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INTRODUCTION: Sesamoiditis is a common, and often painful, musculoskeletal pathology frequently encountered by podiatrists. However, there are currently no recommendations to guide podiatrists in the assessment and management of people with sesamoiditis. The aim of this study was to develop consensus-driven clinical recommendations on the assessment and management of people with sesamoiditis. METHODS: A four-round online Delphi survey was conducted with a panel of New Zealand and Australian podiatrists. In the first round, panellists answered open-ended questions that were used to create statements. In round two, the panellists scored the statements from 1 to 9 (1 = not at all important, 9 = absolutely essential). Consensus was defined using the RAND/University of California Los Angles Disagreement Index. Panellists were asked to reconsider statements that did not achieve consensus in round three. In the final round, content validity and acceptability of the statements for inclusion in clinical recommendations were determined using content validity ratios and the Content Validity Index (CVI). RESULTS: Eighteen panellists completed round one with 16 (89%) completing all four rounds. A total of 118 statements were generated following round one. Following rounds two and three, 78 statements were accepted by panellists as being important, with 62 statements achieving sufficient content validity for inclusion in clinical recommendations. The CVI for these 62 statements was 0.58. These recommendations provide guidance on subjective assessment (pain characteristics/symptomology, activity/sports/training history and medical history) objective assessment (establishing a diagnosis, identifying contributing biomechanical factors, footwear/orthoses, ruling out differential diagnoses) and management (temporary padding/strapping, education, footwear, foot orthoses and when to consider referral). CONCLUSION: This consensus exercise has provided a set of consensus-based recommendations for the assessment and management of people with sesamoiditis. In the current absence of research-based evidence in this area, these recommendations are intended to support clinicians. The recommendations may also serve as a basis for future clinical trials evaluating the efficacy of conservative interventions for people with sesamoiditis.

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BACKGROUND: Sesamoiditis is a common inflammatory condition affecting the sesamoid bones at the plantar aspect of the first metatarsophalangeal joint (1MTPJ). However, there are currently no recommendations or clinical guidelines to support podiatrists in their assessment or management of sesamoiditis. The aim of this study was to explore the views of podiatrists in Aotearoa New Zealand on their approaches to the assessment and management of patients with sesamoiditis. METHODS: This qualitative study included focus group discussions with registered podiatrists. Focus groups took place online via Zoom and were guided by a detailed focus group question schedule. The questions were designed to encourage discussion around assessment approaches used in the diagnosis of sesamoiditis and the treatment tools used to manage patients with sesamoiditis. Focus groups were audio-recorded and transcribed verbatim. Reflexive thematic analysis was used to analyse the data. RESULTS: A total of 12 registered podiatrists participated in one of three focus groups. Four themes were constructed relating to the assessment of sesamoiditis: (1) obtaining a patient history; (2) recreating patient symptoms; (3) determining contributing biomechanical factors; and (4) ruling out differential diagnoses. Seven themes were constructed relating to the management of sesamoiditis: (1) consideration of patient factors; (2) patient education; (3) cushioning of the sesamoids to allow more comfortable weightbearing of the 1MTPJ; (4) pressure redistribution and offloading of the sesamoids; (5) immobilisation of the 1MTPJ and sesamoids; (6) facilitating efficient sagittal plane motion during gait; (7) referring to other health professionals to find different ways to treat or manage patient symptoms. CONCLUSION: Podiatrists in Aotearoa New Zealand demonstrate an analytical approach in the assessment and management of patients with sesamoiditis based on their clinical experience and knowledge of lower limb anatomy. A range of assessment and management techniques are selected based on the practitioners personal preferences, as well as the patient's social factors, symptomology, and lower limb biomechanics.

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OBJECTIVE: The nature and magnitude of molecular interactions on hair surfaces underpin the design of formulated products, of which the application involves a competitive adsorption process between cationic surfactants, fatty alcohols and surface actives such as silicone. The knowledge of molecular interaction with hair surface will not only provide insight on the surface binding affinity but also offer an effective methodology in characterizing surface deposits. METHODS: Untreated and chemically treated hair samples were treated with either conditioner chassis alone (gel network) or conditioner chassis plus silicone (chassis/TAS). Hair surface interactions against four different chemical functional groups, namely methyl (-CH3 ), acid (-COOH), amine (-NH2 ) and hydroxyl (-OH), were quantified in both ambient and aqueous environment using Chemical Force Microscopy, a method based on atomic force microscopy (AFM). RESULTS: Surface adhesion on hair in ambient is dominated by capillary force that is determined by both the wettability of hair fibre (hydrophobic vs. hydrophilic), presence of any deposits and the chemical functionality of the AFM cantilever. Capillary force is diminished and replaced by electrostatic interaction when polar groups are present on both hair and AFM cantilever. A distinctively different force, hydrophobic interaction, plays a major role when virgin hair and hydrophobic functionalized AFM cantilever make contact in water. CONCLUSION: Results acquired by AFM cantilevers of different functional groups show that hydrophobic interaction is a key driver for deposition on virgin hair, whilst electrostatic interaction is the most important one for bleached hair. Interfacial conformation of chassis components upon deposition is determined by the hair surface properties. Our study highlights the possibility of a range of polar groups, not necessarily negatively charged, on the damaged hair. Unlike conventional surface chemical analysis method, it is possible to quantitatively evaluate the interfacial conformation of deposited surface actives on hair, which identifies the target moieties for conditioning products on different types of hair.

OBJECTIF: La nature et l'intensité des interactions moléculaires mesurables à la surface d'un cheveu, caractérisent l'effet de la formulation du produit initialement appliqué sur le cheveu. L'application du produit et son effet sur le cheveu repose sur un mécanisme d'adsorption complexe combinant l'effet de différents éléments tels que des surfactants cationiques, des alcools gras et des agents de surface tel que le silicone. L'étude et l'analyse des interactions moléculaires à la surface du cheveu permettent non seulement de déterminer l'affinité adhésive de surface, mais aussi d'offrir une méthode efficace pour caractériser les dépôts de surface. MÉTHODE: Des cheveux initialement traités et non-traités chimiquement, ont été analysés après l'application d'un après-shampoing chassis (structure en gel) ou d'un après-shampoing chassis avec du silicone (chassis/TAS). Les interactions entre la surface du cheveu et quatre groupes fonctionnels chimiques - méthyle (-CH3 ), acide (-COOH), amine (-NH2) et hydroxy (-OH) ont été quantifiées à l'air et en milieu aqueux par microscopie à force chimique, une méthode basée sur la microscopie à force atomique (AFM). RÉSULTATS: L'adhésion de surface sur cheveu à l'air est dominée par la force capillaire qui est déterminée par la mouillabilité de la fibre capillaire (hydrophobe vs. hydrophile), la présence de dépôts, et la fonction chimique du cantilever. La force capillaire diminue et est remplacée par des interactions électrostatiques quand des groupes polaires sont présents à la fois sur le cheveu et le cantilever. Une autre force - l'interaction hydrophobe, joue un rôle majeur quand un cheveu non-traité / vierge et un cantilever de fonction hydrophobe se rencontrent en milieu aqueux. CONCLUSIONS: Les résultats obtenus à partir de cantilevers de différentes fonctions chimiques, montrent que l'interaction hydrophobe joue un rôle clé dans l'application de produit capillaire sur cheveux non-traité tandis que les interactions électrostatiques sont prédominantes dans le cas de cheveux traités chimiquement. La conformation interfaciale des composés chassis avant déposition est déterminée par les propriétés de surface du cheveu. Notre étude souligne la présence potentielle de différents groupes polaires, pas nécessairement chargés négativement, sur la surface de cheveux endommagés. A l'inverse des méthodes conventionnelles d'analyse chimique de surface, il est possible d'évaluer quantitativement la conformation interfaciale de dépôts d'agents actifs présents à la surface du cheveu, ce qui permet d'identifier les zones cibles pour l'application d'après-shampoing sur différents types de cheveux.

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The seasonal melting of ice entombed cryoconite holes on McMurdo Dry Valley glaciers provides oases for life in the harsh environmental conditions of the polar desert where surface air temperatures only occasionally exceed 0°C during the Austral summer. Here we follow temporal changes in cryoconite hole biogeochemistry on Canada Glacier from fully frozen conditions through the initial stages of spring thaw toward fully melted holes. The cryoconite holes had a mean isolation age from the glacial drainage system of 3.4 years, with an increasing mass of aqueous nutrients (dissolved organic carbon, total nitrogen, total phosphorus) with longer isolation age. During the initial melt there was a mean nine times enrichment in dissolved chloride relative to mean concentrations of the initial frozen holes indicative of an ionic pulse, with similar mean nine times enrichments in nitrite, ammonium, and dissolved organic matter. Nitrate was enriched twelve times and dissolved organic nitrogen six times, suggesting net nitrification, while lower enrichments for dissolved organic phosphorus and phosphate were consistent with net microbial phosphorus uptake. Rates of bacterial production were significantly elevated during the ionic pulse, likely due to the increased nutrient availability. There was no concomitant increase in photosynthesis rates, with a net depletion of dissolved inorganic carbon suggesting inorganic carbon limitation. Potential nitrogen fixation was detected in fully melted holes where it could be an important source of nitrogen to support microbial growth, but not during the ionic pulse where nitrogen availability was higher. This study demonstrates that ionic pulses significantly alter the timing and magnitude of microbial activity within entombed cryoconite holes, and adds credence to hypotheses that ionic enrichments during freeze-thaw can elevate rates of microbial growth and activity in other icy habitats, such as ice veins and subglacial regelation zones.

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PURPOSE: This study evaluates the efficacy of platelet rich plasma (PRP) & porous hydroxyapatite crystals in bone regeneration after surgical removal of mandibular third molar with the help of radiographs and its comparison with control side. MATERIALS AND METHODS: A total of 40 patients; both male and female aged between 18 and 35 years, who had impacted mandibular third molars were randomly selected for this study. Twenty patients were taken for control group and 20 patients for study group. The extraction socket of the study group was packed with PRP and hydroxyapatite granules and that of control group was sutured without PRP and hydroxyapatite. The bone density of both extraction sockets were evaluated radiographically using gray level histogram and compared periodically on immediate postoperative day, 1st and 3rd month postoperatively and postoperative sequelae of both the control group and study group in terms of oedema & pain or any other adverse reactions were also assessed. RESULTS: Data suggested evidence of early bone formation and maturation radiographically in study group as compared to control group. The percentage of facial swelling was numerically greater on the control side as compared to the study side, Pain was also assessed with VAS and it was found that the severity of pain was equal in both study and control groups and the results were not significant. CONCLUSION: This study clearly indicated a definitive improvement in the wound healing, increase in bone density, which signifies and highlights the use of PRP and hydroxyapatite granules, certainly as a valid method in inducing and accelerating bone regeneration.

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OBJECTIVE: The aim of this study is to evaluate the clinical use of amnion as a biodegradable graft material for lower anterior ridge vestibuloplasty. STUDY DESIGN: Ten patients who had been referred for preprosthetic surgery underwent mandibular anterior ridge vestibuloplasty using Clark's technique and amniotic membrane as a graft material. Preoperative vestibular depth was measured. Fresh amniotic membrane was placed in the surgical site and sutured with 4-0 vicryl. In all ten cases suction catheter stent was used and was secured in the depth of the vestibule by using 1-0 mersilk percutaneous sutures. RESULTS: Vestibular depths were measured using a divider and a scale. Post operative measurements were taken at the end of 10th day, 1st month and 3rd month. And an average gain of 4-6 mm in the depth of the labial vestibule was noted. CONCLUSION: Amniotic membrane can be a favorable graft material for vestibuloplasty, promoting healing and preventing relapse. It is easily available and preserved and a cost effective material.

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The treated water at the outlet of treatment plants and representative service reservoirs of Mumbai city have been evaluated for trihalomethane formation potential in 1995-1996. Chloroform, dichlorobromomethane, chlorodibromomethane and bromoform have been monitored during monsoon, winter and summer. The levels of chloroform are found above the regulated WHO guideline value of 200 microg L(-1) in final water during postmonsoon at Ghatkopar (226 microg L(-1)), Malbar (210.3 microg L(-1)) and Tulsi (231.26 microg L(-1)).

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