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%.

Higher-resolution structure of the human insulin receptor ectodomain: Multi-modal inclusion of the insert domain

Insulin receptor (IR) signaling is critical to controlling nutrient uptake and metabolism. However, only a low-resolution (3.8 Å) structure currently exists for the IR ectodomain, with some segments ill-defined or unmodeled due to disorder. Here, we revise this structure using new diffraction data to 3.3 Å resolution that allow improved modeling of the N-linked glycans, the first and third fibronectin type III domains, and the insert domain. A novel haptic interactive molecular dynamics strategy was used to aid fitting to low-resolution electron density maps. The resulting model provides a foundation for investigation of structural transitions in IR upon ligand binding.

The dielectric coated conducting sphere - modal and near field characteristics.

A modal analysis and near-field study for a dielectric-coated conducting sphere excited by a delta function electric field source has been made. The structure can support an infinite number of modes theoretically. For equatorial excitation only odd order modes are excited, whereas for non-equatorial excitation both even and odd order modes are excited. The variation of the amplitude coefficients both internal and external exhibit a different nature of variation with respect to the various structure parameters for different modes. The field distributions both in the r and theta directions for non-equatorial excitation show good agreement between theory and experiment for the strongest mode.

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.

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.

Chemical-shift of the X-ray K-absorption edge of Co in some compounds, complexes and minerals

The chemical-shift of the X-ray K-absorption edge of Co was studied in a large number of compounds, complexes (spinels) and minerals of Co in its different oxidation states having widely different crystal structures and containing different types of bonding and various types of ligands, and were reported collectively, for the first time, in a single paper. A quadratic relationship was established on the basis of least-squares regression analysis to hold between the chemical-shift and the effective charge on the absorbing atom, but the dominance of the linear term was shown. This relation was utilized in evaluating the charge on the Co-ion in a number of minerals. The effect on chemical-shift of oxidation states of the absorbing atom, of the bond length, crystal structure and higher shell atoms of the molecule, and of electronegativity, atomic number and ionic radius of the ligand was discussed.

1,2-Shift in the anodic oxidation of aromatic compounds

The 1,2-shift observed during oxidation of organic substrates can arise by involvement of cation radicals.

Phase-shift randomness in one-dimensional disordered conductors in the quasi-metallic domain

An invariant imbedding method yields exact analytical results for the distribution of the phase theta (L) of the reflection amplitude and for low-order resistance moments (pn) for a disordered conductor of length L in the quasi-metallic regime L<