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.

Blast response and failure analysis of a segmented buried tunnel

Underground tunnels are vulnerable to terrorist attacks which can cause collapse of the tunnel structures or at least extensive damage, requiring lengthy repairs. This paper treats the blast impact on a reinforced concrete segmental tunnel buried in soil under a number of parametric conditions; soil properties, soil cover, distance of explosive from the tunnel centreline and explosive weight and analyses the possible failure patterns. A fully coupled Fluid Structure Interaction (FSI) technique incorporating the Arbitrary Lagrangian-Eulerian (ALE) method is used in this study. Results indicate that the tunnel in saturated soil is more vulnerable to severe damage than that buried in either partially saturated soil or dry soil. The tunnel is also more vulnerable to surface explosions which occur directly above the centre of the tunnel than those that occur at any equivalent distances in the ground away from the tunnel centre. The research findings provide useful information on modeling, analysis, overall tunnel response and failure patterns of segmented tunnels subjected to blast loads. This information will guide future development and application of research in this field.

Odour Emissions from Tunnel Ventilated Poultry Housing

In Australia, factors such as local planning processes, urban encroachment into rural areas and intensification of the poultry industry have increased the potential for odour and dust nuisance. At present, accurate estimates of odour emissions from mechanically ventilated poultry housing systems do not exist for Australian conditions. This has made the poultry industry vulnerable to unsubstantiated criticism. Recently, the Australian poultry industry have made a significant investment in research to obtain accurate estimates of odour, dust and volatile chemical emission rates from typical poultry housing systems. This paper describes the measurement of odour emissions from tunnel ventilated poultry housing systems in different climatic zones in Queensland and Victoria, Australia (humid sub-tropical and Mediterranean respectively) during two seasons (summer and winter). Samples were collected at defined intervals over typical batch production cycles to define the odour emission profiles. These samples were analysed using dynamic olfactometry according to the Australian Standard 4323.3 to derive the odour concentration values. Ventilation rates were measured concurrently, allowing the calculation of odour emission rates. Odour concentration and emission rates were assessed in terms of ventilation rate, ambient and shed air temperature and relative humidity and litter moisture status. Odour emission rates varied with bird age. Seasonal differences in odour emission rate were also observed.

Measurement of Turbulence and pitch of the airstream in the 5'* 7' tunnel of Indian Institute of Science

Abstract is not available.

Odour emissions from tunnel-ventilated broiler sheds: case study of nine Queensland farms.

Odour emission rates were measured from nine tunnel-ventilated broiler farms in south-eastern Queensland, Australia. At one farm, odour emission rates were measured over two sequential batches approximately weekly, while at the remaining farms, odour emission rates were measured just before the first pickup (around Day 35 of the batch) when bird liveweight was greatest and peak odour emission rates were expected. Odour samples were analysed using dynamic olfactometry (to AS/NZS 4323.3:2001), and an artificial olfaction system was used to continuously monitor odour emission rates at one farm. Odour emission rates ranged from 330 to 2960 ou/s per 1000 birds and from 0.19 to 2.12 ou/s.kg, with a significant amount of variability observed throughout the batch and throughout each sampling day. While the wide range in odour emission rates was primarily due to changes in bird liveweight and ventilation requirements, other factors were also involved. The artificial olfaction system proved useful for quantifying the range and variability of odour emission rates, especially when olfactometry analysis was impractical.

On the propagation of a weak shock front: Theory and application

In this paper the kinematics of a weak shock front governed by a hyperbolic system of conservation laws is studied. This is used to develop a method for solving problems, involving the propagation of nonlinear unimodal waves. It consists of first solving the nonlinear wave problem by moving along the bicharacteristics of the system and then fitting the shock into this solution field, so that it satisfies the necessary jump conditions. The kinematics of the shock leads in a natural way to the definition of ldquoshock-raysrdquo, which play the same role as the ldquoraysrdquo in a continuous flow. A special case of a circular cylinder introduced suddenly in a constant streaming flow is studied in detail. The shock fitted in the upstream region propagates with a velocity which is the mean of the velocities of the linear and the nonlinear wave fronts. In the downstream the solution is given by an expansion wave.

On the propagation of a multi-dimensional shock of arbitrary strength

In this paper the kinematics of a curved shock of arbitrary strength has been discussed using the theory of generalised functions. This is the extension of Moslov’s work where he has considered isentropic flow even across the shock. The condition for a nontrivial jump in the flow variables gives the shock manifold equation (sme). An equation for the rate of change of shock strength along the shock rays (defined as the characteristics of the sme) has been obtained. This exact result is then compared with the approximate result of shock dynamics derived by Whitham. The comparison shows that the approximate equations of shock dynamics deviate considerably from the exact equations derived here. In the last section we have derived the conservation form of our shock dynamic equations. These conservation forms would be very useful in numerical computations as it would allow us to derive difference schemes for which it would not be necessary to fit the shock-shock explicitly.

Structure of shock waves at re-entry speeds

The unified structure of steady, one-dimensional shock waves in argon, in the absence of an external electric or magnetic field, is investigated. The analysis is based on a two-temperature, three-fluid continuum approach, using the Navier—Stokes equations as a model and including non-equilibrium collisional as well as radiative ionization phenomena. Quasi charge neutrality and zero velocity slip are assumed. The integral nature of the radiative terms is reduced to analytical forms through suitable spectral and directional approximations. The analysis is based on the method of matched asymptotic expansions. With respect to a suitably chosen small parameter, which is the ratio of atom-atom elastic collisional mean free-path to photon mean free-path, the following shock morphology emerges: within the radiation and electron thermal conduction dominated outer layer occurs an optically transparent discontinuity which consists of a chemically frozen heavy particle (atoms and ions) shock and a collisional ionization relaxation layer. Solutions are obtained for the first order with respect to the small parameter of the problem for two cases: (i) including electron thermal conduction and (ii) neglecting it in the analysis of the outer layer. It has been found that the influence of electron thermal conduction on the shock structure is substantial. Results for various free-stream conditions are presented in the form of tables and figures.

Growth of tin oxide single crystals in porcelain tunnel kilns

Single crystals of tin oxide have been grown under conditions obtained in oil fired porcelain tunnel kilns. It was noted that the reducing conditions in the kilns help in the growth of SnO2 crystals at much lower temperatures (1300°C). The growth seems to more pronounced in presence of silicon carbide. The crystals grow as long fibres of 0.1 to 0.5 mm dia. and 10 to 50 mm length. The crystals exhibit rutile structure and the direction of growth seems to be favoured in any one of the major axes a and c.

Odour, dust and non-methane volatile organic-compound emissions from tunnel-ventilated layer-chicken sheds: a case study of two farms

An observational study was undertaken to measure odour and dust (PM10 and PM2.5) emission rates and identify non-methane volatile organic compounds (NMVOCs) and odorants in the exhaust air from two tunnel-ventilated layer-chicken sheds that were configured with multi-tiered cages and manure belts. The study sites were located in south-eastern Queensland and the West Gippsland region of Victoria, Australia. Samples were collected in summer and winter on sequential days across the manure-belt cleaning cycle. Odour emissions ranged from 58 to 512 ou/s per 1000 birds (0.03-0.27 ou/s.kg) and dust emission rates ranged 0.014-0.184 mg/s per 1000 birds for PM10 and 0.001-0.190 mg/s per 1000 birds for PM2.5. Twenty NMVOCs were identified, including three that were also identified as odorants using thermal desorption-gas chromatography-mass spectrometry/olfactometry analysis. Odour emission rates were observed to vary with the amount of manure accumulation on the manure belts, being lowest 2-4 days after removing manure. Odour emission rates were also observed to vary with diurnal and seasonal changes in ventilation rate. Dust emissions were observed to increase with ventilation rate but not with manure accumulation. Some NMVOCs were identified at both farms and in different seasons whereas others were observed only at one farm or in one season, indicating that odorant composition was influenced by farm-specific practices and season.

Application of shock waves in pencil manufacturing industry

A new shock wave generator has been designed, fabricated and tested for preservative impregnation studies into wood slats used for manufacturing pencils in the Shock Waves Laboratory, IISc, Bangalore. Series of experiments have been carried out in the laboratory to achieve satisfactory preservative impregnation into VATTA wood slats. The experiments have shown that it is indeed possible to impregnate preservatives into VATTA wood slats using shock waves and the depth of penetration and the retention of preservatives by wood slats is as good as the conventional methods. This method is expected to result in substantial reduction in the treatment process time compared to conventional methods that are currently being used by the pencil manufacturing industry.

Experimental investigation of catalytic and non-catalytic surface reactions on SiO2 thin films with shock heated oxygen gas

The present study is to investigate the interaction of strong shock heated oxygen on the surface of SiO2 thin film. The thermally excited oxygen undergoes a three-body recombination reaction on the surface of silicon dioxide film. The different oxidation states of silicon species on the surface of the shock-exposed SiO2 film are discussed based on X-ray Photoelectron Spectroscopy (XPS) results. The surface morphology of the shock wave induced damage at the cross section of SiO2 film and structure modification of these materials are analyzed using scanning electron microscopy and ion microscopy. Whether the surface reaction of oxygen on SiO2 film is catalytic or non-catalytic is discussed in this paper.

Experimental investigation of interaction of strong shock heated oxygen gas on the surface of ZrO2 - a novel method to understand re-combination heating

Interaction of shock heated test gas in the free piston driven shock tube with bulk and thin film of cubic zirconium dioxide (ZrO2) prepared by combustion method is investigated. The test samples before and after exposure to the shock wave are analyzed by X-ray diffraction (XRD), X-Ray Photoelectron Spectroscopy (XPS) and Scanning Electron Microscope (SEM). The study shows transformation of metastable cubic ZrO2 to stable monoclinic ZrO2 phase after interacting with shock heated oxygen gas due to the heterogeneous catalytic recombination surface reaction.

The jump in vorticity across a shock wave in relativistic hydrodynamics

Using the singular surface theory, an expression for the jump in vorticity across a shock wave of arbitrary shape propagating in a uniform, perfect fluid occupying the space-time of special relativity, has been derived. It has been shown that the jump in vorticity across a shock of given strength and curvature depends only on the velocity of the medium ahead of the shock.