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%.

H N.M.R. studies of protected alpha-aminoisobutyric acid containing peptides. Chemical shift nonequivalence of benzyloxycarbonyl methylene protons

The benzylic methylene protons in a large number of benzyloxycarbonyl alpha-aminoisobutyric acid (Z-Aib) containing peptides, show chemical shift nonequivalence. The magnitude of the geminal nonequivalence is correlated with the involvement of the urethane carbonyl group, in an intramolecular hydrogen bond. Studies of the model compounds Z-Aib-Aib-Ala-NHMe, and Z-Aib-Aib-Aib-Pro-OMe clearly establish the presence of intramolecular hydrogen bonds, involving the urethane CO group. In both compounds marked anisochrony of the benzylic methylene protons is demonstrated. In Z-Aib-Aib-Pro-OMe, where a 4 leads to 1 hydrogen bonded beta-turn is not possible, the benzylic-CH2-protons appear as a singlet in CDCl3 and have a very small chemical shift difference in (CD3)2SO. The observation of such nonequivalence is of value in establishing whether the amino terminal Aib-Pro beta-turn is retained in large peptide-fragments of alamethicin.

Shift of peak in summer monsoon rainfall over Korea and its association with El Nino-Southern Oscillation

The annual cycle of rainfall over the Korean Peninsula is marked by two peaks: one during July and the other during August. Since the mid-1970s, the maximum rainfall over the Korean Peninsula has shifted from July to August. This shift in rainfall peak was caused by a significant increase of August rainfall after the mid-1970s. The basic reason for this shift has been traced to a change in teleconnection between El Nino-Southern Oscillation (ENSO) and August rainfall. The relationship between August rainfall over Korea and ENSO changed from 1954-1975 (PI) to 1976-2002 (PII). The variability of August rainfall was significantly associated with sea surface temperature (SST) variation over the eastern equatorial Pacific during PI, but this relationship is absent during the PII period. In El Nino years during PI, low-level westerly and southerly wind anomalies are dominant around the East China Sea, which relates to strong August rainfall. In La Nina years during PI, easterly and northerly wind anomalies are dominant. During the PII period, however, westerly and southerly wind anomalies around the East China Sea were responsible for the high August rainfall over the East Asian region, even though La Nina SST conditions were in effect over the eastern Pacific.

Jet Engine Health Signal Denoising Using Optimally Weighted Recursive Median Filters

The removal of noise and outliers from health signals is an important problem in jet engine health monitoring. Typically, health signals are time series of damage indicators, which can be sensor measurements or features derived from such measurements. Sharp or sudden changes in health signals can represent abrupt faults and long term deterioration in the system is typical of gradual faults. Simple linear filters tend to smooth out the sharp trend shifts in jet engine signals and are also not good for outlier removal. We propose new optimally designed nonlinear weighted recursive median filters for noise removal from typical health signals of jet engines. Signals for abrupt and gradual faults and with transient data are considered. Numerical results are obtained for a jet engine and show that preprocessing of health signals using the proposed filter significantly removes Gaussian noise and outliers and could therefore greatly improve the accuracy of diagnostic systems. [DOI: 10.1115/1.3200907].

An optimal weighted-average congestion based pricing scheme for enhanced QoS

Pricing is an effective tool to control congestion and achieve quality of service (QoS) provisioning for multiple differentiated levels of service. In this paper, we consider the problem of pricing for congestion control in the case of a network of nodes under a single service class and multiple queues, and present a multi-layered pricing scheme. We propose an algorithm for finding the optimal state dependent price levels for individual queues, at each node. The pricing policy used depends on a weighted average queue length at each node. This helps in reducing frequent price variations and is in the spirit of the random early detection (RED) mechanism used in TCP/IP networks. We observe in our numerical results a considerable improvement in performance using our scheme over that of a recently proposed related scheme in terms of both throughput and delay performance. In particular, our approach exhibits a throughput improvement in the range of 34 to 69 percent in all cases studied (over all routes) over the above scheme.

When and why threats go undetected: Impacts of event rate and shift length on threat detection accuracy during airport baggage screening

Objective: We aimed to assess the impact of task demands and individual characteristics on threat detection in baggage screeners. Background: Airport security staff work under time constraints to ensure optimal threat detection. Understanding the impact of individual characteristics and task demands on performance is vital to ensure accurate threat detection. Method: We examined threat detection in baggage screeners as a function of event rate (i.e., number of bags per minute) and time on task across 4 months. We measured performance in terms of the accuracy of detection of Fictitious Threat Items (FTIs) randomly superimposed on X-ray images of real passenger bags. Results: Analyses of the percentage of correct FTI identifications (hits) show that longer shifts with high baggage throughput result in worse threat detection. Importantly, these significant performance decrements emerge within the first 10 min of these busy screening shifts only. Conclusion: Longer shift lengths, especially when combined with high baggage throughput, increase the likelihood that threats go undetected. Application: Shorter shift rotations, although perhaps difficult to implement during busy screening periods, would ensure more consistently high vigilance in baggage screeners and, therefore, optimal threat detection and passenger safety.

Backbone chemical shift assignments of the acyl-acyl carrier protein intermediates of the fatty acid biosynthesis pathway of Plasmodium falciparum

We report the backbone chemical shift assignments of the acyl-acyl carrier protein (ACP) intermediates of the fatty acid biosynthesis pathway of Plasmodium falciparum. The acyl-ACP intermediates butyryl (C4), -octanoyl (C8), -decanoyl (C10), -dodecanoyl (C12) and -tetradecanoyl (C14)-ACPs display marked changes in backbone HN, Cα and Cβ chemical shifts as a result of acyl chain insertion into the hydrophobic core. Chemical shift changes cast light on the mechanism of expansion of the acyl carrier protein core.

A Mechanistic Model for the Water-Gas Shift Reaction over Noble Metal Substituted Ceria

The water-gas shift (WGS) reaction was carried out in the presence of Pd and Pt substituted nanocrystalline ceria catalysts synthesized by solution combustion technique. The catalysts were characterized by powder XRD and XPS. The noble metals were found to be present in ionic form substituted for the cerium atoms. The catalysts showed highactivity for the WGS reaction with high conversions below 250 degrees C. The products of reaction were only carbon dioxide and hydrogen, and no hydrocarbons were observed even in trace quantities. The reactions were carried out with different amounts of noble metal ion substitution and 2% Pt substituted ceria was found to be the best catalyst. The various possible mechanisms for the reaction were proposed and tested for their consistency with experimental data. The dual site mechanism best described the kinetics of the reaction and the corresponding rate parameters were obtained.

Pd and Pt ions as highly active sites for the water-gas shift reaction over combustion synthesized zirconia and zirconia-modified ceria

Noble metal substituted ionic catalysts were synthesized by solution combustion technique. The compounds were characterized by X-ray diffraction, FT-Raman spectroscopy, and X-ray photoelectron spectroscopy. Zirconia supported compounds crystallized in tetragonal phase. The solid solutions of ceria with zirconia crystallized in fluorite structure. The noble metals were substituted in ionic form.The water-gas shift reaction was carried out over the catalysts.Negligible conversions were observed with unsubstituted compounds. The substitution of a noble metal ion was found to enhance the reaction rate. Equilibrium conversion was obtained below 250 degrees C in the presence of Pt ion substituted compounds. The formation of Bronsted acid-Bronsted base pairs was proposed to explain the activity of zirconia catalysts. The effect of oxide ion vacancies on the reactions over substituted ceria-zirconia solid solutions was established. (c)2010 Elsevier B.V. All rights reserved.

Minimizing total weighted tardiness on a batch-processing machine with non-agreeable release times and due dates

This study considers the scheduling problem observed in the burn-in operation of semiconductor final testing, where jobs are associated with release times, due dates, processing times, sizes, and non-agreeable release times and due dates. The burn-in oven is modeled as a batch-processing machine which can process a batch of several jobs as long as the total sizes of the jobs do not exceed the machine capacity and the processing time of a batch is equal to the longest time among all the jobs in the batch. Due to the importance of on-time delivery in semiconductor manufacturing, the objective measure of this problem is to minimize total weighted tardiness. We have formulated the scheduling problem into an integer linear programming model and empirically show its computational intractability. Due to the computational intractability, we propose a few simple greedy heuristic algorithms and meta-heuristic algorithm, simulated annealing (SA). A series of computational experiments are conducted to evaluate the performance of the proposed heuristic algorithms in comparison with exact solution on various small-size problem instances and in comparison with estimated optimal solution on various real-life large size problem instances. The computational results show that the SA algorithm, with initial solution obtained using our own proposed greedy heuristic algorithm, consistently finds a robust solution in a reasonable amount of computation time.

A weighted mean square method of linearization in non-linear oscillations

The paper deals with a linearization technique in non-linear oscillations for systems which are governed by second-order non-linear ordinary differential equations. The method is based on approximation of the non-linear function by a linear function such that the error is least in the weighted mean square sense. The method has been applied to cubic, sine, hyperbolic sine, and odd polynomial types of non-linearities and the results obtained are more accurate than those given by existing linearization methods.

Elimination of cross-talk in diffuse optical tomographic reconstructions through a weighted update procedure: results of simulation study - art. no. 61640S

Reconstructions in optical tomography involve obtaining the images of absorption and reduced scattering coefficients. The integrated intensity data has greater sensitivity to absorption coefficient variations than scattering coefficient. However, the sensitivity of intensity data to scattering coefficient is not zero. We considered an object with two inhomogeneities (one in absorption and the other in scattering coefficient). The standard iterative reconstruction techniques produced results, which were plagued by cross talk, i.e., the absorption coefficient reconstruction has a false positive corresponding to the location of scattering inhomogeneity, and vice-versa. We present a method to remove cross talk in the reconstruction, by generating a weight matrix and weighting the update vector during the iteration. The weight matrix is created by the following method: we first perform a simple backprojection of the difference between the experimental and corresponding homogeneous intensity data. The built up image has greater weightage towards absorption inhomogeneity than the scattering inhomogeneity and its appropriate inverse is weighted towards the scattering inhomogeneity. These two weight matrices are used as multiplication factors in the update vectors, normalized backprojected image of difference intensity for absorption inhomogeneity and the inverse of the above for the scattering inhomogeneity, during the image reconstruction procedure. We demonstrate through numerical simulations, that cross-talk is fully eliminated through this modified reconstruction procedure.