{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T20:29:46Z","timestamp":1781900986843,"version":"3.54.5"},"reference-count":49,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T00:00:00Z","timestamp":1579132800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Diabetes Sci Technol"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Diabetic foot ulceration (DFU) affects only a subgroup of patients with diabetic neuropathy, that is, those with pain-insensitivity due to end-stage sensory failure. Pain perception failure develops insidiously and remains asymptomatic until first DFU. As loss of pain perception is clinically significant, timely detection is mandatory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>A novel suprathreshold pinprick pain stimulus of 512\u2009mN force made from optical glass-fiber was explored in a prospective cross-sectional diagnostic accuracy study to detect DFU-related end-stage sensory failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 116 participants were studied (25 healthy people, 22 patients with diabetes without relevant complications, 19 patients with previous painful foot or leg injuries, and 50 patients with previous or active painless DFU [reference standard]). Palmar and plantar surfaces were stimulated in a standardized fashion. At the feet, the second and third toe skinfolds and the middle of the plantar arch were stimulated. Participants scored stimulated pricking discomfort or pain intensity 0 to 10 on a numerical rating scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At hands, intensity was rated on average 5 (1-10) [median (range)] by 114\/116 participants. Per foot, participants without DFU scored 5 (1-10), while those with DFU scored 0 (0-3) ( P &lt; .0001). At plantar toe skinfolds, the absence of pinprick pain perception detected DFU-associated sensory failure with an accuracy of 99.5% (sensitivity 99.5%, specificity 99.4%, positive likelihood ratio 248, and negative likelihood ratio 0.005).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this pilot study, nociceptive stimulation of a plantar toe skinfold with a 512\u2009mN optical glass-fiber pinprick accurately identified DFU-associated end-stage sensory failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1932296819900256","type":"journal-article","created":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T23:48:07Z","timestamp":1579218487000},"page":"622-629","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["A Novel Diagnostic Test for End-Stage Sensory Failure Associated With Diabetic Foot Ulceration: Proof-of-Principle Study"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8701-8523","authenticated-orcid":false,"given":"Ernst-Adolf","family":"Chantelau","sequence":"first","affiliation":[{"name":"Heinrich-Heine-University, D\u00fcsseldorf, Germany"},{"name":"Practice of Endocrinology and Diabetology PD Dr.Kimmerle, Aachener, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,1,16]]},"reference":[{"key":"bibr1-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-005-0645-y"},{"key":"bibr2-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100040701"},{"key":"bibr3-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh180"},{"key":"bibr4-1932296819900256","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1556"},{"key":"bibr5-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13715"},{"key":"bibr6-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6031-z"},{"key":"bibr7-1932296819900256","first-page":"1266","volume-title":"Management of the Diabetic Foot","volume":"1982","author":"Brand PW"},{"key":"bibr8-1932296819900256","volume-title":"Clinical and Experimental Approaches to the Diagnosis of Diabetic Neuropathy","author":"Tjon-A-Tsien AML.","year":"1995"},{"key":"bibr9-1932296819900256","first-page":"w13682","volume":"142","author":"Wienemann T","year":"2012","journal-title":"Swiss Med Wkly"},{"key":"bibr10-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198805193182005"},{"key":"bibr11-1932296819900256","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-9021"},{"key":"bibr12-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.16.1.1"},{"issue":"3","key":"bibr13-1932296819900256","first-page":"291","volume":"68","author":"Birke JA","year":"2000","journal-title":"Int J Lepr Other Mycobact Dis"},{"issue":"2","key":"bibr14-1932296819900256","first-page":"1","volume":"25","author":"Holewski JJ","year":"1988","journal-title":"J Rehabil Res Dev"},{"key":"bibr15-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.05.017"},{"key":"bibr16-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1080\/08990229771105"},{"key":"bibr17-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1007\/s00482-015-0093-2"},{"key":"bibr18-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh079"},{"key":"bibr19-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0099507"},{"key":"bibr20-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1053\/eujp.2001.0250"},{"key":"bibr21-1932296819900256","unstructured":"Marstock-Nervtest Dr. Heinrich Fruhstorfer, Weinbergweg 24, D-69198 Schriesheim\/Germany. http:\/\/www.marstock.de (Accessed October 23, 2019)."},{"key":"bibr22-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(78)80084-7"},{"key":"bibr23-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/122.12.2245"},{"key":"bibr24-1932296819900256","doi-asserted-by":"publisher","DOI":"10.3109\/08990229109144738"},{"key":"bibr25-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00524.2015"},{"key":"bibr26-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1152\/jn.2001.85.4.1561"},{"key":"bibr27-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1990.sp018135"},{"issue":"4","key":"bibr28-1932296819900256","first-page":"254","volume":"12","author":"Wienemann T","year":"2012","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"bibr29-1932296819900256","doi-asserted-by":"publisher","DOI":"10.3402\/dfa.v5.24926"},{"key":"bibr30-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.12.015"},{"key":"bibr31-1932296819900256","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1421"},{"key":"bibr32-1932296819900256","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.13.10.1057"},{"key":"bibr33-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2011.04.004"},{"key":"bibr34-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510330081039"},{"key":"bibr35-1932296819900256","unstructured":"Deeks JJ, Higgins JPT. Statistical algorithms in review manager 5 (2010). http:\/\/ims.cochrane.org\/revman\/documentation\/Statistical-methods-in-RevMan\u20135.pdf. Accessed October 23, 2019."},{"key":"bibr36-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7458.168"},{"key":"bibr37-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2738"},{"key":"bibr38-1932296819900256","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-S010"},{"key":"bibr39-1932296819900256","first-page":"37","volume-title":"The Foot in Diabetes","author":"Boulton AJM","year":"1994","edition":"2"},{"key":"bibr40-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2002.00706.x"},{"key":"bibr41-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2016.04.013"},{"key":"bibr42-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.12.342"},{"key":"bibr43-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1177\/1932296814531099"},{"key":"bibr44-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.55.1.56"},{"key":"bibr45-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1080\/08990220600700925"},{"key":"bibr46-1932296819900256","doi-asserted-by":"publisher","DOI":"10.5935\/0305-7518.19860028"},{"issue":"4","key":"bibr47-1932296819900256","first-page":"365","volume":"63","author":"Birke JA","year":"1992","journal-title":"Lepr Rev"},{"key":"bibr48-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.2917"},{"key":"bibr49-1932296819900256","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-37041-4"}],"container-title":["Journal of Diabetes Science and Technology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1932296819900256","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1932296819900256","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1932296819900256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:14:28Z","timestamp":1777400068000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1932296819900256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,16]]},"references-count":49,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1177\/1932296819900256"],"URL":"https:\/\/doi.org\/10.1177\/1932296819900256","relation":{},"ISSN":["1932-2968","1932-2968"],"issn-type":[{"value":"1932-2968","type":"print"},{"value":"1932-2968","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,16]]}}}