outcomes for Patients With Diabetic Foot Ulcers: Results From Diabetic Foot in Primary and Tertiary (DEFINITE) Care's Lower Extremity Amputation Prevention Program (LEAPP) Clinic.

Diabetic Foot in Primary and Tertiary (DEFINITE) Care is an inter-institutional, multidisciplinary team (MDT) program for patients with diabetic foot ulcers (DFU) within a healthcare cluster in Singapore. This is one of our subgroup analyses within DEFINITE Care, assessing clinical outcomes of lower extremity amputation prevention program (LEAPP), a multidisciplinary diabetic foot clinic, and non-LEAPP patients within the program. From June 2020 to June 2022, 2798 patients within the DEFINITE cohort completed a minimum of 12-month follow up.

Clinical outcomes of expansion sphincter pharyngoplasty-a 17-year systematic review.

Objectives: To systematically review long-term (> 5 years) outcomes of ESP surgery for OSA treatment over 17 years.

Methods: Systemic review of MEDLINE, Google Scholar, Cochrane Library and Evidence Based Medicine Reviews to identify publications relevant to OSA and Expansion Pharyngoplasty and its variants. All relevant studies published between January 2007 and June 2023 were included.

Ultrafast Vibrational Wave Packet Dynamics of the Aqueous Guanine Radical Anion Induced by Photodetachment.

Studying the ultrafast dynamics of ionized aqueous biomolecules is important for gaining an understanding of the interaction of ionizing radiation with biological matter. Guanine plays an essential role in biological systems as one of the four nucleobases that form the building blocks of deoxyribonucleic acid (DNA). Guanine radicals can induce oxidative damage to DNA, particularly due to the lower ionization potential of guanine compared to the other nucleobases, sugars, and phosphate groups that are constituents of DNA.

Brain magnetic resonance imaging and computed tomography findings in cats and dogs with central nervous system cryptococcosis in Australia: 23 cases (2009-2020).

Objective: To describe the imaging findings in Australian cats and dogs with CNS cryptococcosis.

Animals: 23 cases (10 cats; 13 dogs) with CNS cryptococcosis and brain MRI or CT studies available to review.

Methods: Retrospective, multi-institutional case series.

Persistence of gender biases in Europe.

Prior work suggests that modern gender bias might have historical roots but has not been able to demonstrate long-term persistence of this bias due to a lack of historical data. We follow archaeological research and employ skeletal records of women's and men's health from 139 archaeological sites in Europe dating back, on average, to about 1200 AD to construct a site-level indicator of historical bias in favor of one gender over the other using dental linear enamel hypoplasias. This historical measure of gender bias significantly predicts contemporary gender attitudes, despite the monumental socioeconomic and political changes that have taken place since.

The Interdisciplinary Approach: Preventive and Therapeutic Strategies for Diabetic Foot Ulcers.

The appropriate treatment of the common diabetic foot ulcers (DFUs) in diabetic patients demands enormous human, organizational and financial resources that are finite. Interdisciplinary teams of medical and surgical specialists, as well as allied health professionals, can help to reduce the consumption of these resources, optimize treatment, and prevent DFUs. They consist primarily of vascular surgeons, endocrinologists, and orthopedic foot and ankle surgeons and are closely supported when required by infectious diseases specialists, plastic surgeons, wound care specialist nurses, podiatrists, and orthotists.

Investigation of scan delays for CT evaluation of inner wall layering and peak enhancement of the canine stomach and small intestine using a 20 second fixed-injection-duration and bolus tracking technique.

Many gastrointestinal diseases affect the mucosal layer, suggesting that on computed tomography (CT) examination, detection of consistent inner wall layering of the gastrointestinal tract may aid in detection of disease. Changes in wall enhancement can also characterise specific diseases and provide prognostic information. The objectives of this mixed retrospective and prospective analytical study were therefore to identify the scan delays for peak detection of canine stomach and small intestinal inner wall layering and enhancement when using a 20 s fixed-injection-duration and bolus tracking technique.

Exploring the eHealth literacy and mobile health application utilisation amongst Malaysian pharmacy students.

Introduction: Pharmacy students should be eHealth literate by being skilful in searching, evaluating and applying online health information. Mobile health applications should be utilised when making clinical decisions to achieve optimal patient care with the ever-changing pharmacy practice. This study aims to explore the eHealth literacy and mobile health application utilisation amongst pharmacy undergraduates.

Spectroscopic observation and ultrafast coherent vibrational dynamics of the aqueous phenylalanine radical.

The phenylalanine radical (Phe˙) has been proposed to mediate biological electron transport (ET) and exhibit long-lived electronic coherences following attosecond photoionization. However, the coupling of ultrafast structural reorganization to the oxidation/ionization of biomolecules such as phenylalanine remains unexplored. Moreover, studies of ET involving Phe˙ are hindered by its hitherto unobserved electronic spectrum.

Mismatch between Conventional Femoral Arthroplasty Stems and Hip Morphology in the Elderly Chinese Hip Fracture Population.

Introduction: The morphology of the proximal femur differs in various populations. Based on our clinical experience, conventional femoral stems used in hip arthroplasty do not fit the Chinese population well. Hence, this study aims to evaluate the suitability of conventional femoral stems in the elderly Chinese hip fracture population requiring hip arthroplasty and to establish if gender and age related differences exist within this population.

A prelacrimal approach technique to overcome the limitation of the narrow lacrimal recess.

Purpose: The distance between the anterior wall of the maxillary sinus and the nasolacrimal duct has been classified into three types by Simmen, in which type I (< 3 mm) is the least feasible for a prelacrimal approach. The aim of our study is to present a surgical technique which overcomes the anatomical limitation of the narrow lacrimal recess (type I) in the management of inverted papilloma in the maxillary sinus.

Methods: Case series.

Olfactory taste disorder as a presenting symptom of COVID-19: a large single-center Singapore study.

Purpose: To investigate the prevalence and epidemiological risk factors of olfactory and/or taste disorder (OTD), in particular isolated OTD, in patients with laboratory-confirmed COVID-19 infection.

Methods: We conducted a retrospective and cross-sectional study. Patients with laboratory-confirmed COVID-19 infection were recruited from the National Centre for Infectious Diseases (NCID) Singapore between 24 March 2020 and 16 April 2020.

Caval foramen hernia in a cat.

Case Summary: A 3-year-old neutered female domestic shorthair cat presented for a 2-week history of hyporexia, lethargy and weight loss. Aspartate aminotransferase, alanine aminotransferase and cholesterol were mildly elevated. Thoracic radiographs identified a lobulated soft tissue opacity in the caudal thorax to the right of midline, with the border effacing the caudal vena cava and broad-based towards the diaphragm.

Peripartum clinical manifestations of a mesentericorenocaval shunt in a Burmese cat.

Case Summary: A 3-year-old entire female Burmese cat was presented for investigation of intermittent lethargy during gestation followed by persistent hypersalivation and ataxia postpartum. The cat had queened three litters in total, with clinical signs worsening during the most recent lactation period. Mild anaemia (26%), hypoglycaemia (2.

Indications for Eustachian tube dilation.

Purpose Of Review: Eustachian tube dilation is a controversial surgical procedure because the intended problem for which it is meant to address, obstructive Eustachian tube dysfunction, is a clinical diagnosis without a reliable diagnostic tool to test.In the past 10 years, balloon dilation Eustachian tuboplasty (BDET) has been the most commonly performed Eustachian tube dilation procedure. The present review seeks to identify the patients who may benefit from this procedure and thus propose the indications.

Intramedullary nailing of abnormally bowed atypical femoral shaft fractures: surgical technique.

The treatment of atypical femoral shaft fractures with abnormal bowing provides a unique challenge for surgeons. Whilst intramedullary fixation of atypical femoral shaft fractures affords both mechanical and biological benefits, the mismatch between standard intramedullary devices and the abnormal femoral bowing in these patients makes this method of fixation challenging for the surgeon. The purpose of this manuscript is to illustrate the evolution of our surgical technique through a series of four patients.

Anterior maxillary wall and lacrimal duct relationship in Orientals: CT analysis for prelacrimal access to the maxillary sinus.

Background: The pre-lacrimal window approach (PLWA) is a promising technique in approaching lesions of the anterior wall and floor of the maxillary sinus. Simmen et al. previously reported that this approach is feasible in only 2/3 of their patients.

Zinc toxicosis in a dog secondary to prolonged zinc oxide ingestion.

Zinc toxicosis is commonly associated with ingestion of metallic zinc objects. This report documents an uncommon presentation of zinc toxicosis, secondary to prolonged ingestion of a zinc oxide cream. A 5.