Biomechanical characteristics of peripheral diabetic neuropathy : a systematic review and meta-analysis of findings from the gait cycle, muscle activity and dynamic barefoot plantar pressure

Background: Diabetic peripheral neuropathy is an important cause of foot ulceration and limb loss. This systematic review and meta-analysis investigated the effect of diabetic peripheral neuropathy on gait, dynamic electromyography and dynamic plantar pressures. Methods: Electronic databases were searched systematically for articles reporting the effect of diabetic peripheral neuropathy on gait, dynamic electromyography and plantar pressures. Searches were restricted to articles published between January 2000 and April 2012. Outcome measures assessed included spatiotemporal parameters, lower limb kinematics, kinetics, muscle activation and plantar pressure. Meta-analyses were carried out on all outcome measures reported by ≥3 studies. Findings: Sixteen studies were included consisting of 382 neuropathy participants, 216 diabetes controls without neuropathy and 207 healthy controls. Meta-analysis was performed on 11 gait variables. A high level of heterogeneity was noted between studies. Meta-analysis results suggested a longer stance time and moderately higher plantar pressures in diabetic peripheral neuropathy patients at the rearfoot, midfoot and forefoot compared to controls. Systematic review of studies suggested potential differences in the biomechanical characteristics (kinematics, kinetics, EMG) of diabetic neuropathy patients. However these findings were inconsistent and limited by small sample sizes.; Interpretation: Current evidence suggests that patients with diabetic peripheral neuropathy have elevated plantar pressures and occupy a longer duration of time in the stance-phase during gait. Firm conclusions are hampered by the heterogeneity and small sample sizes of available studies. Interpretation: Current evidence suggests that patients with diabetic peripheral neuropathy have elevated plantar pressures and occupy a longer duration of time in the stance-phase during gait. Firm conclusions are hampered by the heterogeneity and small sample sizes of available studies.

Adhesive characteristics of low dimensional carbon nanomaterial on actin

The biosafety of carbon nanomaterial needs to be critically evaluated with both experimental and theoretical validations before extensive biomedical applications. In this letter, we present an analysis of the binding ability of two dimensional monolayer carbon nanomaterial on actin by molecular simulation to understand their adhesive characteristics on F-actin cytoskeleton. The modelling results indicate that the positively charged carbon nanomaterial has higher binding stability on actin. Compared to crystalline graphene, graphene oxide shows higher binding influence on actin when carrying positive surface charge. This theoretical investigation provides insights into the sensitivity of actin-related cellular activities on carbon nanomaterial.

Damage detection in cable structures using vibration characteristics

Cable structures find many applications such as in power transmission, in anchors and especially in bridges. They serve as major load bearing elements in suspension bridges, which are capable of spanning long distances. All bridges, including suspension bridges, are designed to have long service lives. However, during this long life, they become vulnerable to damage due to changes in loadings, deterioration with age and random action such as impacts. The main cables are more vulnerable to corrosion and fatigue, compared to the other bridge components, and consequently reduces the serviceability and ultimate capacity of the bridge. Detecting and locating such damage at the earliest stage is challenging in the current structural health monitoring (SHM) systems of long span suspension bridges. Damage or deterioration of a structure alters its stiffness, mass and damping properties which in turn modify its vibration characteristics. This phenomenon can therefore be used to detect damage in a structure. The modal flexibility, which depends on the vibration characteristics of a structure, has been identified as a successful damage indicator in beam and plate elements, trusses and simple structures in reinforced concrete and steel. Successful application of the modal flexibility phenomenon to detect and locate the damage in suspension bridge main cables has received limited attention in recent research work. This paper, therefore examines the potential of the modal flexibility based Damage Index (DI) for detecting and locating damage in the main cable of a suspension bridge under four different damage scenarios. Towards this end, a numerical model of a suspension bridge cable was developed to extract the modal parameters at both damaged and undamaged states. Damage scenarios considered in this study with varied location and severity were simulated by changing stiffness at particular locations of the cable model. Results confirm that the DI has the potential to successfully detect and locate damage in suspension bridge main cables. This simple method can therefore enable bridge engineers and managers to detect and locate damage in suspension bridges at an early stage, minimize expensive retrofitting and prevent bridge collapse.

Effects of scaffold architecture on mechanical characteristics and osteoblast response to static and perfusion bioreactor cultures

Tissue engineering focuses on the repair and regeneration of tissues through the use of biodegradable scaffold systems that structurally support regions of injury whilst recruiting and/or stimulating cell populations to rebuild the target tissue. Within bone tissue engineering, the effects of scaffold architecture on cellular response have not been conclusively characterized in a controlled-density environment. We present a theoretical and practical assessment of the effects of polycaprolactone (PCL) scaffold architectural modifications on mechanical and flow characteristics as well as MC3T3-E1 preosteoblast cellular response in an in vitro static plate and custom-designed perfusion bioreactor model. Four scaffold architectures were contrasted, which varied in inter-layer lay-down angle and offset between layers, whilst maintaining a structural porosity of 60 ± 5%. We established that as layer angle was decreased (90° vs. 60°) and offset was introduced (0 vs. 0.5 between layers), structural stiffness, yield stress, strength, pore size and permeability decreased, whilst computational fluid dynamics-modeled wall shear stress was increased. Most significant effects were noted with layer offset. Seeding efficiencies in static culture were also dramatically increased due to offset (~45% to ~86%), with static culture exhibiting a much higher seeding efficiency than perfusion culture. Scaffold architecture had minimal effect on cell response in static culture. However, architecture influenced osteogenic differentiation in perfusion culture, likely by modifying the microfluidic environment.

Epidemiologic characteristics of cases for influenza A(H7N9) virus infections in China

China's National Health and Family Planning Commission announced 3 deaths caused by avian-origin influenza A(H7N9) virus in March, which was the first time that the H7N9 strain has been found in humans [1]. This is of major public health significance and raises urgent questions and global concerns [2, 3]. To explore epidemic characteristics of human infections with H7N9 virus, data on individual cases from 19 February 2013 (onset date of first case) to 14 April 2013 were collected from the China Information System for Disease Control and Prevention, which included information about sex; age; occupation; residential address; and day of symptom onset, diagnosis, and outcome for each case. The definition of an unconfirmed probable H7N9 case is a patient with epidemiologic evidence of contact …

Longitudinal assessment of neuropathy in type 1 diabetes using novel ophthalmic markers (LANDMark) : study design and baseline characteristics

Aims Corneal nerve morphology and corneal sensation threshold have recently been explored as potential surrogate markers for the evaluation of diabetic neuropathy. We present the baseline findings of the ‘Longitudinal Assessment of Neuropathy in type 1 Diabetes using novel ophthalmic Markers’(LANDMark) study. Methods The LANDMark study is a 4-year, two-site, natural history study of three participant groups: type 1 diabetes with neuropathy (T1W), type 1 diabetes without neuropathy (T1WO) and control participants without diabetes or neuropathy. All participants undergo a detailed annual assessment of neuropathy including corneal nerve parameters measured using corneal confocal microscopy and corneal sensitivity measured using non-contact corneal aesthesiometry. Results 76 T1W, 166 T1WO and 154 control participants were enrolled into the study. Corneal sensation threshold (mbars) was significantly higher (i.e. sensitivity was lower) in T1W (1.0 ± 1.1) than T1WO (0.7 ± 0.7) and controls (0.6 ± 0.4) (p < 0.001), with no difference between T1WO and controls. Corneal nerve fibre length was lower in T1W (14.0 ± 6.4 mm/mm2) compared to T1WO (19.1 ± 5.8 mm/mm2) and controls (23.2 ± 6.3 mm/mm2) (p < 0.001). Corneal nerve fibre length was lower in T1WO compared to controls. Conclusions The LANDMark baseline findings confirm a reduction in corneal sensitivity only in Type 1 patients with neuropathy. However, corneal nerve fibre length is reduced even in Type 1 patients without neuropathy with an even greater deficit in Type 1 patients with neuropathy.

High-growth firms : characteristics, job contribution and method observations

Largely as a result of mass unemployment problems in many European countries, the dynamics of job creation has in recent years attracted increased interest on the part of academics as well as policy-makers. In connection to this, a large number of studies carried out in various countries have concluded that SMEs play a very large and/or growing role as job creators (Birch, 1979; Baldwin and Picot, 1995; Davidsson, 1995a; Davidsson, Lindmark and Olofsson, 1993; 1994; 1995; 1997a; 1997b; Fumagelli and Mussati, 1993; Kirchhoff and Phillips, 1988; Spilling, 1995; for further reference to studies carried out in a large number of countries see also Aiginger and Tichy, 1991; ENSR, 1994; Loveman and Sengenberger, 1991; OECD, 1987; Storey and Johnson, 1987). While most researchers agree on the importance of SMEs, there is some controversy as regards whether this is mainly a result of many small start-ups and incremental expansions, or if a small minority of high growth SMEs contribute the lion’s share of new employment. This is known as the ‘mice vs. gazelles’ or ‘flyers vs. trundlers’ debate. Storey strongly advocates the position that the small group of high growth SMEs are the ‘real’ job creators (Storey, 1994; Storey & Johnson, 1987), whereas, e.g., the Davidsson et al research in Sweden (cf. above) gives more support for the ‘mice’ hypothesis.

Mathematical relationships for metal build-up on urban road surfaces based on traffic and land use characteristics

The study investigated the influence of traffic and land use parameters on metal build-up on urban road surfaces. Mathematical relationships were developed to predict metals originating from fuel combustion and vehicle wear. The analysis undertaken found that nickel and chromium originate from exhaust emissions, lead, copper and zinc from vehicle wear, cadmium from both exhaust and wear and manganese from geogenic sources. Land use does not demonstrate a clear pattern in relation to the metal build-up process, though its inherent characteristics such as traffic activities exert influence. The equation derived for fuel related metal load has high cross-validated coefficient of determination (Q2) and low Standard Error of Cross-Validation (SECV) values indicates that the model is reliable, while the equation derived for wear-related metal load has low Q2 and high SECV values suggesting its use only in preliminary investigations. Relative Prediction Error values for both equations are considered to be well within the error limits for a complex system such as an urban road surface. These equations will be beneficial for developing reliable stormwater treatment strategies in urban areas which specifically focus on mitigation of metal pollution.

Time as the critical factor in the investigation of the relationship between pollutant wash-off and rainfall characteristics

The approach adopted for investigating the relationship between rainfall characteristics and pollutant wash-off process is commonly based on the use of parameters which represent the entire rainfall event. This does not permit the investigation of the influence of rainfall characteristics on different sectors of the wash-off process such as first flush where there is a high pollutant wash-off load at the initial stage of the runoff event. This research study analysed the influence of rainfall characteristics on the pollutant wash-off process using two sets of innovative parameters by partitioning wash-off and rainfall characteristics. It was found that the initial 10% of the wash-off process is closely linked to runoff volume related rainfall parameters including rainfall depth and rainfall duration while the remaining part of the wash-off process is primarily influenced by kinetic energy related rainfall parameters, namely, rainfall intensity. These outcomes prove that different sectors of the wash-off process are influenced by different segments of a rainfall event.

Conditions for Successful Reforms : Characteristics of the Organisation and Culture in Chinese Schools in a Global Context

Reforms to the basic education system in China have reflected an increasing awareness of and openness to new ideas from the global education sphere. Many of the concepts involved in the development and implementation of these reforms, including adopting holistic perspectives of student development; decentralising school governance to facilitate local decision-making to address local needs; and, an increased focus on practical, lifelong learning for all involved in schools, have been promoted in research and policies throughout the world. While working within this global context, the system of schooling in China has retained a unique character that is quite different from education in the West. Drawing on an international project on school transformation, this chapter aims to examine how five secondary schools in Chongqing, a municipality in Southwestern China, have harnessed and aligned their resources to provide effective school governance following the curriculum reforms. Furthermore, the chapter will examine the similarities and differences between the organisational structures and cultures of these schools in China and successful schools in Australia, England, Finland, Wales and the United States.

Global characteristics of school transformation in China

In many ways, China’s education system is quite different from systems of education in the West. Rich descriptions of school transformation, however, have revealed that the factors that fuelled transformation in schools in China are also evident in schools in Australia, England, Finland, Wales and the United States. This paper draws on an international project that examined how secondary schools from six countries achieved success by developing and drawing on their resources, referred to as four forms of capital: financial, intellectual, social and spiritual. It describes how five secondary schools in Chongqing, Western China, viewed each form of capital and how the four forms of capital were strengthened and aligned through outstanding governance to support the success of all students. The case is made that, although some aspects of the forms of capital found in schools in China may be viewed differently, the approaches adopted by these schools share a number of common elements with approaches to school transformation identified in Western schools. It is argued that these common elements from a range of international settings constitute a rich evidence base for understanding school transformation and for new insights in governance and leadership.

Characteristics of spatial variation, size distribution, formation and growth of particles in urban environments

This thesis is the first comprehensive study of important parameters relating to aerosols' impact on climate and human health, namely spatial variation, particle size distribution and new particle formation. We determined the importance of spatial variation of particle number concentration in microscale environments, developed a method for particle size parameterisation and provided knowledge about the chemistry of new particle formation. This is a significant contribution to our understanding of processes behind the transformation and dynamics of urban aerosols. This PhD project included extensive measurements of air quality parameters using state of the art instrumentation at each of the 25 sites within the Brisbane metropolitan area and advanced statistical analysis.

Socio-demographic characteristics, modifiable lifestyle factors, and health as predictors of mental health in midlife and older Australian women: a multilevel investigation

Background Poor mental health is a significant cause of morbidity and mortality, yet debate continues about factors most likely to predict poor mental health outcomes. Objective This cohort study examines the influence of modifiable lifestyle factors, menopausal symptoms, and physical health on the mental health of midlife and older Australian women. Methods: Random sampling was used to recruit women aged 40-55, from rural and urban areas of Queensland, Australia. Overall, 340 women completed mailed surveys on socio-demographic characteristics, midlife symptoms (Greene Climacteric Scale©), modifiable lifestyle factors, and mental health (SF-12©) in 2001, 2004 and 2011. Hierarchical repeated-measure models were used to explore the correlates of poor mental health over time. Results The mean age [SD] at baseline was 55 [2.7] years, most were married (73%, n=248) and 18% were pre-menopausal. The model suggested that variance in mental health widened and showed a non-linear increase with age. Decrements in mental health were associated with an increase in midlife symptoms (Greene psychological scale, P <0.01; Greene somatic scale, P <0.05), time (P <0.01), poor physical health (P <0.01) and individual variance (P <0.01). Socio-demographics and lifestyle factors had little influence on mental health over time. Conclusion Findings suggest that while women’s mental health may decline during midlife, the effect is temporary; in older women, physical health and individual factors seem to be increasingly significant. This research highlights the importance of active health promotion as a means of enhancing both physical and mental health in midlife women.

Use of vibration characteristics to predict the axial deformation of columns

Vibration characteristics of columns are influenced by their axial loads. Numerous methods have been developed to quantify axial load and deformation in individual columns based on their natural frequencies. However, these methods cannot be applied to columns in a structural framing system as the natural frequency is a global parameter of the entire framing system. This paper presents an innovative method to quantify axial deformations of columns in a structural framing system using its vibration characteristics, incorporating the influence of load tributary areas, boundary conditions and load migration among the columns.

The penetrance and characteristics of contact lens wear in Australia

Background A population-based, cross-sectional telephone survey was conducted to estimate the penetrance and characteristics of contact lens wear in Australia. Methods Based on postcode distribution, 42,749 households around Australia were randomly selected from the national electronic telephone directory. During calls, the number of individuals and contact lens wearers in each household aged between 15 and 64 years was ascertained. Contact lens wearers were interviewed using a structured questionnaire, to determine details of demographics, lens type, mode of lens wear and hygienic habits. Contact lens wear characteristics and habits were compared by lens type and mode of use. Results Of the 32,405 households contacted, 19,171 (59.2 per cent) agreed to participate. The penetrance of contact lens wear during the study period was 5.01 per cent (95% CI: 4.78-5.24). The mean age of lens wearers was 36.5 ± 18.3 years and 63.4 per cent were female. There were significant differences in the habits and characteristics of lens wearers depending on their lens type and mode of use. Conclusions The penetrance of contact lens wear concurs with market estimates and equates to approximately 680,000 contact lens wearers aged between 15 and 64 years in Australia. This is the most detailed and extensive population-based survey of contact lens wearers ever conducted. The discrepancies found between the characteristics of lens wearers surveyed in this study compared to those in previous studies of contact lens practitioners highlights the importance of study design. These results may be applied to other regions with similar health-care and regulatory systems.