Home monitoring of foot skin temperatures to prevent ulceration

OBJECTIVE - To evaluate the effectiveness of at-home infrared temperature monitoring as a preventative tool in individuals at high risk for diabetes-related lower-extremity ulceration and amputation. RESEARCH DESIGN AND METHODS - Eighty-five patients who fit diabetic foot risk category 2 or 3 (neuropathy and foot deformity or previous history of ulceration or partial foot amputation) were randomized into a standard therapy group (n = 41) or an enhanced therapy group (n = 44). Standard therapy consisted of therapeutic footwear, diabetic foot education, and regular foot evaluation by a podiatrist. Enhanced therapy included the addition of a handheld infrared skin thermometer to measure temperatures on the sole of the foot in the morning and evening. Elevated temperatures (>4°F compared with the opposite foot) were considered to be "at risk" of ulceration due to inflammation at the site of measurement. When foot temperatures were elevated, subjects were instructed to reduce their activity and contact the study nurse. Study subjects were followed for 6 months. RESULTS - The enhanced therapy group had significantly fewer diabetic foot complications (enhanced therapy group 2% vs. standard therapy group 20%, P = 0.01, odds ratio 10.3, 95% CI 1.2-85.3). There were seven ulcers and two Charcot fractures among standard therapy patients and one ulcer in the enhanced therapy group. CONCLUSIONS - These results suggest that at-home patient self-monitoring with daily foot temperatures may be an effective adjunctive tool to prevent foot complications in individuals at high risk for lower-extremity ulceration and amputation

Invariant mechanical properties of calcium-silicate-hydrates (C-H-S) in cement-based materials : instrumented nanoindentation and microporomechanical modeling

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 2006.Includes bibliographical references (p. 455-478).Random porous solids such as bone and geomaterials exhibit a multiphase composite nature, characterized by water-filled pores of nm- to m-scale diameter. The natural synthesis and operating environments of such materials significantly alters phase composition and multiscale structural heterogeneities throughout the material lifetime, defining significant changes in macroscopic mechanical performance for applications ranging from multispan bridges to calcium-phosphate bone replacement cements. However, the nanoscale phases formed within the unique chemical environment of pores cannot be recapitulated ex situ in bulk form, and imaging of the composite microstructure is obfuscated by the size, environmental fragility, and nonconductive nature of such geomaterials and natural composites. Thus, there is an increasing drive to develop new approaches to image, quantify the mechanical contributions of, and understand the chemomechanical coupling of distinct phases in such composites. In this thesis, we utilize recent advances in experimentation namely instrumented indentation, and micromechanical modeling namely homogenization techniques, in an attempt to quantify the mutli-phase, multi-scale heterogeneity observed in all cement-based materials. We report a systematic framework for mechanically enabled imaging, measuring and modeling of structural evolution for cement based materials (CBM), porous geocomposites, at length scales on the order of constituent phase diameters (10-8 - 10-6 m), and thus identify two structurally distinct but compositionally similar phases heretofore hypothesized to exist.(cont.) The presented experimental and modeling results culminated in micromechanical models for elasticity and strength that can predict the macroscopic mechanical behavior for a range of CBM systems. The models directly correlate the changes in chemical and mechanical state to predict the experimentally observed range of macroscopic mechanical properties. This general framework is equally applicable to other man-made and natural composites, and enables accurate prediction of natural composite microstructure and mechanical performance directly from knowledge of material composition.by Georgios ConstantinidesPh.D

The elastic properties of calcium leached cement pastes and mortars : a multi-scale investigation

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 2002.Includes bibliographical references (p. 168-179).Calcium leaching induced aging in concrete creates a new material with degraded macroscopic mechanical properties. Although the degradation of strength has been elaborately studied in the last decade, the degradation of elasticity has not been investigated in the same depth. This thesis presents a combined experimental-theoretical investigation of the loss of elastic modulus due to calcium leaching. The first part of this thesis describes the experimental study performed on the elastic modulus of asymptotically leached cement paste and mortar. A combined qualitative-quantitative approach is adopted to characterize and quantify the chemical degradation at various length scales. The macroscopic elasticity (10-2 - 10-4 m) is measured using three different techniques: (a) Ultrasonic Pulse Velocity, (b) Resonant Frequency, and (c) Uniaxial Compression. The microscopic effect (10-5 - 10-7 m) is quantified using state-of- the-art Nanoindentation tests. Scanning Electron Microscope images complete the characterization by providing qualitative information about the concrete microstructure and its evolution through calcium leaching. The second part of the thesis is devoted to modeling the experimentally observed material behavior. Based on a micromechanical approach, using different homogenization schemes available, the different levels of characterization are linked together by a new multiscale -model. The macroscopic values predicted by the model compare well with the values obtained experimentally. The combined experimental-theoretical approach confirms both the deleterious effects induced by calcium leaching on concrete and the capacity of the model to predict the degradation of elasticity caused at the material level.by Georgios Constantinides.S.M

Spinal versus General Anaesthesia in Postoperative Pain Management during Transurethral Procedures

We compared the analgesic efficacy of spinal and general anaesthesia following transurethral procedures. 97 and 47 patients underwent transurethral bladder tumour resection (TUR-B) and transurethral prostatectomy (TUR-P), respectively. Postoperative pain was recorded using an 11-point visual analogue scale (VAS). VAS score was greatest at discharge from recovery room for general anaesthesia (P = 0.027). The pattern changed significantly at 8 h and 12 h for general anaesthesia's efficacy (P = 0.017 and P = 0.007, resp.). A higher VAS score was observed in pT2 patients. Patients with resected tumour volume >10 cm3 exhibited a VAS score >3 at 8 h and 24 h (P = 0.050, P = 0.036, resp.). Multifocality of bladder tumours induced more pain overall. It seems that spinal anaesthesia is more effective during the first 2 postoperative hours, while general prevails at later stages and at larger traumatic surfaces. Finally, we incidentally found that tumour stage plays a significant role in postoperative pain, a point that requires further verification

The role of CAPG in molecular communication between the embryo and the uterine endometrium: Is its function conserved in species with different implantation strategies?

During the preimplantation period of pregnancy in eutherian mammals, transcriptional and proteomic changes in the uterine endometrium are required to facilitate receptivity to an implanting blastocyst. These changes are mediated, in part, by proteins produced by the developing conceptus (inner cell mass and extraembryonic membranes). We hypothesized that this common process in early pregnancy in eutheria may be facilitated by highly conserved conceptus‐derived proteins such as macrophage capping protein (CAPG). We propose that CAPG may share functionality in modifying the transcriptome of the endometrial epithelial cells to facilitate receptivity to implantation in species with different implantation strategies. A recombinant bovine form of CAPG (91% sequence identity between bovine and human) was produced and bovine endometrial epithelial (bEECs) and stromal (bESCs) and human endometrial epithelial cells (hEECs) were cultured for 24 hours with and without recombinant bovine CAPG (rbCAPG). RNA sequencing and quantitative real‐time PCR analysis were used to assess the transcriptional response to rbCAPG (Control, vehicle, CAPG 10, 100, 1000 ng/mL: n = 3 biological replicates per treatment per species). Treatment of bEECs with CAPG resulted in alterations in the abundance of 1052 transcripts (629 increased and 423 decreased) compared to vehicle controls. Treatment of hEECs with bovine CAPG increased expression of transcripts previously known to interact with CAPG in different systems (CAPZB, CAPZA2, ADD1, and ADK ) compared with vehicle controls (P < .05). In conclusion, we have demonstrated that CAPG, a highly conserved protein in eutherian mammals, elicits a transcriptional response in the endometrial epithelium in species with different implantation strategies that may contribute to pregnancy success

The Roles of Impurities and Surface Area on Thermal Stability and Oxidation Resistance of BN Nanoplatelets

This study considers the influence of purity and surface area on the thermal and oxidation properties of hexagonal boron nitride (h-BN) nanoplatelets, which represent crucial factors in hightemperature oxidizing environments. Three h-BN nanoplatelet-based materials, synthesized with different purity levels and surface areas (~3, ~56, and ~140 m2/g), were compared, including a commercial BN reference. All materials were systematically analyzed by various characterization techniques, including gas pycnometry, scanning electron microscopy, X-ray diffraction, Fouriertransform infrared radiation, X-ray photoelectron spectroscopy, gas sorption analysis, and thermal gravimetric analysis coupled with differential scanning calorimetry. Results indicated that the thermal stability and oxidation resistance of the synthesized materials were improved by up to ~13.5% (or by 120 ◦C) with an increase in purity. Furthermore, the reference material with its high purity and low surface area (~4 m2/g) showed superior performance, which was attributed to the minimized reactive sites for oxygen diffusion due to lower surface area availability and fewer possible defects, highlighting the critical roles of both sample purity and accessible surface area in h-BN thermooxidative stability. These findings highlight the importance of focusing on purity and surface area control in developing BN-based nanomaterials, offering a path to enhance their performance in extreme thermal and oxidative conditions

Boron nitride nanotubes versus carbon nanotubes: A thermal stability and oxidation behavior study

Program and book of abstracts / 2nd International Conference on Innovative Materials in Extreme Conditions i. e. (IMEC2024), 20-22 March 2024 Belgrade, Serbia

Laparoscopic pyeloplasty for ureteropelvic junction obstruction of the lower moiety in a completely duplicated collecting system: a case report

<p>Abstract</p> <p>Introduction</p> <p>There are only a few reports on laparoscopic pyeloplasty in kidney abnormalities and only one case for laparoscopic pyeloplasty in a duplicated system. Increasing experience in laparoscopic techniques allows proper treatment of such anomalies. However, its feasibility in difficult cases with altered kidney anatomy such as that of duplicated renal pelvis still needs to be addressed.</p> <p>Case presentation</p> <p>We present a case of a 22-year-old white Caucasian female patient with ureteropelvic junction obstruction of the lower ureter of a completely duplicated system that was managed with laparoscopic pyeloplasty. Crossing vessels were identified and transposed. The procedure was carried out successfully and the patient's symptoms subsided. Follow-up studies demonstrated complete resolution of the obstruction.</p> <p>Conclusion</p> <p>Since laparoscopic pyeloplasty is still an evolving procedure, its feasibility in complex cases of kidney anatomic abnormalities is herein further justified.</p

Purity and surface area: Key factors on thermal stability and oxidation resistance of BN nanoplatelets

Program and book of abstracts / 2nd International Conference on Innovative Materials in Extreme Conditions i. e. (IMEC2024), 20-22 March 2024 Belgrade, Serbia