Intensive versus conventional glycaemic control for treating diabetic foot ulcers

Background The estimated likelihood of lower limb amputation is 10 to 30 times higher amongst people with diabetes compared to those without diabetes. Of all non-traumatic amputations in people with diabetes, 85% are preceded by a foot ulcer. Foot ulceration associated with diabetes (diabetic foot ulcers) is caused by the interplay of several factors, most notably diabetic peripheral neuropathy (DPN), peripheral arterial disease (PAD) and changes in foot structure. These factors have been linked to chronic hyperglycaemia (high levels of glucose in the blood) and the altered metabolic state of diabetes. Control of hyperglycaemia may be important in the healing of ulcers. Objectives To assess the effects of intensive glycaemic control compared to conventional control on the outcome of foot ulcers in people with type 1 and type 2 diabetes. Search methods In December 2015 we searched: The Cochrane Wounds Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; EBSCO CINAHL; Elsevier SCOPUS; ISI Web of Knowledge Web of Science; BioMed Central and LILACS. We also searched clinical trial databases, pharmaceutical trial databases and current international and national clinical guidelines on diabetes foot management for relevant published, non-published, ongoing and terminated clinical trials. There were no restrictions based on language or date of publication or study setting. Selection criteria Published, unpublished and ongoing randomised controlled trials (RCTs) were considered for inclusion where they investigated the effects of intensive glycaemic control on the outcome of active foot ulcers in people with diabetes. Non randomised and quasi-randomised trials were excluded. In order to be included the trial had to have: 1) attempted to maintain or control blood glucose levels and measured changes in markers of glycaemic control (HbA1c or fasting, random, mean, home capillary or urine glucose), and 2) documented the effect of these interventions on active foot ulcer outcomes. Glycaemic interventions included subcutaneous insulin administration, continuous insulin infusion, oral anti-diabetes agents, lifestyle interventions or a combination of these interventions. The definition of the interventional (intensive) group was that it should have a lower glycaemic target than the comparison (conventional) group. Data collection and analysis All review authors independently evaluated the papers identified by the search strategy against the inclusion criteria. Two review authors then independently reviewed all potential full-text articles and trials registry results for inclusion. Main results We only identified one trial that met the inclusion criteria but this trial did not have any results so we could not perform the planned subgroup and sensitivity analyses in the absence of data. Two ongoing trials were identified which may provide data for analyses in a later version of this review. The completion date of these trials is currently unknown. Authors' conclusions The current review failed to find any completed randomised clinical trials with results. Therefore we are unable to conclude whether intensive glycaemic control when compared to conventional glycaemic control has a positive or detrimental effect on the treatment of foot ulcers in people with diabetes. Previous evidence has however highlighted a reduction in risk of limb amputation (from various causes) in people with type 2 diabetes with intensive glycaemic control. Whether this applies to people with foot ulcers in particular is unknown. The exact role that intensive glycaemic control has in treating foot ulcers in multidisciplinary care (alongside other interventions targeted at treating foot ulcers) requires further investigation.

Multilevel Dodecagonal Space Vector Generation for Open-end Winding Induction Motor Drive Using Conventional Three Level Inverters

A novel dodecagonal space vector structure for induction motor drive is presented in this paper. It consists of two dodecagons, with the radius of the outer one twice the inner one. Compared to existing dodecagonal space vector structures, to achieve the same PWM output voltage quality, the proposed topology lowers the switching frequency of the inverters and reduces the device ratings to half. At the same time, other benefits obtained from existing dodecagonal space vector structure are retained here. This includes the extension of the linear modulation range and elimination of all 6+/-1 harmonics (n=odd) from the phase voltage. The proposed structure is realized by feeding an open-end winding induction motor with two conventional three level inverters. A detailed calculation of the PWM timings for switching the space vector points is also presented. Simulation and experimental results indicate the possible application of the proposed idea for high power drives.

Effect of soil tillage on erosion and nutrient transport in plough layer runoff

Yhteenveto: Viljelymenetelmien vaikutus eroosioon ja ravinteiden huuhtoutumiseen

A Simple Five-Level Inverter Topology for Induction Motor Drive Using Conventional Two-Level Inverters and Flying Capacitor Technique

This paper proposes a new five-level inverter topology for open-end winding induction motor (IM) drive. The popular existing circuit configurations for five-level inverter include the NPC inverter and flying capacitor topologies. Compared to the NPC inverter, the proposed topology eliminates eighteen clamping diodes having different voltage ratings in the present circuit. Moreover it requires only one capacitor bank per phase, whereas flying capacitor schemes for five level topologies require six capacitor banks per phase. The proposed topology is realized by feeding the phase winding of an open-end induction motor with two-level inverters in series with flying capacitors. The flying capacitor voltages are balanced using the switching state redundancy for full modulation range. The proposed inverter scheme is capable of producing two-level to five-level pulse width modulated voltage across the phase winding depending on the modulation range. Additionally, in case of any switch failure in the flying capacitor connection, the proposed inverter topology can be operated as a three-level inverter for full modulation range. The proposed scheme is experimentally verified on a four pole, 5hp induction motor drive.

Studies in biogas technology. Part I. Performance of a conventional biogas plant

This paper gives an account of a conventional 5.66 m3/day (200 cubic ft/day) biogas plant which has been instrumented, operated and monitored for 2 1/2 years. The observations regarding input to the plant, sludge and biogas outputs, and conditions inside the digester, have been described. Three salient features stand out. First, the observed average daily gas yield is much less than the rated capacity of the plant. Secondly, the plants show ease of operation and a very slow response to reductions and cessations of dung supply. Thirdly, the unexpectedly marked uniformity of density and temperature inside the digester indicates the almost complete absence of the stratification which is widely believed to take place; hence, biogas plants may be treated as isothermal, ‘ uniform ’ density, most probably imperfectly mixed, fed-batch reactors operating at the mean ambient temperature and the density of water.

A comparison between conceptual clustering and conventional clustering

Clustering is a process of partitioning a given set of patterns into meaningful groups. The clustering process can be viewed as consisting of the following three phases: (i) feature selection phase, (ii) classification phase, and (iii) description generation phase. Conventional clustering algorithms implicitly use knowledge about the clustering environment to a large extent in the feature selection phase. This reduces the need for the environmental knowledge in the remaining two phases, permitting the usage of simple numerical measure of similarity in the classification phase. Conceptual clustering algorithms proposed by Michalski and Stepp [IEEE Trans. PAMI, PAMI-5, 396–410 (1983)] and Stepp and Michalski [Artif. Intell., pp. 43–69 (1986)] make use of the knowledge about the clustering environment in the form of a set of predefined concepts to compute the conceptual cohesiveness during the classification phase. Michalski and Stepp [IEEE Trans. PAMI, PAMI-5, 396–410 (1983)] have argued that the results obtained with the conceptual clustering algorithms are superior to conventional methods of numerical classification. However, this claim was not supported by the experimental results obtained by Dale [IEEE Trans. PAMI, PAMI-7, 241–244 (1985)]. In this paper a theoretical framework, based on an intuitively appealing set of axioms, is developed to characterize the equivalence between the conceptual clustering and conventional clustering. In other words, it is shown that any classification obtained using conceptual clustering can also be obtained using conventional clustering and vice versa.

A five level inverter scheme with common mode volatge elimination by cascading conventional two level and three level NPC inverters for an induction motor drive

Common-mode voltage generated by the PWM inverter causes shaft voltage, bearing current and ground leakage current in induction motor drive system, resulting in an early motor failure. This paper presents a common-mode elimination scheme for a five-level inverter with reduced power circuit complexity. The proposed scheme is realised by cascading conventional two-level and conventional NPC three-level inverters in conjunction with an open-end winding three-phase induction motor drive and the common-mode voltage (CMV) elimination is achieved by using only switching states that result in zero CMV, for the entire modulation range.

Dispersion and vaporization of biofuels and conventional fuels in a crossflow pre-mixer

In lean premixed pre-vaporized (LPP) combustion, controlled atomization, dispersion and vaporization of different types of liquid fuel in the premixer are the key factors required to stabilize the combustion process and improve the efficiency. The dispersion and vaporization process for biofuels and conventional fuels sprayed into a crossflow pre-mixer have been simulated and analyzed with respect to vaporization rate, degree of mixedness and homogeneity. Two major biofuels under investigation are Ethanol and Rapeseed Methyl Esters (RME), while conventional fuels are gasoline and jet-A. First, the numerical code is validated by comparing with the experimental data of single n-heptane and decane droplet evaporating under both moderate and high temperature convective air now. Next, the spray simulations were conducted with monodispersed droplets with an initial diameter of 80 mu m injected into a turbulent crossflow of air with a typical velocity of 10 m/s and temperature of around 800K. Vaporization time scales of different fuels are found to be very different. The droplet diameter reduction and surface temperature rise were found to be strongly dependent on the fuel properties. Gasoline droplet exhibited a much faster vaporization due a combination of higher vapor pressure and smaller latent heat of vaporization compared to other fuels. Mono-dispersed spray was adopted with the expectation of achieving more homogeneous fuel droplet size than poly-dispersed spray. However, the diameter histogram in the zone near the pre-mixer exit shows a large range of droplet diameter distributions for all the fuels. In order to improve the vaporization performance, fuels were pre-heated before injection. Results show that the Sauter mean diameter of ethanol improved from 52.8% of the initial injection size to 48.2%, while jet-A improved from 48.4% to 18.6% and RME improved from 63.5% to 31.3%. The diameter histogram showed improved vaporization performance of jet-A. (C) 2011 Elsevier Ltd. All rights reserved.

Correlations of vaporization performance of conventional and biofuel sprays in a crossflow heated chamber

Pre-vaporization and pre-mixing are the two main features of LPP type of combustor that operate on liquid fuels. The pre-vaporization length scale is one of its most important design parameters. In this study, the goal is to put forward a simulation based correlation for fuel vaporization performance as a function of dimensionless parameters for crossflow type of injections. Two types of fuels are studied here: jet-A and one of its potential biofuel substitutes, RME. Different sets of spray simulations are considered for crossflow type of injections. Correlations are provided for both jet-A and RME's vaporization performance as a function of non-dimensional inlet air temperature, fuel/air momentum flux ratio and normalized spray traverse distance. (C) 2012 Elsevier Ltd. All rights reserved.

A Comparison of mechanical and tribological behavior of nanostructured and conventional WC-12Co detonation-sprayed coatings

In the present study, WC-12Co coatings were deposited by detonation-spraying technique using conventional and nanostructured WC-12Co feedstock at four different oxy/fuel ratios (OF ratio). The coatings exhibited the presence of phases like W2C and W due to the decarburization of the WC phase, and the proportions of these phases were higher in the nano WC-12Co coatings compared with conventional WC-12Co coatings. Coating hardness and fracture toughness were measured. The tribological performance of coatings was examined under dry sand rubber wheel abrasion wear, and solid particle erosion wear conditions. The mechanical and wear properties of coatings were influenced by degree of decarburization and more so in the case of nanostructured WC-Co coatings. The results indicate that the extent of decarburization has a substantial influence on the elastic modulus of the coating which in turn is related to the extent of intersplat cracking of the coating.

Failure modes and fatigue behavior of conventional and refilled friction stir spot welds in AA 6061-T6 sheets

The fatigue behavior of conventional friction stir spot welding (FSSW) and friction stir spot welding refilled by the friction forming process (FSSW-FFP) in aluminum 6061-T6 lap shear specimens, are investigated based on the experimental observations. Optical micrographs of the welds after fatigue failure in both the cases are examined to study the fatigue crack propagation and failure modes. Experimental results indicate that the fatigue strength of the FSSW-FFP weld samples is higher than that of the conventional FSSW samples at all loads. Fracture surfaces are analyzed in detail using the scanning electron microscope. (C) 2013 Elsevier Ltd. All rights reserved.

New physics in e(+)e(-) -> Z(gamma) at the ILC with polarized beams: explorations beyond conventional anomalous triple gauge boson couplings

One of the most-studied signals for physics beyond the standard model in the production of gauge bosons in electron-positron collisions is due to the anomalous triple gauge boson couplings in the Z(gamma) final state. In this work, we study the implications of this at the ILC with polarized beams for signals that go beyond traditional anomalous triple neutral gauge boson couplings. Here we report a dimension-8 CP-conserving Z(gamma)Z vertex that has not found mention in the literature. We carry out a systematic study of the anomalous couplings in general terms and arrive at a classification. We then obtain linear-order distributions with and without CP violation. Furthermore, we place the study in the context of general BSM interactions represented by e(+)e(-)Z(gamma) contact interactions. We set up a correspondence between the triple gauge boson couplings and the four-point contact interactions. We also present sensitivities on these anomalous couplings, which will be achievable at the ILC with realistic polarization and luminosity.

Performance comparison for 12 V lead-carbon hybrid ultracapacitors with substrate-integrated and conventional pasted positive plates

Lead-carbon hybrid ultracapacitors comprise positive lead dioxide plates of the lead-acid battery and negative plates of carbon-based electrical double-layer capacitors (EDLCs). Accordingly, a lead-carbon hybrid ultracapacitor has the features of both the battery and that of an EDLC. In this study, the development and performance comparison between the two types of lead-carbon hybrid ultracapacitors, namely those with substrate-integrated and conventional pasted positive plates, is presented as such a study is lacking in the literature. The study suggests that the faradaic efficiencies for both types of lead-carbon hybrid ultracapacitors are comparable. However, their capacitance values as well as energy and power densities differ significantly. For substrate-integrated positive plate hybrid ultracapacitor, capacitance and energy density values are lower, but power density values are higher than pasted positive plate lead-carbon hybrid ultracapacitors due to their shorter response time. Accordingly, internal resistance values are also lower for substrate-integrated lead-carbon hybrid ultracapacitors. Both types of lead-carbon hybrid ultracapacitors exhibit good cycle life of 100,000 pulse charge-discharge cycles with only a nominal loss in their capacitance values.