Enhanced pullulanase production through expression system optimization and biofilm-immobilized fermentation strategies.

Pullulanase (PUL) plays a crucial role in breaking down α-1,6-glycosidic bonds in starch, a key process in starch processing and conversion. Based on PulB with high enzymatic activity, the expression of PUL in Bacillus subtilis was enhanced by plasmid screening, double promoter optimization, and signal peptide engineering. Furthermore, we innovatively employed a mussel foot protein to enhance the cell adhesion to carriers and utilized biofilm-based cell immobilization technology to optimize the fermentation process and stimulate biofilm formation.

A Study of Orthopedic Patient Leaflets and Readability of AI-Generated Text in Foot and Ankle Surgery (SOLE-AI).

Introduction The internet age has broadened the horizons of modern medicine, and the ever-increasing scope of artificial intelligence (AI) has made information about healthcare, common pathologies, and available treatment options much more accessible to the wider population. Patient autonomy relies on clear, accurate, and user-friendly information to give informed consent to an intervention. Our paper aims to outline the quality, readability, and accuracy of readily available information produced by AI relating to common foot and ankle procedures.

Vaginal delivery of the second twin: simulation to improve trainee knowledge and comfort.

Background: Vaginal delivery in twins is feasible but challenging. Successful vaginal delivery of a non-vertex second twin depends on knowledge of specific obstetrical maneuvers. Skill acquisition at the patient's bedside is difficult, making simulation training an integral part of obstetrics and gynecology residency programs.

Acellular fish skin grafts in diabetic foot ulcer care: Advances and clinical insights.

Diabetic foot ulcers (DFUs) represents a significant public health issue, with a rising global prevalence and severe potential complications including amputation. Traditional treatments often fall short due to various limitations such as high recurrence rates and extensive resource utilization. This editorial explores the innovative use of acellular fish skin grafts as a transformative approach in DFU management.

A three-dimensional kinematic analysis of bipedal walking in a white-handed gibbon (Hylobates lar) on a horizontal pole and flat surface.

Gibbons, a type of lesser ape, are brachiators but also walk bipedally and without forelimb assistance, not only on the ground but also on tree branches. The arboreal bipedal walking strategy of the gibbons has been studied in previous studies in relation to two-dimensional (2D) kinematic analysis. However, because tree branches and the ground differ greatly in width, leading to a constrained foot contact point on the tree branches, gibbons must adjust their 3D joint motions of trunk and hindlimb on the tree branches.

Development of biomaterials for bone tissue engineering based on bile acids.

Diseases and injuries can cause significant bone loss, leading to increased medical expenses, decreased work efficiency, and a decline in quality of life. Bone tissue engineering (BTE) is gaining attention as an alternative to autologous and allogeneic transplantation due to the limited availability of donors. Biomaterials represent a promising strategy for bone regeneration, and their design should consider the three key processes in bone tissue engineering: osteogenesis, bone conduction, and bone induction.

Uncovering Barriers to the Diagnosis and Treatment of Metastatic Melanoma: A Case Report.

Melanoma is a malignant disorder of the skin that originates from melanocytes. It is the most aggressive of the skin malignancies. This case study presents a unique case of a 52-year-old male gardener with melanoma on the plantar side of his foot, which progressed to a large ulcer.

Foot trajectory as a key factor for diverse gait patterns in quadruped robot locomotion.

Four-legged robots are becoming increasingly pivotal in navigating challenging environments, such as construction sites and disaster zones. While substantial progress in robotic mobility has been achieved using reinforcement learning techniques, quadruped animals exhibit superior agility by employing fundamentally different strategies. Bio-inspired controllers have been developed to replicate and understand biological locomotion strategies.

Matrix Metalloproteinase-9 as a Predictor of Healing in Diabetic Foot Ulcers.

Background Wound healing in diabetic foot ulcers (DFUs) is hindered by several physiological and biochemical abnormalities, including prolonged inflammation, an imbalance in extracellular matrix (ECM) synthesis and degradation, insufficient neovascularization, and reduced macrophage activity. In DFUs, excessive and uncontrolled matrix metalloproteinases (MMPs) degrade the ECM and impede wound healing. Matrix metalloproteinase-9 (MMP-9) concentration plays a key role in inflammation and ECM degradation.

A Novel Dynamic Growth Rod Inducing Spinal Growth Modulation for the Correction of Spinal Deformities.

Background: Growth rods are the gold standard for treating early-onset scoliosis (EOS). However, current treatments with growth rods do not optimize spinal growth in EOS patients, and frequent distraction surgeries significantly increase complications, imposing considerable economic and psychological burdens on patients. An improved growth rod is urgently required to address the need for dynamic growth and external regulation.

Healing of diabetic foot ulcer in an amputation candidate with below-knee cellulitis using combination of negative pressure wound therapy and platelet-rich plasma injection: A case report study.

Introduction And Importance: Diabetic foot ulcers, especially when complicated by cellulitis, pose a significant challenge in diabetes management, often leading to amputation. This case report highlights the successful treatment of a diabetic foot ulcer in an amputation candidate using a combination of negative pressure wound therapy and platelet-rich plasma injection, potentially reducing the risk of amputation in high-risk patients.

Case Presentation: A 62-year-old male with poorly controlled diabetes presented with a chronic diabetic foot ulcer and cellulitis.

Negative-pressure wound therapy compared with advanced moist wound therapy: A comparative study on healing efficacy in diabetic foot ulcers.

Objective: This randomized controlled trial aimed to compare the efficacy of negative-pressure wound therapy with advanced moist wound therapy in managing diabetic foot ulcers.

Methods: A total of 450 participants with diabetic foot ulcers were randomized to receive either negative-pressure wound therapy (n = 204) or advanced moist wound therapy (n = 246) over 18 months. The primary outcome was complete ulcer closure, with secondary outcomes including time to closure, wound size reduction, infection rates, recurrence, and amputation rates.

An overview of plantar pressure distribution measurements and its applications in health and medicine.

Background: Measuring plantar pressure distribution is critical for understanding foot-ground interactions, providing valuable insights for diagnosing and managing various health conditions. Since its initial studies in 1984, this field has garnered increasing attention within healthcare and medicine due to its broad applications across clinical settings.

Research Question: How does measuring plantar pressure distribution affect healthcare outcomes across different age groups and health conditions?

Methods: This review thoroughly explores the literature concerning plantar pressure distribution, focusing on studies conducted from 1984 onwards.

Platelet-Rich Plasma in the Treatment of Diabetic Foot Ulcers.

Background: Chronic nonhealing neuropathic foot ulcers affect approximately 15% to 30% of patients with diabetes mellitus and are associated with significant morbidity and mortality. Although current strategies to address these chronic wounds include a multifactorial approach, clinical outcomes remain poor and warrant improvement. Platelet-rich plasma (PRP), derived from autologous or allogeneic blood, is an emerging regenerative product that aims to serve as an adjuvant to standard diabetic foot ulcer (DFU) treatment.

First metatarsal osteotomy with an intramedullary locking plate is a good alternative for the reintervention of recurrent hallux valgus.

This study describes the results of first metatarsal (M1) distal osteotomy with an intramedullary locking plate in persistent/recurrent painful hallux valgus (HV) deformity (without advanced degenerative changes) after primary surgery. Outcomes included postoperative incidences of HV angle (HVA)<16°, intermetatarsal angle (IMA)<9°, proximal articular set angle (PASA)<10°, and the American Orthopedic Foot and Ankle Society (AOFAS) score. Data normality was assessed with the Shapiro-Wilk test, and preoperative vs.

Appropriate surgical management in skin and soft tissue infections.

Purpose Of Review: To present standards and recent technical innovations in the surgical management of skin and soft tissue infections (SSTI).

Recent Findings: SSTI are a frequent cause of presentation in the acute care setting. They can range from simple and uncomplicated to severe and necrotizing infections.

Acetylation-ubiquitination crosstalk of DJ-1 mediates microcalcification formation in diabetic plaques via collagen-matrix vesicles interaction.

Aim: Microcalcification increases the vulnerability of plaques and has become an important driver of acute cardiovascular events in diabetic patients. However, the regulatory mechanisms remain unclear. DJ-1, a multifunctional protein, may play a potential role in the development of diabetic complications.

Effective Management Strategies for Primary Lymphedema of the Lower Extremities: Integrating Conservative and Surgical Therapies in Early and Late Stages.

Introduction: Lymphedema, a debilitating characterized by localized fluid retention and tissue swelling, results from abnormalities in the lymphatic system. In the case of primary lymphedema, this condition is attributed to malformations in lymphatic vessels or nodes, and it is marked by a relentless progression leading to irreversible tissue fibrosis after repetitive inflammation. Many questions regarding its treatment, such as the choice of the type of intervention and the timing, still remain unanswered.

Novel insights into the role of gut microbiota and its metabolites in diabetic chronic wounds.

Wounds in patients with diabetes present significant physical and economic challenges due to impaired healing and prolonged inflammation, exacerbated by complex interactions between microbes. Especially, the development and healing of diabetic foot ulcers (DFUs) remain an urgent clinical problem. The human gut harbors a vast microbial ecosystem comprising intestinal flora and their metabolic products.

Efficacy and safety of anlotinib combined with vinorelbine as second‑line treatment for elderly patients with advanced squamous cell lung carcinoma: A retrospective cohort.

The aim of the present study was to investigate the efficacy and safety of anlotinib combined with vinorelbine (NVB) as a second-line treatment for elderly patients with advanced squamous cell lung carcinoma (SqCLC). The present retrospective analysis included 48 elderly patients (aged ≥65 years) diagnosed with advanced SqCLC who received anlotinib in combination with NVB as a second-line therapy between January 2021 and December 2023. The primary endpoints assessed were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) and safety profile.

Advancing the clinical assessment of glomerular podocyte pathology in kidney biopsies via super-resolution microscopy and angiopoietin-like 4 staining.

The tertiary structure of normal podocytes prevents protein from leaking into the urine. However, observing the complexity of podocytes is challenging because of the scale differences in their three-dimensional structure and the close proximity between neighboring cells in space. In this study, we explored podocyte-secreted angiopoietin-like 4 (ANGPTL4) as a potential morphological marker via super-resolution microscopy (SRM).

Endoscopic Flexor Hallucis Longus Tendon Transfer for the Treatment of Chronic Achilles Tendon Defects.

Background: An all-inside endoscopic flexor hallucis longus (FHL) tendon transfer is indicated for the treatment of chronic, full-thickness Achilles tendon defects. The aim of this procedure is to restore function of the gastrocnemius-soleus complex while avoiding the wound complications associated with open procedures.

Description: This procedure can be performed through 2 endoscopic portals, a posteromedial portal (the working portal) and a posterolateral portal (the visualization portal).

Enhancing Intelligent Shoes with Gait Analysis: A Review on the Spatiotemporal Estimation Techniques.

The continuous, automated monitoring of sensor-based data for walking capacity and mobility has expanded gait analysis applications beyond controlled laboratory settings to real-world, everyday environments facilitated by the development of portable, cost-efficient wearable sensors. In particular, the integration of Inertial Measurement Units (IMUs) into smart shoes has proven effective for capturing detailed foot movements and spatiotemporal gait characteristics. While IMUs enable accurate foot trajectory estimation through the double integration of acceleration data, challenges such as drift errors necessitate robust correction techniques to ensure reliable performance.

Harnessing the Power of Our Immune System: The Antimicrobial and Antibiofilm Properties of Nitric Oxide.

Nitric oxide (NO) is a free radical of the human innate immune response to invading pathogens. NO, produced by nitric oxide synthases (NOSs), is used by the immune system to kill microorganisms encapsulated within phagosomes via protein and DNA disruption. Owing to its ability to disperse biofilm-bound microorganisms, penetrate the biofilm matrix, and act as a signal molecule, NO may also be effective as an antibiofilm agent.

An Overview of Recent Clinical Trials for Diabetic Foot Ulcer Therapies.

Diabetic foot ulcers (DFUs) are a major complication of diabetes, leading to high mortality, reduced quality of life, neuropathy, ischemia, infection, and amputation risks. The prevalence of these ulcers is only on the rise as more people suffer from type 2 diabetes and obesity. The current wound management involves wound dressings, offloading, debridement, and infection control, but more must be done to keep up with the rising prevalence of DFUs and the strain they put on patients and the healthcare system.