Total contact casts versus removable offloading interventions for the treatment of diabetic foot ulcers: a systematic review and meta-analysis

ObjectiveThis study aimed to evaluate the effectiveness of total contact casts (TCCs) versus removable offloading interventions among patients with diabetic foot ulcers (DFUs).MethodsA comprehensive search was done in databases Embase, Cochrane Library, and, PubMed. The references of retrieved articles were reviewed, up until February 2023. Controlled trials comparing the effects of TCCs with removable offloading interventions (removable walking casts and footwear) in patients with DFUs were eligible for review.ResultsTwelve studies were included in the meta-analysis, involving 591 patients with DFUs. Among them, 269 patients were in the intervention group (TCC), and 322 in the control group (removable walking casts/footwear). The analysis revealed that the TCC group had higher healing rates (Risk Ratio(RR)=1.22; 95% confidence interval(CI):1.11 to 1.34, p<0.001), shorter healing time (Standard Mean Difference(SMD)=-0.57; 95%CI: -1.01 to -0.13, P=0.010), and elevated occurrence of device-related complications (RR=1.70; 95%CI:1.01 to 2.88, P=0.047), compared with the control group. Subgroup analysis illustrated patients using TCCs had higher healing rates than those using removable walking casts (RR=1.20; 95%CI:1.08 to 1.34, p=0.001) and footwear (RR=1.25; 95%CI:1.04 to 1.51, p=0.019), but they required comparable time for ulcer healing compared with those using removable walking casts (SMD=-0.60; 95%CI: -1.22 to 0.02, P=0.058) or footwear group (SMD=-0.52; 95%CI: -1.17 to 0.12, P=0.110). Although patients using TCCs had significantly higher incidence of device-related complications than those using footwear (RR=4.81; 95%CI:1.30 to 17.74, p=0.018), they had similar one compared with those using the removable walking casts (RR=1.27; 95%CI:0.70 to 2.29, p=0.438).ConclusionThe use of TCCs in patients with DFUs resulted in improved rates of ulcer healing and shorter healing time compared to removable walking casts and footwear. However, it is important to note that TCCs were found to be associated with increased prevalence of complications

On Extended Representable Uninorms and Their Extended Fuzzy Implications (Coimplications)

In this work, by Zadeh’s extension principle, we extend representable uninorms and their fuzzy implications (coimplications) to type-2 fuzzy sets. Emphatically, we investigate in which algebras of fuzzy truth values the extended operations are type-2 uninorms and type-2 fuzzy implications (coimplications), respectively

Amino(oligo)thiophene-based Environmentally Sensitive Biomembrane Chromophores

There is a growing need for cellular imaging with fluorescent probes that emit at longer wavelengths to minimize the effects of absorption, autofluorescence and scattering from biological tissue. In this paper a series of new environmentally-sensitive hemicyanine dyes featuring amino(oligo)thiophene donors have been synthesized via aldol condensation between a 4-methylpyridinium salt and various amino(oligo)thiophene carboxaldehydes, which were, in turn, obtained from amination of bromo (oligo)thiophene carboxaldehyde. Side chains on these fluorophores impart a strong affinity for biological membranes. Compared with benzene analogues, these thiophene fluorophores show significant red shift in the absorption and emission spectra, offering compact red and near-infrared emitting fluorophores. More importantly, both the fluorescence quantum yields and the emission peaks are very sensitive to various environmental factors such as solvent polarity or viscosity, membrane potential, and membrane composition. These chromophores also exhibit strong nonlinear optical properties, including two-photon fluorescence and second harmonic generation, which are themselves environmentally-sensitive. The combination of long wavelength fluorescence and nonlinear optical properties make these chromophores very suitable for applications that require sensing or imaging deep inside tissues

The Symmetric Exchange Reaction OH + H₂O → H₂O + OH: Convergent Quantum Mechanical Predictions

The symmetric hydrogen exchange reaction OH + H₂O → H₂O + OH has been studied using the “gold standard” CCSD­(T) method with the correlation-consistent basis sets up to aug-cc-pV5Z. The CCSDT and CCSDT­(Q) methods were used for the final energic predictions. Two entrance complexes and two transition states on the H₃O₂ potential surface were located. The vibrational frequencies and the zero-point vibrational energies of these stationary points for the reaction are reported. The entrance complex H₂O···HO is predicted to lie 3.7 kcal mol^–1 below the separated reactants, whereas the second complex HOH···OH lies only 2.1 kcal mol^–1 below the separated reactants. The classical barrier height for the title reaction is predicted to be 8.4 kcal mol^–1, and the transition state between the two complexes is only slightly higher than the second complex. We estimate a reliability of ±0.2 kcal mol^–1 for these predictions. The capabilities of different density functional theory methods is also tested for this reaction