A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable

Diabetic foot ulceration poses a heavy burden on the patient and the healthcare system, but prevention thereof receives little attention. For every euro spent on ulcer prevention, ten are spent on ulcer healing, and for every randomized controlled trial conducted on prevention, ten are conducted on healing. In this article, we argue that a shift in priorities is needed. For the prevention of a first foot ulcer, we need more insight into the effect of interventions and practices already applied globally in many settings. This requires systematic recording of interventions and outcomes, and well-designed randomized controlled trials that include analysis of cost-effectiveness. After healing of a foot ulcer, the risk of recurrence is high. For the prevention of a recurrent foot ulcer, home monitoring of foot temperature, pressure-relieving therapeutic footwear, and certain surgical interventions prove to be effective. The median effect size found in a total of 23 studies on these interventions is large, over 60%, and further increases when patients are adherent to treatment. These interventions should be investigated for efficacy as a state-of-the-art integrated foot care approach, where attempts are made to assure treatment adherence. Effect sizes of 75-80% may be expected. If such state-of-the-art integrated foot care is implemented, the majority of problems with foot ulcer recurrence in diabetes can be resolved. It is therefore time to act and to set a new target in diabetic foot care. This target is to reduce foot ulcer incidence with at least 75%.

Running Men

In this multi-screen installation, iconic male characters from Hollywood films are reconfigured to create infinitely looping scenes of running; trapping the characters in a kind of Nietchzen eternal recurrence. Stemming primarily from my investigation into anxiety as a shared social experience, the carefully edited, looped, and rotoscoped characters become avatars or surrogates for myself, and for the viewer. Through this editing, they are caught in a space of relentless confusion and paranoia – they run with, and from, anxiety. They are never caught by any unseen pursuers, but are equally unable to catch up to any unseen goal. These figures act as models of masculinity, they are objects of identification and emulation. Simultaneously, as celebrities, they are also fictions of the media sphere, both real and ethereal, they are impossible to grasp. In this duality, the work also references cinema’s tangled conflation of character and celebrity identity. It examines the subjective and intersubjective engagements we can have with popular culture, and the way that these engagements can as strategies to ‘make sense’ of social experiences. The work was exhibited in the Carriageworks space of ‘You Imagine What You Desire’, the 19th Biennale of Sydney.

Running men: The precarious, paranoid body in screen culture

This paper discusses my video installation Running Men as an example of how an artist’s appropriative engagements with screen images of the perilous body can reflect the technological zeitgeist of the last hundred years but also create a space of meditative and mediated reflection in Slavoj Žižek’s “endlessness” of the present-future. In this artwork, iconic male characters from Hollywood films are recontextualised to create infinitely looping scenes of running; trapping the characters in a kind of Nietchzen eternal recurrence that suspends them between impending violence and uncertain futures. Stemming primarily from my investigation into anxiety as a shared social experience, one perhaps primed by the increasing intensity of visual culture in the 21st century, these digitally reconfigured bodies become avatars or surrogates for myself, and for the viewer. Through selective editing, these emblematic figures are caught in a space of relentless confusion and paranoia – they run with, and from anxiety. They are never caught by any unseen pursuers, but are equally unable to catch up to any unseen goal. These figures map an historical trajectory of violence and masculinity as it has been projected through various iterations of screen culture Simultaneously, as celebrities, they are also fictions of the media sphere, both real and ethereal, they are impossible to grasp but paradoxically are objects of identification and emulation. In this duality, the work also references cinema’s tangled conflation of character and celebrity identity. This discussion will address the two distinct but connected sites and activities of body/image engagement. Firstly, the artistic process and conceptual ramifications of this activity, and secondly in the artwork’s potential as an installation to provide an opportunity for the viewer (like the artist) to reflect on the constructed-ness and complicated power structures at play in the representation of a gendered body.

Cancer stem cells in oesophageal squamous cell carcinoma: Identification, prognostic and treatment perspectives

Cancer stem cells (CSCs) are a vital subpopulation of cells to target for the treatment of cancers. In oesophageal squamous cell carcinoma (ESCC), there are several markers such as CD44, ALDH, Pygo2, MAML1, Twist1, Musashi1, Side population (SP), CD271 and CD90 that have been proposed to identify the cancer stem cells in individual cancer masses. It has also been demonstrated that stem cell markers like ALDH1, HIWI, Oct3/4, ABCG2, SOX2, SALL4, BMI-1, NANOG, CD133 and podoplanin are associated with patient's prognosis, pathological stages, cancer recurrence and therapy resistance. Finding new cancer stem cell targets or designing drugs to manipulate the known molecular targets in CSCs could be useful for improvements in clinical outcomes of the disease. To conclude, data suggest that CSCs in oesophageal squamous cell carcinoma are related to resistance to therapy and poor prognosis of patients with ESCC. Therefore, innovative insights into CSC biology and CSC-targeted therapies will help to achieve more effective management of patients with oesophageal squamous cell carcinoma.

Selecting rainfall events for effective Water Sensitive Urban Design: A case study in Gold Coast City, Australia

The current approach for protecting the receiving water environment from urban stormwater pollution is the adoption of structural measures commonly referred to as Water Sensitive Urban Design (WSUD). The treatment efficiency of WSUD measures closely depends on the design of the specific treatment units. As stormwater quality is influenced by rainfall characteristics, the selection of appropriate rainfall events for treatment design is essential to ensure the effectiveness of WSUD systems. Based on extensive field investigations in four urban residential catchments based at Gold Coast, Australia, and computer modelling, this paper details a technically robust approach for the selection of rainfall events for stormwater treatment design using a three-component model. The modelling results confirmed that high intensity-short duration events produce 58.0% of TS load while they only generated 29.1% of total runoff volume. Additionally, rainfall events smaller than 6-month average recurrence interval (ARI) generates a greater cumulative runoff volume (68.4% of the total annual runoff volume) and TS load (68.6% of the TS load exported) than the rainfall events larger than 6-month ARI. The results suggest that for the study catchments, stormwater treatment design could be based on the rainfall which had a mean value of 31 mm/h average intensity and 0.4 h duration. These outcomes also confirmed that selecting smaller ARI rainfall events with high intensity-short duration as the threshold for treatment system design is the most feasible approach since these events cumulatively generate a major portion of the annual pollutant load compared to the other types of events, despite producing a relatively smaller runoff volume. This implies that designs based on small and more frequent rainfall events rather than larger rainfall events would be appropriate in the context of efficiency in treatment performance, cost-effectiveness and possible savings in land area needed.