The Forgotten Joint Score Is a Valid Outcome Measure for Total Ankle Arthroplasty: A Prospective Study.

BACKGROUND: The success of total ankle arthroplasty (TAA) involves objective and subjective parameters such as joint motion and implant survival. Patient-reported outcome measures provide key context from the patient's perspective so that we can evaluate the results of these procedures. The Forgotten Joint Score (FJS) has demonstrated validity and reliability in other arthroplasties, but the existing evidence on the FJS in TAA is very limited. QUESTION/PURPOSES: We aimed to assess the reliability, validity, responsiveness to change, and floor and ceiling effects, as well as to perform a gender analysis, of the FJS in patients who had undergone TAA. METHODS: A prospective, observational study enrolled patients who underwent TAA at our institution between June 2021 and May 2023. The three-component TAA was performed through an anterior approach. A total of 120 patients (mean age 62 ± 10 years) participated, which was 83% (120 of 145) of those eligible, and 77% (92 of 120) of those patients underwent follow-up assessments at 12 ± 1 months after surgery. A cross-culturally adapted and validated version of the FJS in our language (Italian) was used. Additionally, three other commonly used patient-reported outcome measures for TAA were administered: the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the Manchester-Oxford Foot Questionnaire (MOXFQ), and the VAS. RESULTS: Reliability was demonstrated by excellent internal consistency (Cronbach α coefficient = 0.95) and excellent test-retest reliability (intraclass correlation coefficient = 0.99; standard error of measurement = 2.7). Robust validity was observed, in that the FJS had a strong correlation with the AOFAS ankle-hindfoot score, the MOXFQ, and the VAS (Pearson and Spearman values consistently above 0.7 or below -0.7). Responsiveness to change was observed between 6 and 12 months (Cohen d = 0.37). Low ceiling and floor effects at both 6 months (4% and 3% reached top and bottom scores, respectively) and 12 months (10% and 0% reached top and bottom scores, respectively) were demonstrated, below the recommended 15% interpretability threshold. No association between outcomes and patient gender was observed. CONCLUSION: Test properties and validity of the FJS were strong in patients who underwent TAA. It seems suitable for clinical use, although future studies should seek to replicate or refute our findings in other patient populations. LEVEL OF EVIDENCE: Level II, therapeutic study.

Reproducibility and Repeatability Tests on (SnTiNb)O2 Sensors in Detecting ppm-Concentrations of CO and Up to 40% of Humidity: A Statistical Approach.

Nowadays, most medical-diagnostic, environmental monitoring, etc. devices employ sensors whose fabrication reproducibility and response repeatability assessment are crucial. The former consists of large-scale sensor manufacture through a standardized process with almost identical morphology and behavior, while the latter consists of giving the same response upon repeating the same stimulus. The thermo-activated chemoresistive sensors, which change their conductance by interacting with the molecules composing the surrounding gas, are currently employed in many devices: in particular, thick-film (SnTiNb)O2 nanosensors were demonstrated to be particularly suitable in the medical and biological fields. Therefore, a set of thirteen of them, randomly selected from the same screen-printing deposition, were laboratory tested, and the outcomes were statistically analyzed in order to assess their consistency. At first, the working temperature that maximized both the sensor sensitivity and response repeatability was identified. Then, the sensors were subjected to different gas concentrations and humidities at this optimal working temperature. It resulted in the (SnTiNb)O2 nanosensors detecting and discriminating CO concentrations as low as 1 ppm and at high humidity degrees (up to 40%) with high repeatability since the response relative standard error ranged from 0.8 to 3.3% for CO and from 3.6 to 5.4% for water vapor.

Tin, Titanium, Tantalum, Vanadium and Niobium Oxide Based Sensors to Detect Colorectal Cancer Exhalations in Blood Samples.

User-friendly, low-cost equipment for preventive screening of severe or deadly pathologies are one of the most sought devices by the National Health Services, as they allow early disease detection and treatment, often avoiding its degeneration. In recent years more and more research groups are developing devices aimed at these goals employing gas sensors. Here, nanostructured chemoresistive metal oxide (MOX) sensors were employed in a patented prototype aimed to detect volatile organic compounds (VOCs), exhaled by blood samples collected from patients affected by colorectal cancer and from healthy subjects as a control. Four sensors, carefully selected after many years of laboratory tests on biological samples (cultured cells, human stools, human biopsies, etc.), were based here on various percentages of tin, tungsten, titanium, niobium, tantalum and vanadium oxides. Sensor voltage responses were statistically analyzed also with the receiver operating characteristic (ROC) curves, that allowed the identification of the cut-off discriminating between healthy and tumor affected subjects for each sensor, leading to an estimate of sensitivity and specificity parameters. ROC analysis demonstrated that sensors employing tin and titanium oxides decorated with gold nanoparticles gave sensitivities up to 80% yet with a specificity of 70%.

Nanostructured Chemoresistive Sensors for Oncological Screening and Tumor Markers Tracking: Single Sensor Approach Applications on Human Blood and Cell Samples.

Preventive screening does not only allow to preemptively intervene on pathologies before they can harm the host; but also to reduce the costs of the intervention itself; boosting the efficiency of the NHS (National Health System) by saving resources for other purposes. To improve technology advancements in this field; user-friendly yet low-cost devices are required; and various applications for gas sensors have been tested and proved reliable in past studies. In this work; cell cultures and blood samples have been studied; using nanostructured chemoresistive sensors; to both verify if this technology can reliably detect tumor markers; and if correlations between responses from tumor line metabolites and the screening outcomes on human specimens could be observed. The results showed how sensors responded differently to the emanations from healthy and mutant (for cells) or tumor affected (for blood) samples, and how those results were consistent between them, since the tumoral specimens had higher responses compared to the ones of their healthy counterparts. Even though the patterns in the responses require a bigger population to be defined properly; it appeared that the different macro-groups between the same kind of samples are distinguishable from some of the sensors chosen in the study; giving promising outcomes for further research.

Impact of Subtalar Distraction Arthrodesis on Ankle Joint: Radiological Insights from Modified Grice-Green Procedure.

Subtalar distraction arthrodesis (SDA) is a surgical procedure designed to treat hindfoot deformities associated with isolated subtalar joint arthritis. In 1996, Fitzgibbons was the first to observe that, in some cases, hindfoot fusion appeared to be associated with the development of tibiotalar valgus tilt. Since then, few studies have addressed this issue. Given that hindfoot fusion can be performed using various techniques, this study investigated the potential tibiotalar joint frontal or sagittal modifications resulting from the modified Grice-Green technique. All the consecutive patients who underwent the modified Grice-Green procedure were included. The patient records were reviewed to extract demographic data. Weight-bearing foot and ankle radiographs were assessed to measure the talar tilt angle and the tibiotalar ratio on the same picture archiving and communication system by three independent observers. A total of 69 patients met the criteria for inclusion. The mean talar tilt showed no substantial changes, since the increase from 1.46 ± 1.62 preoperatively to 1.93 ± 2.19 at a minimum of 8 months postoperatively was not statistically significant (p = 0.47). The average preoperative tibiotalar ratio significantly increased from 33.4 ± 4.4% to 35 ± 4% postoperatively (p = 0.007), although remaining within the normal range, indicating a possible realignment of the posterior facet of the subtalar joint. In conclusion, this study highlights the effectiveness of the modified Grice-Green procedure in achieving a favorable realignment without impacting the ankle joint, particularly regarding tibiotalar valgus tilt.

Chemoresistive Nanosensors Employed to Detect Blood Tumor Markers in Patients Affected by Colorectal Cancer in a One-Year Follow Up.

Colorectal cancer (CRC) represents 10% of the annual tumor diagnosis and deaths occurring worldwide. Given the lack of specific symptoms, which could determine a late diagnosis, the research for specific CRC biomarkers and for innovative low-invasive methods to detect them is crucial. Therefore, on the basis of previously published results, some volatile organic compounds (VOCs), detectable through gas sensors, resulted in particularly promising CRC biomarkers, making these sensors suitable candidates to be employed in CRC screening devices. A new device was employed here to analyze the exhalations of blood samples collected from CRC-affected patients at different stages of their pre- and post-surgery therapeutic path, in order to assess the sensor's capability for discriminating among these samples. The stages considered were: the same day of the surgical treatment (T1); before the hospital discharge (T2); after one month and after 10-12 months from surgery (T3 and T4, respectively). This device, equipped with four different sensors based on different metal-oxide mixtures, enabled a distinction between T1 and T4 with a sensitivity and specificity of 93% and 82%, respectively, making it suitable for clinical follow-up protocols, patient health status monitoring and to detect possible post-treatment relapses.

A Portable Device for I-V and Arrhenius Plots to Characterize Chemoresistive Gas Sensors: Test on SnO2-Based Sensors.

Chemoresistive nanostructured gas sensors are employed in many diverse applications in the medical, industrial, environmental, etc. fields; therefore, it is crucial to have a device that is able to quickly calibrate and characterize them. To this aim, a portable, user-friendly device designed to easily calibrate a sensor in laboratory and/or on field is introduced here. The device comprises a small hermetically sealed chamber (containing the sensor socket and a temperature/humidity sensor), a pneumatic system, and a custom electronics controlled by a Raspberry Pi 4 developing board, running a custom software (Version 1.0) whose user interface is accessed via a multitouch-screen. This device automatically characterizes the sensor heater in order to precisely set the desired working temperature, it acquires and plots the sensor current-to-voltage and Arrhenius relationships on the touch screen, and it can record the sensor responses to different gases and environments. These tests were performed in dry air on two representative sensors based on widely used SnO2 material. The device demonstrated the independence of the Arrhenius plot from the film applied voltage and the linearity of the I-Vs, which resulted from the voltage step length (1-30 min) and temperature (200-550 °C).

Chemoresistive Sensors for Cellular Type Discrimination Based on Their Exhalations.

The detection of volatile organic compounds (VOCs) exhaled by human body fluids is a recent and promising method to reveal tumor formations. In this feasibility study, a patented device, based on nanostructured chemoresistive gas sensors, was employed to explore the gaseous exhalations of tumoral, immortalized, and healthy cell lines, with the aim of distinguishing their VOC patterns. The analysis of the device output to the cell VOCs, emanated at different incubation times and initial plating concentrations, was performed to evaluate the device suitability to identify the cell types and to monitor their growth. The sensors ST25 (based on tin and titanium oxides), STN (based on tin, titanium, and niobium oxides), and TiTaV (based on titanium, tantalum and vanadium oxides) used here, gave progressively increasing responses upon the cell density increase and incubation time; the sensor W11 (based on tungsten oxide) gave instead unreliable responses to all cell lines. All sensors (except for W11) gave large and consistent responses to RKO and HEK293 cells, while they were less responsive to CHO, A549, and CACO-2 ones. The encouraging results presented here, although preliminary, foresee the development of sensor arrays capable of identifying tumor presence and its type.

Colorectal Cancer Study with Nanostructured Sensors: Tumor Marker Screening of Patient Biopsies.

Despite the great progress in screening techniques and medical treatments, colorectal cancer remains one of the most widespread cancers in both sexes, with a high death rate. In this work, the volatile compounds released from human colon cancer tissues were detected by a set of four different chemoresistive sensors, made with a nanostructured powder of metal-oxide materials, inserted into an innovative patented device. The sensor responses to the exhalation of a primary cancer sample and of a healthy sample (both of the same weight, collected during colorectal surgery from the intestine of the same patient) were statistically analyzed. The sensors gave reversible, reproducible, and fast responses for at least one year of continuous use, making them quite superior in respect to the existing diagnostic methods. Preliminary results obtained using principal component analysis of the sensor responses to samples removed from 13 patients indicate that the nanostructured sensors employed in this study were able to distinguish between healthy and tumor tissue samples with coherent responses (the discrimination power of the most sensitive sensor was about 17%), highlighting a strong potential for clinical practice.