The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: Development of an evidence-based global consensus

Foot problems complicating diabetes are a source of major patient suffering and societal costs. Investing in evidence-based, internationally appropriate diabetic foot care guidance is likely among the most cost-effective forms of healthcare expenditure, provided it is goal-focused and properly implemented. The International Working Group on the Diabetic Foot (IWGDF) has been publishing and updating international Practical Guidelines since 1999. The 2015 updates are based on systematic reviews of the literature, and recommendations are formulated using the Grading of Recommendations Assessment Development and Evaluation system. As such, we changed the name from 'Practical Guidelines' to 'Guidance'. In this article we describe the development of the 2015 IWGDF Guidance documents on prevention and management of foot problems in diabetes. This Guidance consists of five documents, prepared by five working groups of international experts. These documents provide guidance related to foot complications in persons with diabetes on: prevention; footwear and offloading; peripheral artery disease; infections; and, wound healing interventions. Based on these five documents, the IWGDF Editorial Board produced a summary guidance for daily practice. The resultant of this process, after reviewed by the Editorial Board and by international IWGDF members of all documents, is an evidence-based global consensus on prevention and management of foot problems in diabetes. Plans are already under way to implement this Guidance. We believe that following the recommendations of the 2015 IWGDF Guidance will almost certainly result in improved management of foot problems in persons with diabetes and a subsequent worldwide reduction in the tragedies caused by these foot problems.

Sangen ialo Rucous : Schwenckfeldiläisten rukouskirja Mikael Agricolan lähteenä

Sangen ialo Rucous. The prayer book of the Schwenckfeldiens as a source for Michael Agricola The significance of the prayer book published by the Finnish reformer Michael Agricola in the year of 1544 has not been comprehended enough among the prayer literature of the Reformation century. Especially in foreign research literature one of the era s most extensive and versatile prayer books has been practically disregarded. According to the prayer book, Agricola appears to be a traditionalist, who derives most of his source material from medieval and old church prayer books. The low number of the prayers from Evangelical prayer books is noteworthy. The study in hand examines Agricola s theology expressed in his translation work of the prayer book of the mystic spiritualistic Schwenckfeldien movement. The prayer book of the Schwenckdeldiens diverged from Lutheranism was called Bekantnus der sünden and it was composed around the year of 1526. Agricola is the only prayer book collector who has regarded it as necessary to add all the 45 prayers of the Schwenckfeldien prayer book and its introduction to his book. In the prayers containing the Schwenckfeldien communion theology and Christology Agricola has not changed the content of the text, apparently because he was not aware of the problems involved in the Schwenckfeldien theology. On a few occasions Agricola added points of view concerning the church, priesthood, preaching the Word and sacraments to his prayers, which the Schwenckfeldiens despised. From the ten additions four Agricola created himself, the rest he borrowed from Wolfgang Capito s prayer book. As a source Agricola used Capito s Latin prayer book together with the German text from Bekantnus. When looking at the studied material, Agricola does not turn out to be a creative translator. Even though he had a model for a less restricted translation in Wolfgang Capito s prayer book, he sticks to his habit of translating word by word. Because not even a good example has had a liberating effect on his translation principles, Agricola cannot be considered a theologically orientated writer. The translation of the Schwenckfeldien prayers Agricola starts with Capito s prayer book. Very soon he takes the Bekantnus alongside Capito s text and abandons the use of Capito s prayer book in the middle of the translation process. Comparing Agricola s translation with the two texts in different languages has made it possible to create the disposition theory described above. On the basis of the disposition theory it can be concluded that Agricola first worked out a precise plan for his prayer book. Then he translated prayers theme by theme using multiple sources at the same time. Later Agricola fixed the disposition, which does not seem to have a direct paragon. From the prayers of the Schwenckfeldien prayer book Agricola translated 26 texts using the Bekantnus as an only base, from Capito s prayer book he translated four texts and 17 texts he translated using the two basic texts simultaneously. In the previous studies, words and texts added by Agricola have been examined as one problem unit. In this study the additions have been placed into three different categories: additions consequential on tautological parataxis, specifying additions and additions significant to the content. Due to Agricola s meticulous translation techniques, there are so few additions. Agricola does not show his own creativity even in the additions significant to the content but uses there some complete sentences or word fragments from the other prayers he has translated. In the translations of the prayers there are some unique appearing words and the analysis of the translation work shed a new light on the background of their first literary appearance in Finnish. Agricola s linguistic abilities turned out to be great. In those prayers where Agricola uses both the German and Latin basic texts at the same time, the translation process is a very intensive twine made on the basis of the two sources.

One Word, One Body, One Voice : Studies in Apophatic Theology and Christocentric Anthropology in Gregory of Nyssa

The thesis consists of five international congress papers and a summary with an introduction. The overarching aim of the studies and the summary is to examine the inner coherency of the theological and anthropological thinking of Gregory of Nyssa (331-395). To the issue is applied an "apophatic approach" with a "Christological focus". It is suggested that the coherency is to be found from the Christological concept of unity between "true God" and "true man" in the one person of Jesus Christ. Gregory is among the first to make a full recognition of two natures of Christ, and to use this recognition systematically in his writings. The aim of the studies is pursued by the method of "identification", a combination of the modern critical "problematic method" and Gregory's own aphairetic method of "following" (akolouthia). The preoccupation with issues relating to the so-called Hellenization of Christianity in the patristic era was strong in the twentieth-century Gregory scholarship. The most discussed questions have been the Greek influence in his thought and his philosophical sources. In the five articles of the thesis it is examined how Gregory's thinking stands in its own right. The manifestly apophatic character of his theological thinking is made a part of the method of examining his thought according to the principles of his own method of following. The basic issue concerning the relation of theology and anthropology is discussed in the contexts of his central Trinitarian, anhtropological, Christological and eschatological sources. In the summary the Christocentric integration of Gregory's thinking is discussed also in relation to the issue of the alledged Hellenization. The main conclusion of the thesis concerns the concept of theology in Gregory. It is not indebted to the classical concept of theology as metaphysics or human speculation of God. Instead, it is founded to the traditional Judeo-Christian idea of God who speaks with his people face to face. In Gregory, theologia connotes the oikonomia of God's self-revelation. It may be regarded as the state of constant expression of love between the Creator and his created image. In theology, the human person becomes an image of the Word by which the Father expresses his love to "man" whom he loves as his own Son. Eventually the whole humankind, as one, gives the divine Word a physical - audible and sensible - Body. Humankind then becomes what theology is. The whole humanity expresses divine love by manifesting Christ in words and deeds, singing in one voice to the glory of the Father, the Son and the Holy Spirit.

Finite field computation technique for exact solution of systems of linear equations and interval linear programming problems

An error-free computational approach is employed for finding the integer solution to a system of linear equations, using finite-field arithmetic. This approach is also extended to find the optimum solution for linear inequalities such as those arising in interval linear programming probloms.

Gene therapy: Principles, practice, problems and prospects

The remarkable advances made in recombinant DNA technology over the last two decades have paved way for the use of gene transfer to treat human diseases. Several protocols have been developed for the introduction and expression of genes in humans, but the clinical efficacy has not been conclusively demonstrated in any of them. The eventual success of gene therapy for genetic and acquired disorders depends on the development of better gene transfer vectors for sustained, long term expression of foreign genes as well as a better understanding of the pathophysiology of human diseases, it is heartening to note that some of the gene therapy protocols have found other applications such as the genetic immunization or DNA vaccines, which is being heralded as the third vaccine revolution, Gene therapy is yet to become a dream come true, but the light is seen at the end of the tunnel.

Effect of soil variability on the bearing capacity of clay and in slope stability problems

Site-specific geotechnical data are always random and variable in space. In the present study, a procedure for quantifying the variability in geotechnical characterization and design parameters is discussed using the site-specific cone tip resistance data (qc) obtained from static cone penetration test (SCPT). The parameters for the spatial variability modeling of geotechnical parameters i.e. (i) existing trend function in the in situ qc data; (ii) second moment statistics i.e. analysis of mean, variance, and auto-correlation structure of the soil strength and stiffness parameters; and (iii) inputs from the spatial correlation analysis, are utilized in the numerical modeling procedures using the finite difference numerical code FLAC 5.0. The influence of consideration of spatially variable soil parameters on the reliability-based geotechnical deign is studied for the two cases i.e. (a) bearing capacity analysis of a shallow foundation resting on a clayey soil, and (b) analysis of stability and deformation pattern of a cohesive-frictional soil slope. The study highlights the procedure for conducting a site-specific study using field test data such as SCPT in geotechnical analysis and demonstrates that a few additional computations involving soil variability provide a better insight into the role of variability in designs.

On Sharma-Swarup algorithm for time minimising transportation problems

In this note, the fallacy in the method given by Sharma and Swarup, in their paper on time minimising transportation problem, to determine the setS hkof all nonbasic cells which when introduced into the basis, either would eliminate a given basic cell (h, k) from the basis or reduce the amountx hkis pointed out.

An FETI-preconditioned conjuerate gradient method for large-scale stochastic finite element problems

In the spectral stochastic finite element method for analyzing an uncertain system. the uncertainty is represented by a set of random variables, and a quantity of Interest such as the system response is considered as a function of these random variables Consequently, the underlying Galerkin projection yields a block system of deterministic equations where the blocks are sparse but coupled. The solution of this algebraic system of equations becomes rapidly challenging when the size of the physical system and/or the level of uncertainty is increased This paper addresses this challenge by presenting a preconditioned conjugate gradient method for such block systems where the preconditioning step is based on the dual-primal finite element tearing and interconnecting method equipped with a Krylov subspace reusage technique for accelerating the iterative solution of systems with multiple and repeated right-hand sides. Preliminary performance results on a Linux Cluster suggest that the proposed Solution method is numerically scalable and demonstrate its potential for making the uncertainty quantification Of realistic systems tractable.

Pseudo-time marching schemes for inverse problems in structural health assessment and medical imaging

We propose a self-regularized pseudo-time marching strategy for ill-posed, nonlinear inverse problems involving recovery of system parameters given partial and noisy measurements of system response. While various regularized Newton methods are popularly employed to solve these problems, resulting solutions are known to sensitively depend upon the noise intensity in the data and on regularization parameters, an optimal choice for which remains a tricky issue. Through limited numerical experiments on a couple of parameter re-construction problems, one involving the identification of a truss bridge and the other related to imaging soft-tissue organs for early detection of cancer, we demonstrate the superior features of the pseudo-time marching schemes.

Problems and prospects in neurochemistry

The importance of neurochemistry in understanding the functional basis of the nervous system was emphasized. Attention was drawn to the role of lipids, particularly the sphingolipids,whose metabolic abnormalities lead to 'sphingolipidosis' In the brain and to gangliosides, which show growth-promoting and neuritogenic properties. Several questions that remain to be answered in this area were enumerated. It was pointed out that neurons make a large number of proteins, an order of magnitude higher than other cells, and several of these are yet to be characterized and their functional significance established. Myelination and synapto-genesis are two fundamental processes in brain development. Although much is known about myelin lipids and proteins, it is not known what signals the glial cell receives to initiate myelin synthesis around the axon, In fact, the process of myelination provides an excellent system for studying membrane biogenesis and cell-sell interaction. Great strides were made in the understanding of neurotransmitter receptors and their function in synaptic transmission, but how neurons make synapses with other specific neurons in a preprogrammed manner is not known and requires immediate study. In this context, it was stressed that developmental neurobiology of the human brain could be most profitably done in India. The importance and complexity of signal transduction mechanisms in the brain was explained and many fundamental questions that remain to be answered were discussed. In conclusion, several other areas of contemporary research interest in the nervous system were mentioned and it was suggested that a 'National Committee for Brain Research' be constituted to identify and intensify research programmes in this vital field.

Multi-channel curve crossing problems: analytically solvable model

We have proposed a general method for finding the exact analytical solution for the multi-channel curve crossing problem in the presence of delta function couplings. We have analysed the case where aa potential energy curve couples to a continuum (in energy) of the potential energy curves.

Shortcomings of discontinuous-pressure finite element methods on a class of transient problems

Past studies that have compared LBB stable discontinuous- and continuous-pressure finite element formulations on a variety of problems have concluded that both methods yield Solutions of comparable accuracy, and that the choice of interpolation is dictated by which of the two is more efficient. In this work, we show that using discontinuous-pressure interpolations can yield inaccurate solutions at large times on a class of transient problems, while the continuous-pressure formulation yields solutions that are in good agreement with the analytical Solution.

Re-inventing the f word - it's feminism!

This article discusses approaches to feminist art practice by early career Australian women artists in the context of 'Contemporary Australia: Women', an exhibition held at the Gallery of Modern Art (GOMA), Brisbane in 2012.

Agents Based Algorithms for Design Parameter Estimation in Contaminant Transport Inverse Problems

A considerable amount of work has been dedicated on the development of analytical solutions for flow of chemical contaminants through soils. Most of the analytical solutions for complex transport problems are closed-form series solutions. The convergence of these solutions depends on the eigen values obtained from a corresponding transcendental equation. Thus, the difficulty in obtaining exact solutions from analytical models encourages the use of numerical solutions for the parameter estimation even though, the later models are computationally expensive. In this paper a combination of two swarm intelligence based algorithms are used for accurate estimation of design transport parameters from the closed-form analytical solutions. Estimation of eigen values from a transcendental equation is treated as a multimodal discontinuous function optimization problem. The eigen values are estimated using an algorithm derived based on glowworm swarm strategy. Parameter estimation of the inverse problem is handled using standard PSO algorithm. Integration of these two algorithms enables an accurate estimation of design parameters using closed-form analytical solutions. The present solver is applied to a real world inverse problem in environmental engineering. The inverse model based on swarm intelligence techniques is validated and the accuracy in parameter estimation is shown. The proposed solver quickly estimates the design parameters with a great precision.