Predictors of barefoot plantar pressure during walking in patients with diabetes, peripheral neuropathy and a history of ulceration

OBJECTIVE:Elevated dynamic plantar foot pressures significantly increase the risk of foot ulceration in diabetes mellitus. The aim was to determine which factors predict plantar pressures in a population of diabetic patients who are at high-risk of foot ulceration. METHODS:Patients with diabetes, peripheral neuropathy and a history of ulceration were eligible for inclusion in this cross sectional study. Demographic data, foot structure and function, and disease-related factors were recorded and used as potential predictor variables in the analyses. Barefoot peak pressures during walking were calculated for the heel, midfoot, forefoot, lesser toes, and hallux regions. Potential predictors were investigated using multivariate linear regression analyses. 167 participants with mean age of 63 years contributed 329 feet to the analyses. RESULTS:The regression models were able to predict between 6% (heel) and 41% (midfoot) of the variation in peak plantar pressures. The largest contributing factor in the heel model was glycosylated haemoglobin concentration, in the midfoot Charcot deformity, in the forefoot prominent metatarsal heads, in the lesser toes hammer toe deformity and in the hallux previous ulceration. Variables with local effects (e.g. foot deformity) were stronger predictors of plantar pressure than global features (e.g. body mass, age, gender, or diabetes duration). CONCLUSION:The presence of local deformity was the largest contributing factor to barefoot dynamic plantar pressure in high-risk diabetic patients and should therefore be adequately managed to reduce plantar pressure and ulcer risk. However, a significant amount of variance is unexplained by the models, which advocates the quantitative measurement of plantar pressures in the clinical risk assessment of the patient

Pixel classification for automated diabetic foot diagnosis

Worldwide, more than 180 million people suffer from diabetes mellitus. Approximately 50% of these patients will develop complications to their feet. Neuropathy, combined with poor blood supply and biomechanical changes results in a high risk for foot ulcers, which is a key problem in the diabetic foot; when these wounds become infected, this can ultimately result in lower extremity amputation, which has a serious effect on the quality of life of the patient, and causes a large economic burden on society.\ud \ud This was the motivation for a collaborate project (Vincent50) in which a photographic foot imaging device was developed. The system allows scanning of the foot soles on a daily basis which may lead to early recognition of foot problems. The goal of the present study is to determine whether pixel classification is a useful intermediate step towards automatically assessing the images of the foot soles for signs of diabetic foot disease. If successful, this approach will further relief health care professionals in assessing the foot and enable the placement of more devices in the future. \ud \ud The best agreement between automated recognition and expert diagnosis was achieved with a combination of RGB and derived features, proves that the RGB data is informative with respect to detection of ulcers. However, the automatic detection of pre-signs of ulcers and other anomalies needs more sophistication than pixel classification alone. Firstly, other physical features, such as hyperspectral data, infrared and/or textural features are expected to be more informative. Secondly, we expect to be able to boost the performance by using the context between neighboring pixels. Thirdly, an individualized and normalized classification process might help with the large variability in foot soles between individuals. \u

Spectral and Spin Measurement of Two Small and Fast-Rotating Near-Earth Asteroids

In May 2012 two asteroids made near-miss "grazing" passes at distances of a few Earth-radii: 2012 KP24 passed at nine Earth-radii and 2012 KT42 at only three Earth-radii. The latter passed inside the orbital distance of geosynchronous satellites. From spectral and imaging measurements using NASA's 3-m Infrared Telescope Facility (IRTF), we deduce taxonomic, rotational, and physical properties. Their spectral characteristics are somewhat atypical among near-Earth asteroids: C-complex for 2012 KP24 and B-type for 2012 KT42, from which we interpret the albedos of both asteroids to be between 0.10 and 0.15 and effective diameters of 20+-2 and 6+-1 meters, respectively. Among B-type asteroids, the spectrum of 2012 KT42 is most similar to 3200 Phaethon and 4015 Wilson-Harrington. Not only are these among the smallest asteroids spectrally measured, we also find they are among the fastest-spinning: 2012 KP24 completes a rotation in 2.5008+-0.0006 minutes and 2012 KT42 rotates in 3.634+-0.001 minutes.Comment: 4 pages, 3 figures, accepted for publication in Icaru

Characterization of Hayabusa II Target Asteroid (162173) 1999 JU3

The Japanese Hayabusa II mission is planned to rendezvous with and return a sample from the near-Earth asteroid (162173) 1999 JU3. Previous mid-infrared studies have constrained the albedo and thermal properties of this object (Muller et al. 2011; Campins et al. 2011; Hasegawa et al. 2008). Visible wavelength spectra from 1999 and 2007 reveal a C-type asteroid that displays pronounced spectroscopic variability around 0.7 microns. Variability in the strength of a 0.7 micron band could be due to heterogeneous concentrations of iron-bearing phyllosilicates across its surface (Vilas 2008). We will present new observations from the favorable 2012 apparition to further characterize this object. In June of 2012 spectroscopic observations were conducted with the LDSS3 and FIRE instruments on the Magellan telescopes at Las Campanas Observatory in Chile. Between April and July of 2012 broadband visible-wavelength photometry was obtained with the Tenagra II telescope in Arizona and with the IMACS, Megacam and LDSS3 instruments on the Magellan telescopes. Our visible and near-infrared spectra confirm a C-type taxonomic classification, but do not show evidence for the presence of a 0.7 micron phyllosilicate band. Our time series of visible spectra cover approximately 60% of the rotational phases of 1999 JU3, but do not display any pronounced variability. We use our new optical light curves, combined with photometry from 2007, to refine a shape model of the asteroid. This shape model provides a means for mapping surface regions accessed by the spectroscopic observations from both 2007 and 2012, and thus to directly address the possibility of surface heterogeneity. This surface map, in conjunction with the newly measured photometric phase curve of the asteroid, will be used to make predictions regarding composition and surface properties that will ultimately be tested upon arrival of the Hayabusa II spacecraft

Consumers` sensory and nutritional perceptions of three types of milk

Objective: To identify consumer perceptions of whole milk, reduced-fat milk and soy milk, and to investigate demographic influences on perceptions and types of milk consumption. Design and setting: Questionnaires covering nutritional and sensory perceptions of three types of milk.Subjects: Three hundred and sixty-one randomly selected shoppers in Melbourne, Australia.Results: Generally, respondents held positive perceptions about milk. Milk was considered as having good sensory properties, providing a good source of nutrients, and being a convenient and safe product. However, despite these findings, misperceptions and unawareness about the nutrient content of milk were prevalent. Negative perceptions were most common for whole milk and were mostly related to its perceived high fat, cholesterol and energy contents. Soy milk received lower ratings on sensory quality and convenience than dairy milk. There were few sociodemographic differences in consumers\u27 perceptions. Although reduced-fat milk consumption was more frequent among elderly people and type of milk consumption was related to parenthood, no other significant effects of demographic variables were found on the consumption of specific milk types.Conclusion: Although positive perceptions were common, negative perceptions and misperceptions appear to be prevalent, presenting a challenge for nutrition education. Sociodemographic factors were not shown to be important predictors of perceptions and type of milk consumption

Geospatial mapping and data linkage uncovers variability in outcomes of foot disease according to multiple deprivation: a population cohort study of people with diabetes

Aims/hypothesis: Our aim was to investigate the geospatial distribution of diabetic foot ulceration (DFU), lower extremity amputation (LEA) and mortality rates in people with diabetes in small geographical areas with varying levels of multiple deprivation. Methods: We undertook a population cohort study to extract the health records of 112,231 people with diabetes from the Scottish Care Information – Diabetes Collaboration (SCI-Diabetes) database. We linked this to health records to identify death, LEA and DFU events. These events were geospatially mapped using multiple deprivation maps for the geographical area of National Health Service (NHS) Greater Glasgow and Clyde. Tests of spatial autocorrelation and association were conducted to evaluate geographical variation and patterning, and the association between prevalence-adjusted outcome rates and multiple deprivation by quintile. Results: Within our health board region, people with diabetes had crude prevalence-adjusted rates for DFU of 4.6% and for LEA of 1.3%, and an incidence rate of mortality preceded by either a DFU or LEA of 10.5 per 10,000 per year. Spatial autocorrelation identified statistically significant hot spot (high prevalence) and cold spot (low prevalence) clusters for all outcomes. Small-area maps effectively displayed near neighbour clustering across the health board geography. Disproportionately high numbers of hot spots within the most deprived quintile for DFU (p < 0.001), LEA (p < 0.001) and mortality (p < 0.001) rates were found. Conversely, a disproportionately higher number of cold spots was found within the least deprived quintile for LEA (p < 0.001). Conclusions/interpretation: In people with diabetes, DFU, LEA and mortality rates are associated with multiple deprivation and form geographical neighbourhood clusters

Inhomogeneities on the surface of 21 Lutetia, the asteroid target of the Rosetta mission

CONTEXT: In July 2010 the ESA spacecraft Rosetta will fly-by the main belt asteroid 21 Lutetia. Several observations of this asteroid have been so far performed, but its surface composition and nature are still a matter of debate. For long time Lutetia was supposed to have a metallic nature due to its high IRAS albedo. Later on it has been suggested to have a surface composition similar to primitive carbonaceous chondrite meteorites, while further observations proposed a possible genetic link with more evolved enstatite chondrite meteorites. AIMS: In order to give an important contribution in solving the conundrum of the nature of Lutetia, in November 2008 we performed visible spectroscopic observations of this asteroid at the Telescopio Nazionale Galileo (TNG, La Palma, Spain). METHODS: Thirteen visible spectra have been acquired at different rotational phases. RESULTS: We confirm the presence of a narrow spectral feature at about 0.47-0.48 micron already found by Lazzarin et al. (2009) on the spectra of Lutetia. We also find a spectral feature at about 0.6 micron, detected by Lazzarin et al. (2004) on one of their Lutetia's spectra. More importantly, our spectra exhibit different spectral slopes between 0.6 and 0.75 micron and, in particular, we found that up to 20% of the Lutetia surface could have flatter spectra. CONCLUSIONS: We detected a variation of the spectral slopes at different rotational phases that could be interpreted as possibly due to differences in the chemical/mineralogical composition, as well as to inhomogeneities of the structure of the Lutetia's surface (e.g., the presence of craters or albedo spots) in the southern hemisphere.Comment: 3 pages, 2 figures. Accepted for publication in Astronomy and Astrophysics. Updated on 25 March 2010

Вероятностно-детерминированная модель расчета безопасного расстояния при разливе топлива

В статье рассматриваются основные опасные факторы при эксплуатации автозаправочных станций, опасные факторы топливных жидкостей, их физические и физико-химические свойства. Основная задача в статье - проанализировать все возможные риски, возникающие при эксплуатации АЗС, выявить наиболее вероятные неблагоприятные события, способные привести к повреждениям и разрушениям АЗС. Проанализировать возможные сценарии развития аварии для выявления наиболее опасного. Данные исследования позволят в дальнейшем использовать математическую модель для определения радиуса поражения зданий, сооружений и населения, и определения безопасного расстояния для опасных объектов - АЗС.The article deals with the main hazards during the operation of gasoline stations, the dangerous factors of fuel fluids, their physical and physicochemical properties. The main task in the article is to analyze all possible risks arising from the operation of the filling station, to identify the most likely adverse events that can lead to damage and destruction of the filling stations. Analyze possible scenarios for the development of an accident to identify the most dangerous. The given researches will allow to use in the further mathematical model for definition of radius of destruction of buildings, constructions and the population, and definition of a safe distance for dangerous objects - the gas station

Upaya Pengembangan USAha Mikro Kecil dan Menengah (UMKM) Handycraft Kayu Jati di Dusun Bandar Desa Batokan Kecamatan Kasiman Kabupaten Bojonegoro

The objectives of this research are to describe: (1) the development efforts of micro-, small-, and medium-scale enterprises of teakwood handicraft in Bandar sub-village, Batokan village, Kasiman sub-district, Bojonegoro regency through the aspect of production to increase the community income; and (2) the development efforts of micro-, small-, and medium-scale enterprises of teakwood handicraft in Bandar sub-village, Batokan village, Kasiman sub-district, Bojonegoro regency through the aspect of marketing to increase the community income. This research used the descriptive research method with the qualitative phenomonology approach.The samples of research were taken by using the purposive and snowball sampling techniques.The data of research were gathered through in-depth interview, observation, and documentation. They were validated by using source triangulation and method triangulation. The data were analyzed by using the interactive model of analysis comprising four components, namely: data gathering, data reduction, data display, and conclusion drawing. The results of research show that there are six development efforts of micro-, small-, and medium-scale enterprises of teakwood handicraft in Bandar sub-village, Batokan village, Kasiman sub-district, Bojonegoro. This research conclude that: (1) In term of production aspect, the efforts include granting production aids by the government and conducting product innovations; and (2) In term of marketing, they include holding exhibitions, conducting comparative studies, conducting wood fair activities, and marketing the products through internet. The result of observation shows that the highest turnover average achieved by the micro-, small-, and medium-enterprises took place in 2013, that is, 4.01%, whereas the lowest turnover average persisted in 2011, that is, 0.81%. Therefore, a conclusion can be drawn that the most strategic development efforts were applied in 2013. The efforts included product innovations, exhibitions, wood fair, and product marketing through internet