Preventing foot ulceration in diabetes:systematic review and meta-analyses of RCT data

Aims/hypothesis: Foot ulceration is a serious complication for people with diabetes that results in high levels of morbidity for individuals and significant costs for health and social care systems. Nineteen systematic reviews of preventative interventions have been published, but none provides a reliable numerical summary of treatment effects. The aim of this study was to systematically review the evidence from RCTs and, where possible, conduct meta-analyses to make the best possible use of the currently available data. Methods: We conducted a systematic review and meta-analysis of RCTs of preventative interventions for foot ulceration. OVID MEDLINE and EMBASE were searched to February 2019 and the Cochrane Central Register of Controlled Trials to October 2018. RCTs of interventions to prevent foot ulcers in people with diabetes who were free from foot ulceration at trial entry were included. Two independent reviewers read the full-text articles and extracted data. The quality of trial reporting was assessed using the Cochrane Risk of Bias tool. The primary outcome of foot ulceration was summarised using pooled relative risks in meta-analyses. Results: Twenty-two RCTs of eight interventions were eligible for analysis. One trial of digital silicone devices (RR 0.07 [95% CI 0.01, 0.55]) and meta-analyses of dermal infrared thermometry (RR 0.41 [95% CI 0.19, 0.86]), complex interventions (RR 0.59 [95% CI 0.38, 0.90], and custom-made footwear and offloading insoles (RR 0.53 [95% CI 0.33, 0.85]) showed beneficial effects for these interventions. Conclusions/interpretation: Four interventions were identified as being effective in preventing foot ulcers in people with diabetes, but uncertainty remains about what works and who is most likely to benefit

PT-conditions of deformation within the Palaeoproterozoic South Finland shear zone: Some geothermobarometric results

Four rock samples were collected from the crustal-scale South Finland shear zone in order to compare PT-conditions of deformation between gneissose and mylonitic rock types. Two of the samples were collected from a garnet-bearing gneiss representing an early ductile shearing phase. The two other samples were collected from a 30-meter-wide ultramylonite zone; first sample representing the ultramylonite and the second sample a less deformed amphibole-rich gneiss lens within the zone, interpreted to be the mylonite protolith. The new GBPQ geobarometer and the Gt-Bt exchange geothermometer were applied to the two garnet-bearing samples. The temperature conditions of the ultramylonites and the gneissose protolith were compared with the amphibole-plagioclase thermometer by Holland and Blundy (1994). The transpressive ductile shearing that produced the granodioritic and tonalitic gneisses within the study area is interpreted to have taken place in conditions with minimum metamorphic peaks at approximately 680 °C and 7 kbar as indicated by the GBPQ barometer and Gt-Bt thermometer. The results of the Hbl-Plg thermometry, based on the ultramylonite and amphibole gneiss data, suggest that the ultramylonite was formed at minimum 50 °C lower temperature conditions than the surrounding gneisses (the uncertainty of the Hbl-Plg thermometer is 35-40 °C). This is consistent with field observations of a large-scale reactivation of the shear zone after the main transpressive phase of the late stages of the Svecofennian orogen in Southern Finland

Pulse-assisted homonuclear dipolar recoupling of half-integer quadrupolar spins in magic-angle spinning NMR

We demonstrate numerically and experimentally that zero-quantum homonuclear dipolar recoupling techniques employing rotor-synchronized 180 degrees pulses, previously introduced for spin-1/2 applications, are useful also for magnetization transfers between half-integer quadrupolar nuclei in rotating solids. The recoupling sequences are incorporated as mixing periods in two-dimensional experimental protocols, that correlate either single-quantum coherences of coupled spins, or triple-quantum with single-quantum coherences for improving spectral resolution. We present Na-23 and Al-27 NMR experiments on powders of sodium sulphite [Na2SO3], YAG [Y3Al5O12] and a synthetic chlorite mineral [Mg4.5Al3Si2.5O10(OH)(8)].</p

Mössbauer study of iron-rich biotites

It has been possible by detailed studies of the Mossbauer spectra for biotite, to distinguish between the two iron sites.</p