Objective: Hyperextension of the Big Toe is described here as a simple and reliable sign to predict undercorrection of cavus deformity of clubfoot in the Ponseti Method. Materials & Methods: This retrospective study was conducted on children with clubfoot who were treated successfully by Ponseti Method in the King Fahad Hospital, Saudi Arabia, and Emam Reza Hospital, Mashad, Iran, from 2003 through 2008. The total number of the patients in our study was 191, with 306 affected feet. Of them, 115 children had bilateral clubfeet (230 feet) and 76 had unilateral clubfoot. There were 119 males and 72 females. Hyperextension of the Big Toe at MTPJ was present in five cases of clubfoot. The average follow-up period was 20 months (range: 8-38 months). Results: The authors observed that hyperextension of Big Toe at MTPJ had a linear relationship with the severity of cavus deformity of clubfoot. On the other hand, the Big Toe had a normal relationship with other Toes after satisfactory treatment of the initial or relapsed cavus deformity by Ponseti Method.Conclusions: Hyperextension of the Big Toe at MTPJ can be regarded as a reliable prognostic sign for detecting the severity, correction, and the number of castings needed for cavus deformity correction in clubfoot treatment in the Ponseti Method.

Background: Mitchell osteotomy is one of first metatarsal distal corrective osteotomies for hallux valgus deformity. The purpose of this study was to evaluate the outcome of Mitchellosteotomy. Methods: Eighteen patients underwent Mitchell corrective osteotomy using screw fixation for hallux valgus deformities from 2011 to 2015 were included. Clinical outcome was assessed using American Orthopedic Foot and Ankle Score, Hallux metatarsophalangeal-interphalangeal scale, (AOFAS Hallux), visual analogue score, and changes in hallux valgus and intermetatarsal angles based on standard weight-bearing radiographs, at least one year after surgery. Results: About 95 % of patients were completely satisfied. Mean of AOFAS score was 86. 7 at final follow-up. The mean of changes in intermetatarsal and hallux valgus angles were 5. 6 ± 3. 1 and 17. 0 ± 5. 2 respectively. Pain of the cases based on visual analogue score decreased from 5. 8 ± 0. 8 preoperatively to 1. 3 ± 1. 2 postoperatively. There were no deep infections, non: : union: : or osteonecrosis of first metatarsal head. Conclusion: Mitchell corrective osteotomy with screw fixation could bea simple and effective procedure to correct hallux valgus deformity with high levels of patient satisfaction.

Introduction: Hallux valgus is a common foot deformity causing lateral deviation of the first Toe and progressive subluxation of the first metatarsophalangeal joint. The purpose of this study was to investigate the effect of kinesiotype and ankle strengthening exercises with a bosu ball on pain, balance and Big Toe angle in women with hallux valgus. Methods: This clinical trial study used a pre-test and post-test design. First, forty-five women with hallux valgus and flat feet were selected via convenience sampling and randomly assigned to three groups: a kinesiotape group (four weeks, three sessions/week, 24-hour tape application per session), a kinesiotape with Bosu ball ankle strengthening exercises (four weeks, three sessions/week, 30 minutes of exercises and 24-hour tape application per session), and a control group (no intervention). Pain, balance, and hallux valgus angle were measured using the Visual Analogue Scale (VAS), stork test, and goniometer, respectively. Data were analyzed using one-way ANOVA at a significance level (P ≥ 0. 05). Results: After performing the exercises, comparing the data between the two groups before and after 4 weeks revealed a significant difference in pain, balance, and hallux valgus angle in the two groups of kinesiotape and kinesiotape along with the strengthening exercises of Boussou bathop compared to The control group showed (P = 0. 001). Conclusions: A combined program of kinesiotape and Bosu ball ankle strengthening exercises may improve pain, balance, and hallux valgus alignment in women.

In this paper, the effects of the addition of an active Toe joint on a 2D humanoid robot with heel-off and Toe-off motions are studied. To this end, the trajectories of joints and links are designed first. After gait planning, the dynamic model of the humanoid robot in different phases of motion is derived using Kane and Lagrange methods. Then, the veracity of the derived dynamic model is demonstrated by two different methods. The under-study model is in accordance with the features of SURENA III, which is a humanoid robot designed and fabricated at the Center of Advanced Systems and Technologies (CAST) located in University of Tehran. Afterward, the optimization procedure is done by selection of two different goal functions; one of them minimizes the energy consumption and the other maximizes the stability of the robot. At last, the obtained results are presented. According to the results, there is an optimum value for heel-off and Toe-off angles in each velocity which minimizes the consumption of energy. The results also show that, the heel-off angle does not have any significant effects on the stability of the robot while increasing the Toe-off angle improves the stability of motion. Finally, the effects of mass and length of the Toe joint is inspected. These inspections suggest that heavier Toe joints cause an increase in both energy consumption and stability of the robot while increasing the length of the Toe joint does not have any effects on both goal functions.

Extended AbstractIntroductionNowadays, due to the high position of Mashhad in smartening all related issues, the classic risks and threats are not the only dangers. As various urban networks are interconnected, disruption in one part of the system will affect all other parts, which can make governing the city difficult and in danger of disasters. As complexity increases in cities, the need to pay attention to risk management increases. Mashhad is considered the leading city in urban smartening in Iran. It holds a certificate of successful implementation of the key indicators of a sustainable smart city from the World Smart Sustainable Cities Organization (WeGO). Moreover, Mashhad Municipality faces huge challenges in technology, the external environment, and the ability of organize risks and hazards. Therefore, it is a must to identify the most significant risks in this regard. Using a descriptive analytical method, this applied study tried to identify threats and risks a high level of impact and probability of occurrence in Mashhad Municipality.MethodTaking into account the approach, the technology dimension entails 14 indicators and 49 variables, the organization dimension has 14 indicators and 43 variables, and the environment dimension consists of 10 indicators and 41 variables related to risks. A researcher-made questionnaire was used as a tool for collecting the required data. The statistical population consists of 55 experts and specialists on the subject matter of this research, who were selected based on accessibility in the Mashhad’s municipality. The collected data were analyzed using structural equation modeling and AMOS software.ResultsThe results revealed that the most significant risks that threat smart urban governance of Mashhad Municipality among the three studied dimensions have to do with the organization dimension. Regarding the technology dimension, the highest factor loads related to threats, in terms of the impact and probability of occurrence, is related to artificial intelligence (0.79), software (0.768), sensors (0.767), cyber security (0.761), and Big data (0.719). Regarding organization, electronic transactions (0.820), confidentiality (0.760), electronic communication (0.753), and information accuracy (0.752) held the highest percentage. Among the risk indicators examined for the urban environment, public places (0.798), energy (0.795), urban safety (0.760), and wastewater (0.684) were identified as the most threats in the Mashhad Municipality.Discussion and ConclusionThis study tried to identify the impact and probability of risks from several studies on the Iranian context and at the international on three dimensions of the approach (technology, organization, environment) through field study. The results showed that Mashhad Municipality faces several dangers and threats in all three dimensions of the approach this study (technology, organization, and environment). It showed that the existing plans for addressing these risks have many weaknesses, and it is necessary that the policies regarding the management of risks be implemented by the managers and officials of the municipality, especially the policies on to the organization dimension, which has the highest level of risk. Afrakhteh et al. (2021) had focused on evaluating the risks of the municipalities’ information technology sector through questionnaires completed by 751 municipalities of Iran. They concluded that safety, operational, strategic, and financial risks in the field of information technology of municipalities in Iran are the most important type of threats. The results of this study are in line with the results of the risks studied in the technology dimension of the Mashhad Municipality, which faces threats in terms of safety. Beiramizadeh and Mollahosseini (2019) conducted a study on the challenges of cyber security in smart cities. They emphasize that the field of smart city cyber security in Iran is in its infancy level and needs the efforts of governments and developers. The finding is true about the Mashhad Municipality, since the results showed that in the Mashhad Municipality, cyber security is also a threat with a high risk. Among the studies conducted on the international level, Ullah et al. (2021) analyzed the risk management in the governance of sustainable smart cities that have a technology, organization, and environment approach. They conducted a systematic review and showed that from among the 56 identified risks, 7 risks (38.7%) were technological risks, 11 organization risks consist 15.0% of the total, and 24 risks are related to the external environment. The results of the present study showed that the most risks are related to the organization dimension of Mashhad Municipality.The results revealed that the most significant risks among the three dimensions (technology, organization, and urban environment) in Mashhad Municipality are related to the organization dimension and its risk indicators. The indicators related to the environment and technology are the second and third, respectively, in terms of threats and risks. The results on the impact and probability of risks in all three dimensions showed that the most risks in the technology sector, both in terms of impact and in terms of probability of occurrence, have to do with artificial intelligence and software, and the least impact and probability of occurrence are related to urban smart displays. Regarding the organization dimension, the highest level of impact and probability of risks belongs to the indicators of electronic transactions and confidentiality, and the least impact and probability belongs to flexibility in the organization. Regarding the urban environment dimension, the highest level belongs to public places and energy, and the lowest level of impact and probability of occurrence is related to the population density.

Introduction: Osteosarcoma is the second most common primary bone tumor, however, osteosarcoma of the foot and especiallyof the Toe phalanges are very rare. Case Presentation: The current report includes the radiological, pathological, andshort term clinical results of a conventional highgrade osteosarcoma of the little Toe in a 17-year-old adolescent. He referred to the center with a painful swelling at posterolateralaspect of his left fifth Toe. Imaging studies were consistent withanaggressive lesion. Biopsyconfirmedthe diagnosis of conventionalosteosarcoma. Conclusions: In case of osteosarcoma of little Toe proximal phalanx in patients with a bone destructive lesion, malignancy shouldalways be considered.