Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer.

BackgroundIn 2007, we reported a summary of data comparing diabetic foot complications to cancer. The purpose of this brief report was to refresh this with the best available data as they currently exist. Since that time, more reports have emerged both on cancer mortality and mortality associated with diabetic foot ulcer (DFU), Charcot arthropathy, and diabetes-associated lower extremity amputation.MethodsWe collected data reporting 5-year mortality from studies published following 2007 and calculated a pooled mean. We evaluated data from DFU, Charcot arthropathy and lower extremity amputation. We dichotomized high and low amputation as proximal and distal to the ankle, respectively. This was compared with cancer mortality as reported by the American Cancer Society and the National Cancer Institute.ResultsFive year mortality for Charcot, DFU, minor and major amputations were 29.0, 30.5, 46.2 and 56.6%, respectively. This is compared to 9.0% for breast cancer and 80.0% for lung cancer. 5 year pooled mortality for all reported cancer was 31.0%. Direct costs of care for diabetes in general was $237 billion in 2017. This is compared to$80 billion for cancer in 2015. As up to one-third of the direct costs of care for diabetes may be attributed to the lower extremity, these are also readily comparable.ConclusionDiabetic lower extremity complications remain enormously burdensome. Most notably, DFU and LEA appear to be more than just a marker of poor health. They are independent risk factors associated with premature death. While advances continue to improve outcomes of care for people with DFU and amputation, efforts should be directed at primary prevention as well as those for patients in diabetic foot ulcer remission to maximize ulcer-free, hospital-free and activity-rich days

Cooling of rocket thrust chambers with liquid oxygen

Rocket engines using high pressure liquid oxygen (LOX) and kerosene (RP-1) as the propellants have been considered for future launch vehicle propulsion. Generally, in regeneratively cooled engines, the fuel is used to cool the combustion chamber. However, hydrocarbons such as RP-1 are limited in their cooling capability at high temperatures and pressures. Therefore, LOX is being considered as an alternative coolant. However, there has been concern as to the effect on the integrity of the chamber liner if oxygen leaks into the combustion zone through fatigue cracks that may develop between the cooling passages and the hot-gas side wall. To address this concern, an investigation was previously conducted with simulated fatigue cracks upstream of the thrust chamber throat. When these chambers were tested, an unexpected melting in the throat region developed which was not in line with the simulated fatigue cracks. The current experimental program was conducted in order to determine the cause for the failure in the earlier thrust chambers and to further investigate the effects of cracks in the thrust chamber liner upstream of the throat. The thrust chambers were tested at oxygen-to-fuel mixture ratios from 1.5 to 2.86 at a nominal chamber pressure of 8.6 MPa. As a result of the test series, the reason for the failure occurring in the earlier work was determined to be injector anomalies. The LOX leaking through the simulated fatigue cracks did not affect the integrity of the chambers

Sweep maps: A continuous family of sorting algorithms

We define a family of maps on lattice paths, called sweep maps, that assign levels to each step in the path and sort steps according to their level. Surprisingly, although sweep maps act by sorting, they appear to be bijective in general. The sweep maps give concise combinatorial formulas for the q,t-Catalan numbers, the higher q,t-Catalan numbers, the q,t-square numbers, and many more general polynomials connected to the nabla operator and rational Catalan combinatorics. We prove that many algorithms that have appeared in the literature (including maps studied by Andrews, Egge, Gorsky, Haglund, Hanusa, Jones, Killpatrick, Krattenthaler, Kremer, Orsina, Mazin, Papi, Vaille, and the present authors) are all special cases of the sweep maps or their inverses. The sweep maps provide a very simple unifying framework for understanding all of these algorithms. We explain how inversion of the sweep map (which is an open problem in general) can be solved in known special cases by finding a "bounce path" for the lattice paths under consideration. We also define a generalized sweep map acting on words over arbitrary alphabets with arbitrary weights, which is also conjectured to be bijective.Comment: 21 pages; full version of FPSAC 2014 extended abstrac

Weakly bound states of polar molecules in bilayers

We investigate a system of two polarized molecules in a layered trap. The molecules reside in adjacent layers and interact purely via the dipole-dipole interaction. We determine the properties of the ground state of the system as a function of the dipole moment and polarization angle. A bound state is always present in the system and in the weak binding limit the bound state extends to a very large distance and shows universal behavior.Comment: Presented at the 21st European Conference on Few-Body Problems in Physics, Salamanca, Spain, 30 August - 3 September 201

High-pressure calorimeter chamber tests for liquid oxygen/kerosene (LOX/RP-1) rocket combustion

An experimental program was conducted to investigate the rocket combustion and heat transfer characteristics of liquid oxygen/kerosene (LOX/RP-1) mixtures at high chamber pressures. Two water-cooled calorimeter chambers of different combustion lengths were tested using 37- and 61-element oxidizer-fuel-oxidizer triplet injectors. The tests were conducted at nominal chamber pressures of 4.1, 8.3, and 13.8 MPa abs (600, 1200, and 2000 psia). Heat flux Q/A data were obtained for the entire calorimeter length for oxygen/fuel mixture ratios of 1.8 to 3.3. Test data at 4.1 MPa abs compared favorably with previous test data from another source. Using an injector with a fuel-rich outer zone reduced the throat heat flux by 47 percent with only a 4.5 percent reduction in the characteristic exhaust velocity efficiency C* sub eff. The throat heat transfer coefficient was reduced approximately 40 percent because of carbon deposits on the chamber wall

Manifestation of the JLab proton polarization data on the behaviour of strange nucleon form factors

Special eight-resonance unitary and analytic model of nucleon electromagnetic structure is used to analyze, first the classical proton form factor data obtained by the Rosenbluth technique and then also the contradicting JLab proton polarization data on the ratio $\mu_p G_{Ep}(Q^2)/G_{Mp}(Q^2)$ with the aim to investigate a manifestation of the latter on the strange nucleon form factors behaviour.Comment: Latex, 9 pages, 3 figures. Talk given at the PAVI06 International Workshop, 16-20 May, 2006, Milos, Greec

Bound States and Universality in Layers of Cold Polar Molecules

The recent experimental realization of cold polar molecules in the rotational and vibrational ground state opens the door to the study of a wealth of phenomena involving long-range interactions. By applying an optical lattice to a gas of cold polar molecules one can create a layered system of planar traps. Due to the long-range dipole-dipole interaction one expects a rich structure of bound complexes in this geometry. We study the bilayer case and determine the two-body bound state properties as a function of the interaction strength. The results clearly show that a least one bound state will always be present in the system. In addition, bound states at zero energy show universal behavior and extend to very large radii. These results suggest that non-trivial bound complexes of more than two particles are likely in the bilayer and in more complicated chain structures in multi-layer systems.Comment: 6 pages, 5 figures. Revised version to be publishe

Simultaneous observations of solar protons inside and outside the magnetosphere Progress report

Simultaneous observations of solar protons inside and outside magnetosphere by Explorer XXXIII AND Injun I