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Introduction : Standardization of diagnostic and treatment concepts in diabetes-related foot infection (DFI) is challenging. In 2019, specific recommendations regarding diagnostic principles and antibiotic therapy (ABT) for DFI, including the one for osteomyelitis (DFO), were introduced in our institution. In this study, we assessed the adherence to these in-house guidelines 2 years after their implementation. Methods : Adult patients with DFI with and without DFO who underwent surgical intervention between 2019 and 2021 were included. Patients' charts were retrospectively reviewed. Accordance to recommendations regarding biopsy sampling, labeling, requesting microbiological and histopathological examinations, and treatment duration were assessed. Results : A total of 80 patients with 117 hospital episodes and 163 surgical interventions were included; 84.6 % required an amputation. Patients with HbA1c levels of < 6.5  % more often required a revision during the same hospitalization than those with HbA1c levels of ≥ 6.5  % (29.4 % vs. 12.1 %, respectively, p = 0.023 ). Specimens were obtained in 71.8 % of operations and sent for histological examination in 63.2 %. The mean duration of ABT was 9 (interquartile range (IQR) 5-15) d in macroscopically surgically cured episodes and 40.5 (IQR 15-42) d in cases with resection margins in non-healthy bone ( p < 0.0001 ). Treatment duration results were similar when using histological results: 13 (IQR 8-42) d for healthy bone vs. 29 (IQR 13-42) d for resection margins consistent with osteomyelitis ( p = 0.026 ). Conclusion : The adherence to recommendations in terms of biopsy sampling was good, moderate for histopathological analysis and poor for labeling the anatomic location. Adherence to recommendations for ABT duration was good, but further shortening of treatment duration for surgically cured cases is necessary., Competing Interests: At least one of the (co-)authors is a member of the editorial board of Journal of Bone and Joint Infection. The peer-review process was guided by an independent editor, and the authors also have no other competing interests to declare., (Copyright: © 2024 Noémie Reinert et al.)

Background: The aim of this study is to investigate the influence of a judoka's psychological readiness in relation to his ability to return to sport. At the present time, the relationship between physical and psychological readiness to return to sport has not been adequately elucidated., Methods: This is a cross-sectional study. An online survey was distributed via social networks and the German Judo Association collecting data from competitive and recreational judo athletes. The survey collected data on participants' characteristics, history of injury, and psychological readiness to return to sport after injury as determined by either the Anterior Cruciate Ligament-Return to Sport after Injury Scale, the Shoulder Instability-Return to Sport after Injury Scale, or a modified version of the Return to Sport after Injury Scale depending on the respective type of injury., Results: The study included 383 judo athletes (272 competitive judo athletes and 112 recreational judo athletes). Regardless of injury location, athletes who achieved return to sports (M = 70.67; SD = 16.47) had higher RSI scores than athletes that did not return to sports (M = 53.88; SD = 19.12; p < 0.0001). Male athletes (M = 65.60; SD = 19.34) did show significantly higher RSI scores than female athletes (M = 60.45; SD = 19.46). The RSI score differed for different time loss categories, F(7, 375) = 11.309, p < 0.001, η 2  = .174 with decreasing RSI scores for longer time loss and lowest RSI scores in athletes, who never returned to sports. RSI scores of athletes with knee injuries differed from athletes with other injury locations (10.23, 95% CI [4.08, 16.38]). After adjusting for time loss due to injury, competitive athletes had higher RSI scores than competitive athletes (F (1, 382) = 7.250, p < 0.001, partial η 2  = .02). Conservatively treated athletes (M = 66.58; SD = 18.54) had higher RSI scores than surgically treated athletes (M = 59.05; SD = 20.01; p < 0.05)., Conclusion: Based on the data of this study, type of injury, sport level, treatment method, and gender appear to influence psychological readiness on judoka and their ability to return to sport. The multiple factors that influence a judoka and their ability to return to sport argue for individualized treatment of judoka and their psychological state after injury in the return to sport process., (© 2023. The Author(s).)

Assist-as-needed (AAN) algorithms for the control of lower extremity rehabilitation robots can promote active participation of patients during training while adapting to their individual performances and impairments. The implementation of such controllers requires the adaptation of a control parameter (often the robot impedance) based on a performance (or error) metric. The choice of how an adaptive impedance controller is formulated implies different challenges and possibilities for controlling the patient's leg movement. In this paper, we analyze the characteristics and limitations of controllers defined in two commonly used formulations: joint and end-point space, exploring especially the implementation of an AAN algorithm. We propose then, as a proof-of-concept, an AAN impedance controller that combines the strengths of working in both spaces: a hybrid joint/end-point impedance controller. This approach gives the possibility to adapt the end-point stiffness in magnitude and direction in order to provide a support that targets the kinematic deviations of the end-point with the appropriate force vector. This controller was implemented on a two-link rehabilitation robot for gait training-the Lokomat®Pro V5 (Hocoma AG, Switzerland) and tested on 5 able-bodied subjects and 1 subject with Spinal Cord Injury. Our experiments show that the hybrid controller is a feasible approach for exoskeleton devices and that it could exploit the benefits of the end-point controller in shaping a desired end-point stiffness and those of the joint controller to promote the correct angular changes in the trajectories of the joints. The adaptation algorithm is able to adapt the end-point stiffness based on the subject's performance in different gait phases, i.e., the robot can render a higher stiffness selectively in the direction and gait phases where the subjects perform with larger kinematic errors. The proposed approach can potentially be generalized to other robotic applications for rehabilitation or assistive purposes., (Copyright © 2018 Maggioni, Reinert, Lünenburger and Melendez-Calderon.)

Background: Microglia-the resident immune cells of the brain-are activated after brain lesions, e.g., cerebral ischemia, and polarize towards a classic "M1" pro-inflammatory or an alternative "M2" anti-inflammatory phenotype following characteristic temporo-spatial patterns, contributing either to secondary tissue damage or to regenerative responses. They closely interact with endogenous neural stem cells (NSCs) residing in distinct niches of the adult brain. The current study aimed at elucidating the dynamics of microglia polarization and their differential effects on NSC function., Results: Primary rat microglia in vitro were polarized towards a M1 phenotype by LPS, or to a M2 phenotype by IL4, while simultaneous exposure to LPS plus IL4 resulted in a hybrid phenotype expressing both M1- and M2-characteristic markers. M2 microglia migrated less but exhibit higher phagocytic activity than M1 microglia. Defined mediators switched microglia from one polarization state to the other, a process more effective when transforming M2 microglia towards M1 than vice versa. Polarized microglia had differential effects on the differentiation potential of NSCs in vitro and in vivo, with M1 microglia promoting astrocytogenesis, while M2 microglia supported neurogenesis. Regardless of their polarization, microglia inhibited NSC proliferation, increased NSC migration, and accelerated NSC differentiation., Conclusion: Overall, this study shed light on the complex conditions governing microglia polarization and the effects of differentially polarized microglia on critical functions of NSCs in vitro and in vivo. Refining the understanding of microglia activation and their modulatory effects on NSCs is likely to facilitate the development of innovative therapeutic concepts supporting the innate regenerative capacity of the brain.