How to perform Baxter's nerve blockage easily by ultrasound in chronic heel pain: Four simple steps.

Baxter's neuropathy is one of the overlooked causes of chronic heel pain. Diagnosing neuropathy in Baxter's can be challenging due to its potential occurrence as a secondary condition to other common syndromes that cause heel pain, such as plantar fasciitis, calcaneal spur, hypertrophic muscle, tenosynovitis, space-occupying lesions or trauma. Ultrasound is a reliable and easily accessible device that guides injections for the treatment of Baxter's neuropathy. We have written this letter as a guide, especially for beginner and professional pain specialists.

Elucidating the lotus and rose-petal effects on hierarchical surfaces: Study of the effect of topographical scales on the contact angle hysteresis.

In nature, superhydrophobicity is almost systematically associated with a multiscale topography. Nevertheless, multiscale-textured natural surfaces can either produce water-repellent properties such as on the sacred lotus leaf or high liquid-to-solid adhesion such as on the rose petal. To conceive bio-inspired surfaces with self-cleaning properties, the proper contributions of each topographical scale to the wetting behavior need to be investigated. Conditions for the equilibrium of menisci produced at a given topographical scale are derived, yielding a recursion relation between each topographical scale. We introduce the equilibrium anchorage depth to quantify the penetration of water at equilibrium. To study the contact angle hysteresis (CAH), we thoroughly describe the mechanisms driving the advancing and receding motions of the triple line. Both phenomena depend on what we define as precursor advancing and receding motions. Eventually, the equilibrium, advancing and receding anchorage depths are related to the CAH. Topographical heterogeneities at a topographical subscale i are always associated with a reduced equilibrium anchorage depth and an enhanced robustness at all topographical scales of higher orders of magnitude. Eventually, it is demonstrated that advancing and receding anchorage depths are bounded by the equilibrium anchorage depth, elucidating how rose-petal-like surfaces systematically produce a high CAH.

Unconventional Dually-Mobile Superrepellent Surfaces.

The ability of water droplets to move freely on superrepellent surfaces is a crucial feature that enables effective liquid repellency. Common superrepellent surfaces allow free motion of droplets in the Cassie state, with the liquid resting on the surface textures. However, liquid impalement into the textures generally leads to a wetting transition to the Wenzel state and droplet immobilization on the surface, thereby destroying the liquid repellency. This study reports the creation of a novel type of superrepellent surface through rational structural control combined with liquid-like surface chemistry, which allows for the free movement of water droplets and effective repellency in both the Cassie and Wenzel states. Theoretical guidelines for designing such surfaces are provided, and experimental results are consistent with theoretical analysis. Furthermore, this work demonstrates the enhanced ice resistance of the dually-mobile superrepellent surfaces, along with their distinctive self-cleaning capability to eliminate internal contaminants. This study expands the understanding of superrepellency and offers new possibilities for the development of repellent surfaces with exceptional anti-wetting properties.

Dual-Energy-Barrier Stable Superhydrophobic Structures for Long Icing Delay.

Using superhydrophobic surfaces (SHSs) with the water-repellent Cassie-Baxter (CB) state is widely acknowledged as an effective approach for anti-icing performances. Nonetheless, the CB state is susceptible to diverse physical phenomena (e.g., vapor condensation, gas contraction, etc.) at low temperatures, resulting in the transition to the sticky Wenzel state and the loss of anti-icing capabilities. SHSs with various micronanostructures have been empirically examined for enhancing the CB stability; however, the energy barrier transits from the metastable CB state to the stable Wenzel state and thus the CB stability enhancement is currently not enough to guarantee a well and appliable anti-icing performance at low temperatures. Here, we proposed a dual-energy-barrier design strategy on superhydrophobic micronanostructures. Rather than the typical single energy barrier of the conventional CB-to-Wenzel transition, we introduced two CB states (i.e., CB I and CB II), where the state transition needed to go through CB I and CB II then to Wenzel state, thus significantly improving the entire CB stability. We applied ultrafast laser to fabricate this dual-energy-barrier micronanostructures, established a theoretical framework, and performed a series of experiments. The anti-icing performances were exhibited with long delay icing times (over 27,000 s) and low ice-adhesion strengths (0.9 kPa). The kinetic mechanism underpinning the enhanced CB anti-icing stability was elucidated and attributed to the preferential liquid pinning in the shallow closed structures, enabling the higher CB-Wenzel transition energy barrier to sustain the CB state. Comprehensive durability tests further corroborated the potentials of the designed dual-energy-barrier structures for anti-icing applications.

Plantar Fasciitis with Chronic Baxter's Neuropathy Causing Hindfoot Pain - A Case Report.

Introduction: The main differentials of non-traumatic heel pain are plantar fasciitis (PF), plantar heel fat pad atrophy, worn-out footwear, especially asymmetric wear and tear, hyperuricemia, corns, callosities, tumors of the calcaneum, osteomyelitis, calcaneal stress fractures due to overweight or unaccustomed over usage, radiating pain from S1 nerve root compression, and seronegative spondyloarthropathies. Compression of the tibial nerve or the medial calcaneal nerve at or around the flexor retinaculum is the other possibility. In this case report, we want to highlight a sparsely known pathology, caused due to the entrapment of the first branch of the lateral plantar nerve or inferior calcaneal nerve, also known as Baxter's nerve that may present independently or accompany the common PF. Non-steroidal anti-inflammatory medications or injections of local steroids are typically used for conservative management. However, hydro-dissection or surgical release may be needed in non-responsive cases. Case Report: We present the case of a 57-year-old female with complaints of chronic pain and tenderness in the middle of the heel radiating laterally. She underwent magnetic resonance imaging that revealed chronic denervation changes in the form of marked atrophy and near complete fatty replacement of abductor digiti minimi muscle suggesting chronic Baxter neuropathy. A mildly thickened and hyperintense plantar fascia adjacent to the calcaneal spur and significant heel fat pad edema were seen too. The patient responded well to a local steroid injection and remains pain-free at the 1-year follow-up. Conclusion: When heel pain is present, Baxter's nerve impingement presents as a challenging clinical diagnosis that may accompany the common PF and is often overlooked. MRI can be used to assess the denervation effects of both the acute and chronic stages of Baxter's nerve impingement by identifying abnormalities of the abductor digiti minimi muscle belly.

An anatomical approach to the tarsal tunnel syndrome: what can ankle's medial side anatomy reveal to us?

BACKGROUND: The heel is a complex anatomical region and is very often the source of pain complaints. The medial heel contains a number of structures, capable of compressing the main nerves of the region and knowing its anatomical topography is mandatory. The purpose of this work is to evaluate if tibial nerve (TN) and its main branches relate to the main anatomical landmarks of the ankle's medial side and if so, do they have a regular path after emerging from TN. METHODS: The distal part of the legs, ankles and feet of 12 Thiel embalmed cadavers were dissected. The pattern of the branches of the TN was registered and the measurements were performed according to the Dellon-McKinnon malleolar-calcaneal line (DML) and the Heimkes Triangle (HT). RESULTS: The TN divided proximal to DML in 87.5%, on top of the DML in 12,5% and distal in none of the feet. The Baxter's nerve (BN) originated proximally in 50%, on top of the DML in 12,5% and distally in 37.5% of the cases. There was a strong and significant correlation between the length of DML and the distance from the center of the medial malleolus (MM) to the lateral plantar nerve (LPN), medial plantar (MPN) nerve, BN and Medial Calcaneal Nerve (MCN) (ρ: 0.910, 0.866, 0.970 and 0.762 respectively, p <  0.001). CONCLUSIONS: In our sample the TN divides distal to DML in none of the cases. We also report a strong association between ankle size and the distribution of the MPN, LPN, BN and MCN. We hypothesize that location of these branches on the medial side of the ankle could be more predictable if we take into consideration the distance between the MM and the medial process of the calcaneal tuberosity.

Molecular Simulation Study on the Wettability of a Surface Texturized with Hierarchical Pillars.

By using molecular dynamics simulation, we investigate the wettability of a surface texturized with a periodic array of hierarchical pillars. By varying the height and spacing of the minor pillars on top of major pillars, we investigate the wetting transition from the Cassie-Baxter (CB) to Wenzel (WZ) states. We uncover the molecular structures and free energies of the transition and meta-stable states existing between the CB and WZ states. The relatively tall and dense minor pillars greatly enhance the hydrophobicity of a pillared surface, in that, the CB-to-WZ transition requires an increased activation energy and the contact angle of a water droplet on such a surface is significantly larger.

Friction force-based measurements for simultaneous determination of the wetting properties and stability of superhydrophobic surfaces.

HYPOTHESIS: Contact angle and sliding angle measurements are widely used to characterize superhydrophobic surfaces because of the simplicity and accessibility of the technique. We hypothesize that dynamic friction measurements, with increasing pre-loads, between a water drop and a superhydrophobic surface is more accurate because this technique is less influenced by local surface inhomogeneities and temporal surface changes. EXPERIMENTS: A water drop, held by a ring probe which is connected to a dual-axis force sensor, is sheared against a superhydrophobic surface while maintaining a constant preload. From this force-based technique, static and kinetic friction forces measurements are used to characterize the wetting properties of the superhydrophobic surfaces. Furthermore, by applying increased pre-loads to the water drop while shearing, the critical load at which the drop transitions from the Cassie-Baxter to Wenzel state is also measured. FINDINGS: The force-based technique predicts sliding angles with reduced standard deviations (between 56 and 64%) compared to conventional optical-based measurements. Kinetic friction force measurements show a higher accuracy (between 35 and 80%) compared to static friction force measurements in characterizing the wetting properties of superhydrophobic surfaces. The critical loads for the Cassie-Baxter to Wenzel state transition allows for stability characterization between seemingly similar superhydrophobic surfaces.

Biomolecular map of albumin identifies signatures of severity and early mortality in acute liver failure.

BACKGROUND & AIMS: Acute liver failure (ALF) is associated with high mortality. Alterations in albumin structure and function have been shown to correlate with outcomes in cirrhosis. We undertook a biomolecular analysis of albumin to determine its correlation with hepatocellular injury and early mortality in ALF. METHODS: Altogether, 225 participants (200 patients with ALF and 25 healthy controls [HC]) were enrolled. Albumin was purified from the baseline plasma of the training cohort (ALF, n = 40; survivors, n = 8; non-survivors, n = 32; and HC, n = 5); analysed for modifications, functionality, and bound multi-omics signatures; and validated in a test cohort (ALF, n = 160; survivors, n = 53; non-survivors, n = 107; and HC, n = 20). RESULTS: In patients with ALF, albumin is more oxidised and glycosylated with a distinct multi-omics profile than that in HC, more so in non-survivors (p <0.05). In non-survivors, albumin was more often bound (p <0.05, false discovery rate <0.01) to proteins associated with inflammation, advanced glycation end product, metabolites linked to arginine, proline metabolism, bile acid, and mitochondrial breakdown products. Increased bacterial taxa (Listeria, Clostridium, etc.) correlated with lipids (triglycerides [4:0/12:0/12:0] and phosphatidylserine [39:0]) and metabolites (porphobilinogen and nicotinic acid) in non-survivors (r2 >0.7). Multi-omics signature-based probability of detection for non-survival was >90% and showed direct correlation with albumin functionality and clinical parameters (r2 >0.85). Probability-of-detection metabolites built on the top five metabolites, namely, nicotinic acid, l-acetyl carnitine, l-carnitine, pregnenolone sulfate, and N-(3-hydroxybutanoyl)-l-homoserine lactone, showed diagnostic accuracy of 98% (AUC 0.98, 95% CI 0.95-1.0) and distinguish patients with ALF predisposed to early mortality (log-rank <0.05). On validation using high-resolution mass spectrometry and five machine learning algorithms in test cohort 1 (plasma and paired one-drop blood), the metabolome panel showed >92% accuracy/sensitivity and specificity for prediction of mortality. CONCLUSIONS: In ALF, albumin is hyperoxidised and substantially dysfunctional. Our study outlines distinct 'albuminome' signatures capable of distinguishing patients with ALF predisposed to early mortality or requiring emergency liver transplantation. IMPACTS AND IMPLICATIONS: Here, we report that the biomolecular map of albumin is distinct and linked to severity and outcome in patients with acute liver failure (ALF). Detailed structural, functional, and albumin-omics analysis in patients with ALF led to the identification and classification of albumin-bound biomolecules, which could segregate patients with ALF predisposed to early mortality. More importantly, we found albumin-bound metabolites indicative of mitochondrial damage and hyperinflammation as a putative indicator of <30-day mortality in patients with ALF. This preclinical study validates the utility of albuminome analysis for understanding the pathophysiology and development of poor outcome indicators in patients with ALF.

Internal and interfacial microstructure characterization of ice droplets on surfaces by X-ray computed tomography.

HYPOTHESIS: Characterizing the microstructure of an ice/surface interface and its effect on the icephobic behavior of surfaces remains a significant challenge. Introducing X-ray Computed Tomography (XCT) can provide unprecedented insights into the internal (porosity) and interfacial structures, i.e. wetting regime, between (super)hydrophobic surfaces and ice by visualizing these optically inaccessible regions. EXPERIMENTS: Frozen droplets with controlled volume were deposited on top of metallic and polymeric substrates with different levels of wettability. Different modes of XCT (3D and 4D) were utilized to obtain information on the internal and interfacial structure of the ice/surface system. The results were supplemented by conventional surface analysis techniques, including optical profilometry and contact angle measurements. FINDINGS: Using XCT on ice/surface systems, the 3D and 4D (imaging with temporal resolution) structural information can be visualized. From these datasets, qualitative and quantitative results were obtained, not only for characterizing the interface but also for analyzing the entire droplet/surface system, e.g., measurement of porosity size, shape, and location. These results highlight the potential of XCT in the characterization of both droplets and substrates and proves that the technique can aid to develop hydrophobic surfaces for use as icephobic materials.

From Baltimore to Italy: The contribution of Grace Baxter (1869-1954) to the development of Italian nursing.

The recent discovery of unpublished documents in the archives of the Camerata hospital, (Florence, I) sheds light on an important chapter in the history of nursing education and the role played by Grace Baxter (1869-1954), of English parentage but born and lived in Florence. The introduction of professional nurses was part of the international movement for the emancipation of women that included education for an active role in society. Her contribution, with other women, to the history of Italian nursing resulted in the secularisation the profession away from the attitudes of the nuns, permeation of relevant ethical standards, and the beginning of professionalisation of nurses in Italy in accordance with Florence Nightingale's teaching.

Case report: Baxter's nerve radiofrequency in patient with plantar fasciitis nonresponsive to conventional treatment.

Plantar fasciitis is recognized as the leading cause of talalgia worldwide. In the vast majority of cases it can be controlled with the use of appropriate footwear, stretching exercises and changes in the sport activity, while a few cases require infiltrations or surgical interventions. The latter puts the patient at greater risk, and is reserved for the most severe cases. We propose using pulsed radiofrequency ablation of Baxter's nerve to treat this painful symptom in patients who do not respond adequately to conventional treatment. We present the case of a patient with refractory plantar fasciitis in whom surgery had been ruled out. The patient underwent pulsed radiofrequency treatment with satisfactory results in the short and medium term.

NIR-Reflective and Hydrophobic Bio-Inspired Nano-Holed Configurations on Titanium Alloy.

Near-infrared (NIR) radiation plays an important role in guided external stimulus therapies; its application in bone-related treatments is becoming more and more frequent. Therefore, metallic biomaterials that exhibit properties activated by NIR are promising for further orthopedic procedures. In this work, we present an adapted electroforming approach to attain a biomorphic nano-holed TiO2 coating on Ti6Al4V alloy. Through a precise control of the anodization conditions, structures revealed the formation of localized nano-pores arranged in a periodic assembly. This specific organization provoked higher stability against thermal oxidation and precise hydrophobic wettability behavior according to Cassie-Baxter's model; both characteristics are a prerequisite to ensure a favorable biological response in an implantable structure for guided bone regeneration. In addition, the periodically arranged sub-wavelength-sized unit cell on the metallic-dielectric structure exhibits a peculiar optical response, which results in higher NIR reflectivity. Accordingly, we have proved that this effect enhances the efficiency of the scattering processes and provokes a significant improvement of light confinement producing a spontaneous NIR fluorescence emission. The combination of the already favorable mechanical and biocompatibility properties of Ti6Al4V, along with suitable thermal stability, wetting, and electro-optical behavior, opens a promising path toward strategic bone therapeutic procedures.

A robust underwater superoleophobic aminated polyacrylonitrile membrane embedded with CNTs-COOH for durable oil/water and dyes/oil emulsions separation.

Considering the emulsified oil and water-soluble dyes in wastewater, the exploitation of easy-manufacturing, energy-saving and high-efficiency separation materials is urgently required. In this work, integrating the positively charged polyethyleneimine (PEI) with negatively charged CNTs-COOH constructed the superhydrophilic Cassie-Baxter structure onto the electrospun polyacrylonitrile (PAN) membrane surface by ultrasonic, electrostatic interaction and thermal treatment. Based on it, the PEN@CNTs membrane achieved efficient separation for surfactant-free, tween 80-stabilized, SDS-stabilized, and CTAB-stabilized emulsions (the fluxes reached 508-3158 L m-2 h-1, the separation efficiency reached 99.42%) by the splendid water-penetration and oil-repellency, electrostatic interaction, and "aperture sieve". Moreover, because of the porosity and strong charged surface of PEN@CNTs membrane, the anionic dyes can be quickly removed by one-step filtrate method (∼403 L m-2 h-1). Meanwhile, the PEN@CNTs membrane also achieved synchronous and efficient remediation for oil/dye mixture emulsions after many cycles. More importantly, facing the complex physical and chemical environments, the combination of the stabilized PEN membrane, inactive CNTs-COOH layer, and the bond of embedding method between CNTs-COOH and PEN nanofibers made the PEN@CNTs membrane demonstrated robust stability and durable separation capability.

Binary mixture droplet wetting on micro-structure decorated surfaces.

Liquid surface tension as well as solid structure play a paramount role on the intimate wetting and non-wetting regimes and interactions between liquids droplets and solid substrates. We hypothesise that the coupling of these two variables, independently addressed in the past, eventually offer a wider range of understanding to the surface science and interfacial communities. In this work, intrinsically hydrophobic micro-pillared surfaces varying in the spacing between structures, and pure ethanol, pure water and their binary mixtures (as well as acetone-water and ethylene glycol-water mixtures) are utilised, accessing a wide range of substrate solid fractions and liquid surface tensions experimentally. Wettability measurements are carried out at different azimuthal directions to exemplify the wetting/non-wetting behaviour as well as the droplet asymmetry function of both liquid composition and structure spacing. Our findings reveal that high water concentration droplets, i.e., high surface tension fluids, sit in the Cassie-Baxter regime while partial non-wetting Wenzel or mixed-mode regimes with enhanced droplet asymmetry ensuing for medium and high ethanol concentrations, i.e., low surface tension fluids, below certain micropillar spacing. Beyond micropillar spacing s ≥ 40 µm, the impact of the surface structure on the droplet shape is negligible, and droplets adopt a similar contact angle and circular shape as on a flat smooth hydrophobic surface. Wetting and non-wetting regimes are then supported by classical wetting theories and equations. A wetting regime map for a wide range of surface tension fluids and/or their mixtures on a wide domain of solid fractions is then proposed.

Topography versus chemistry - How can we control surface wetting?

HYPOTHESIS: Wetting characterization and the production of engineered surfaces showing distinct contact angles or spreading behavior is of major importance for many industrial and scientific applications. As chemical composition plays a major role in the wetting behavior of flat samples, wettability, capillary forces and resulting droplet spreading on anisotropic surface patterns are expected to be highly dependent on surface chemistry as well. EXPERIMENTS: To gain understanding of the fundamental principles of the interplay between surface topography and surface chemistry regarding water wettability, anisotropic line patterns were produced on steel samples in a direct laser writing process. Homogeneous surface coatings allowed for a chemical masking of the laser patterns and therewith the identification of the influence of surface chemistry on static contact angles and wetting anisotropy. FINDINGS: While a carbon coating leads to pronounced wettability and spreading along the topographic anisotropy, an inert gold-palladium coating can fully suppress anisotropic droplet spreading. Model calculations show that an amorphous carbon coating leads to Wenzel wetting while the gold-palladium coating causes air inclusions between the water and the surface in the Cassie-Baxter wetting state. Only in combination with the right chemical composition of the surface, directional patterns show their potential of anisotropic wetting behavior.

Universal description of wetting on multiscale surfaces using integral geometry.

HYPOTHESIS: Emerging energy-related technologies deal with multiscale hierarchical structures, intricate surface morphology, non-axisymmetric interfaces, and complex contact lines where wetting is difficult to quantify with classical methods. We hypothesise that a universal description of wetting on multiscale surfaces can be developed by using integral geometry coupled to thermodynamic laws. The proposed approach separates the different hierarchy levels of physical description from the thermodynamic description, allowing for a universal description of wetting on multiscale surfaces. THEORY AND SIMULATIONS: The theoretical framework is presented followed by application to limiting cases of wetting on multiscale surfaces. Limiting cases include those considered in the Wenzel, Cassie-Baxter, and wicking state models. Wetting characterisation of multiscale surfaces is explored by conducting simulations of a fluid droplet on a structurally rough surface and a chemically heterogeneous surface. FINDINGS: The underlying origin of the classical wetting models is shown to be rooted within the proposed theoretical framework. Integral geometry provides a topological-based wetting metric that is not contingent on any type of wetting state. The wetting metric is demonstrated to account for multiscale features along the common line in a scale consistent way; providing a universal description of wetting for multiscale surfaces.

Effect of Protein Adsorption on Air Plastron Behavior of a Superhydrophobic Surface.

Protein fouling on critical biointerfaces causes significant public health and clinical ramifications. Multiple strategies, including superhydrophobic (SHP) surfaces and coatings, have been explored to mitigate protein adsorption on solid surfaces. SHP materials with underwater air plastron (AP) layers hold great promise by physically reducing the contact area between a substrate and protein molecules. However, sustaining AP stability or lifetime is crucial in determining the durability and long-term applications of SHP materials. This work investigated the effect of protein on the AP stability using model SHP substrates, which were prepared from a mixture of silica nanoparticles and epoxy. The AP stability was determined using a submersion test with real-time visualization. The results showed that AP stability was significantly weakened by protein solutions compared to water, which could be attributed to the surface tension of protein solutions and protein adsorption on SHP substrates. The results were further examined to reveal the correlation between protein fouling and accelerated AP dissipation on SHP materials by confocal fluorescent imaging, surface energy measurement, and surface robustness modeling of the Cassie-Baxter to Wenzel transition. The study reveals fundamental protein adsorption mechanisms on SHP materials, which could guide future SHP material design to better mitigate protein fouling on critical biointerfaces.

Ultrasound block of first branch of the lateral plantar nerve (baxter nerve): case report of a promising and effective treatment for heel chronic pain.

Chronic heel pain is a challenging diagnosis and although it is a common and disabling condition frequently mistreated. Baxter Nerve (BN) entrapment is responsible for 20% of heel pain and can be managed by an ultrasound guide nerve block, a simple, safe, and durable technique. A 67-year-old woman complained of paraesthesia on the left heel and a "stepping on glass" feeling. Various techniques were performed to manage her symptoms without any results. An ultrasound BN block was finally performed with an instant relief and satisfactory pain control for the follow-up period of six months. This clinical report highlights the success of the ultrasound BN block as an effective and lasting solution for chronic heel pain.

Robust Control of a New Asymmetric Teleoperation Robot Based on a State Observer.

This study is mainly about the designation of a new type of haptic device and an asymmetric teleoperation robot system. Aiming at the problems of tracking and transparency of an asymmetric teleoperation system, a robust control algorithm based on a state observer was proposed. The Haptic Device was designed and was chosen as the master-robot of the system. The Baxter dual-arm robot was chosen as the slave-robot of the system. The simulation experiment of robust control based on a state observer of the asymmetric teleoperation robot was carried out. The experiment results showed that the maximum values of displacement tracking errors in three directions x, y, and z are 0.02 m, 0.01 m, and 0.015 m, respectively. Compared with single- joint PID control, the performance of the new control algorithm is improved. The force feedback experiment on the real asymmetric teleoperation robot system was carried out. The results showed that the force feedback wave is consistent with the actual situation and showed that the robust control algorithm proposed is superior to PID. Therefore, the algorithm perfectly satisfied the system. The experiment parameters also demonstrate that the haptic device satisfies the design requirements of the asymmetric teleoperation robots system and the industry standards.