Tarsal tunnel syndrome: A narrative literature review

Background Tarsal tunnel syndrome is classified as a focal compressive neuropathy of the posterior tibial nerve or one of its associated branches individually or collectively. The tunnel courses deep to fascia, the flexor retinaculum and within the abductor hallucis muscle of the foot/ankle. The condition is rare and regularly under-diagnosed leading to a range of symptoms affecting the plantar margins of the foot. There are many intervention strategies for treating tarsal tunnel syndrome with limited robust evidence to guide the clinical management of this condition. The role of conservative versus surgical interventions at various stages of the disease process remains unclear, and there is a need for a structured, step-wise approach in treating patients with this syndrome based on derived empirical evidence. This narrative review attempts to scrutinize the literature to date by clarifying initial presentation, investigations and definitive treatment for the purpose of assisting future informed clinical decision and prospective research endeavours. Process The literature searches that have been incorporated in compiling a rigorous review of this condition have included: the Cochrane Neuromuscular Group's Specialized Register (Cochrane Library 2013), the databases of EMBASE, AMED, MEDLINE, CINAHL, Physiotherapy evidence database (PEDRO), Biomed Central, Science Direct and Trip Database (1972 to the present). Reference listings of located articles were also searched and scrutinized. Authors and experts within the field of lower-limb orthopaedics were contacted to discuss applicable data. Subject-specific criteria searches utilizing the following key terms were performed across all databases: tarsal tunnel syndrome, tibial neuralgia, compression neuropathy syndromes, tibial nerve impingement, tarsal tunnel neuropathy, entrapment tibial nerve, posterior tibial neuropathy. These search strategies were modified with differing databases, adopting specific sensitivity-searching tools and functions unique to each. This search strategy identified 88 journal articles of relevance for this narrative literature review. Findings This literature review has appraised the clinical significance of tarsal tunnel syndrome, whilst assessing varied management interventions (non-surgical and surgical) for the treatment of this condition in both adults and children. According to our review, there is limited high-level robust evidence to guide and refine the clinical management of tarsal tunnel syndrome. Requirements for small-scaled randomized controlled trials in groups with homogenous aetiology are needed to analyse the effectiveness of specific treatment modalities. Conclusions It is necessary that further research endeavours be pursued for the clinical understanding, assessment and treatment of tarsal tunnel syndrome. Accordingly, a structured approach to managing patients who have been correctly diagnosed with this condition should be formulated on the basis of empirical evidence where possible.

Generalized Query-By-Rule: a heterogeneous database query language

This paper describes the design and implementation of a high-level query language called Generalized Query-By-Rule (GQBR) which supports retrieval, insertion, deletion and update operations. This language, based on the formalism of database logic, enables the users to access each database in a distributed heterogeneous environment, without having to learn all the different data manipulation languages. The compiler has been implemented on a DEC 1090 system in Pascal.

ADAMIS: a database for medical information systems

This paper describes the design and implementation of ADAMIS (‘A database for medical information systems’). ADAMIS is a relational database management system for a general hospital environment. Apart from the usual database (DB) facilities of data definition and data manipulation, ADAMIS supports a query language called the ‘simplified medical query language’ (SMQL) which is completely end-user oriented and highly non-procedural. Other features of ADAMIS include provision of facilities for statistics collection and report generation. ADAMIS also provides adequate security and integrity features and has been designed mainly for use on interactive terminals.

Access path query language for relational database systems

Database management systems offer a very reliable and attractive data organization for fast and economical information storage and processing for diverse applications. It is much more important that the information should be easily accessible to users with varied backgrounds, professional as well as casual, through a suitable data sublanguage. The language adopted here (APPLE) is one such language for relational database systems and is completely nonprocedural and well suited to users with minimum or no programming background. This is supported by an access path model which permits the user to formulate completely nonprocedural queries expressed solely in terms of attribute names. The data description language (DDL) and data manipulation language (DML) features of APPLE are also discussed. The underlying relational database has been implemented with the help of the DATATRIEVE-11 utility for record and domain definition which is available on the PDP-11/35. The package is coded in Pascal and MACRO-11. Further, most of the limitations of the DATATRIEVE-11 utility have been eliminated in the interface package.

Data definition and manipulation languages for a CAD database

In this paper the main features of ARDBID (A Relational Database for Interactive Design) have been described. An overview of the organization of the database has been presented and a detailed description of the data definition and manipulation languages has been given. These have been implemented on a DEC 1090 system.

Implementation of an interactive relational graphics database

The benefits that accrue from the use of design database include (i) reduced costs of preparing data for application programs and of producing the final specification, and (ii) possibility of later usage of data stored in the database for other applications related to Computer Aided Engineering (CAE). An INTEractive Relational GRAphics Database (INTERGRAD) based on relational models has been developed to create, store, retrieve and update the data related to two dimensional drawings. INTERGRAD provides two languages, Picture Definition Language (PDL) and Picture Manipulation Language (PML). The software package has been implemented on a PDP 11/35 system under the RSX-11M version 3.1 operating system and uses the graphics facility consisting of a VT-11 graphics terminal, the DECgraphic 11 software and an input device, a lightpen.

GRDB: A general purpose relational database system

This article discusses the design and development of GRDB (General Purpose Relational Data Base System) which has been implemented on a DEC-1090 system in Pascal. GRDB is a general purpose database system designed to be completely independent of the nature of data to be handled, since it is not tailored to the specific requirements of any particular enterprise. It can handle different types of data such as variable length records and textual data. Apart from the usual database facilities such as data definition and data manipulation, GRDB supports User Definition Language (UDL) and Security definition language. These facilities are provided through a SEQUEL-like General Purpose Query Language (GQL). GRDB provides adequate protection facilities up to the relation level. The concept of “security matrix” has been made use of to provide database protection. The concept of Unique IDentification number (UID) and Password is made use of to ensure user identification and authentication. The concept of static integrity constraints has been used to ensure data integrity. Considerable efforts have been made to improve the response time through indexing on the data files and query optimisation. GRDB is designed for an interactive use but alternate provision has been made for its use through batch mode also. A typical Air Force application (consisting of data about personnel, inventory control, and maintenance planning) has been used to test GRDB and it has been found to perform satisfactorily.

Development of a New Zealand database of plant virus and virus-like organisms.

The recent 8th Australasian plant virology workshop in Rotorua, New Zealand, discussed the development of a New Zealand database of plant virus and virus-like organisms. Key points of discussion included: (i) the purpose of such a database; (ii) who would benefit from the information in a database; (iii) the scope of a database and its associated collections; (iv) database information and format; and (v) potential funding of such a database. From the workshop and further research, we conclude that the preservation and verification of specimens within the collections and the development of a New Zealand database of plant virus and virus-like organisms is essential. Such a collection will help to fulfil statutory requirements in New Zealand and assist in fulfilling international obligations under the International Plant Protection Convention. Sustaining such a database will assist New Zealand virologists and statutory bodies to undertake scientifically sound research. Establishing reliable records and an interactive database will help to ensure accurate and timely diagnoses of diseases caused by plant viruses and virus-like organisms. Detection of new incursions and their diagnosis will be further enhanced by the use of such reference collections and their associated database. Connecting and associating this information to similar overseas databases would assist international collaborations and allow access to the latest taxonomic and diagnostic resources. Associated scientists working in the areas of plant breeding, export phytosanitary assurance and in the area of the conservation estate would also benefit from access to verified specimens of plant viruses and virus-like organisms. We conclude that funding of a New Zealand database of virus and virus-like organisms and its associated collections should be based partly on Crown funds, as it is a nationally significant biological resource.

Performance Study of a Centralized Concurrency Control Algorithm for Distributed Database Systems using SIMULA

The stimulation technique has gained much importance in the performance studies of Concurrency Control (CC) algorithms for distributed database systems. However, details regarding the simulation methodology and implementation are seldom mentioned in the literature. One objective of this paper is to elaborate the simulation methodology using SIMULA. Detailed studies have been carried out on a centralised CC algorithm and its modified version. The results compare well with a previously reported study on these algorithms. Here, additional results concerning the update intensiveness of transactions and the degree of conflict are obtained. The degree of conflict is quantitatively measured and it is seen to be a useful performance index. Regression analysis has been carried out on the results, and an optimisation study using the regression model has been performed to minimise the response time. Such a study may prove useful for the design of distributed database systems.

CRC27012 A National Diagnostic Database for Emergency Plant Pests

Development of a national diagnostic database for Emergency Plant Pests which will be web-accessible.

Recognition And Top-Down Generation Of Beta-Acyclic Database Schemes

Database schemes can be viewed as hypergraphs with individual relation schemes corresponding to the edges of a hypergraph. Under this setting, a new class of "acyclic" database schemes was recently introduced and was shown to have a claim to a number of desirable properties. However, unlike the case of ordinary undirected graphs, there are several unequivalent notions of acyclicity of hypergraphs. Of special interest among these are agr-, beta-, and gamma-, degrees of acyclicity, each characterizing an equivalence class of desirable properties for database schemes, represented as hypergraphs. In this paper, two complementary approaches to designing beta-acyclic database schemes have been presented. For the first part, a new notion called "independent cycle" is introduced. Based on this, a criterion for beta-acyclicity is developed and is shown equivalent to the existing definitions of beta-acyclicity. From this and the concept of the dual of a hypergraph, an efficient algorithm for testing beta-acyclicity is developed. As for the second part, a procedure is evolved for top-down generation of beta-acyclic schemes and its correctness is established. Finally, extensions and applications of ideas are described.

Searching for common threads in threadfins: phylogeography of Australian polynemids in space and time

Proper management of marine fisheries requires an understanding of the spatial and temporal dynamics of marine populations, which can be obtained from genetic data. While numerous fisheries species have been surveyed for spatial genetic patterns, temporally sampled genetic data is not available for many species. We present a phylogeographic survey of the king threadfin Polydactylus macrochir across its species range in northern Australia and at a temporal scale of 1 and 10 yr. Spatially, the overall AMOVA fixation index was Omega(st) = 0.306 (F-st' = 0.838), p < 0.0001 and isolation by distance was strong and significant (r(2) = 0.45, p < 0.001). Temporally, genetic patterns were stable at a time scale of 10 yr. However, this did not hold true for samples from the eastern Gulf of Carpentaria, where populations showed a greater degree of temporal instability and lacked spatial genetic structure. Temporal but not spatial genetic structure in the Gulf indicates demographic interdependence but also indicates that fishing pressure may be high in this area. Generally, genetic patterns were similar to another co-distributed threadfin species Eleutheronema tetradactylum, which is ecologically similar. However, the historical demography of both species, evaluated herein, differed, with populations of P. macrochir being much younger. The data are consistent with an acute population bottleneck at the last glacio-eustatic low in sea level and indicate that the king threadfin may be sensitive to habitat disturbances.

A Bayesian hurdle model for analysis of an insect resistance monitoring database

Motivated by the analysis of the Australian Grain Insect Resistance Database (AGIRD), we develop a Bayesian hurdle modelling approach to assess trends in strong resistance of stored grain insects to phosphine over time. The binary response variable from AGIRD indicating presence or absence of strong resistance is characterized by a majority of absence observations and the hurdle model is a two step approach that is useful when analyzing such a binary response dataset. The proposed hurdle model utilizes Bayesian classification trees to firstly identify covariates and covariate levels pertaining to possible presence or absence of strong resistance. Secondly, generalized additive models (GAMs) with spike and slab priors for variable selection are fitted to the subset of the dataset identified from the Bayesian classification tree indicating possibility of presence of strong resistance. From the GAM we assess trends, biosecurity issues and site specific variables influencing the presence of strong resistance using a variable selection approach. The proposed Bayesian hurdle model is compared to its frequentist counterpart, and also to a naive Bayesian approach which fits a GAM to the entire dataset. The Bayesian hurdle model has the benefit of providing a set of good trees for use in the first step and appears to provide enough flexibility to represent the influence of variables on strong resistance compared to the frequentist model, but also captures the subtle changes in the trend that are missed by the frequentist and naive Bayesian models. © 2014 Springer Science+Business Media New York.

An incident database for improving metro safety: The case of shanghai

Large cities depend heavily on their metro systems to reduce traffic congestion, which is particularly the case with Shanghai, the largest and most developed city in China. For the purposes of enhancing the possibility in quantitative risk assessment and promoting the safety management level in Shanghai metro, an adaptable metro operation incident database (MOID) is therefore presented for containing details of all incidents that have occurred in metro operation. Taking compatibility and simplicity into consideration, Microsoft Access 2010 software is used for the comprehensive and thorough design of the MOID. Based on MOID, statistical characteristics of incident, such as types, causes, time, and severity, are discovered and 24 accident precursors are identified in Shanghai metro. The processes are demonstrated to show how the MOID can be used to identify trends in the incidents that have occurred and to anticipate and prevent future accidents. In order to promote the application of MOID, an organizational structure is proposed from the four aspects of supervision, research, implementation, and manufacturer. This research would be conducive to safety risk analysis in identifying relevant precursors in safety management and assessing safety level as a qualitative tool.