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

Polymer Brush‐Modified Microring Resonators for Partition‐Enhanced Small Molecule Chemical Detection

Silicon photonic microring resonators have emerged as a promising technology for the sensitive detection of biological macromolecules, including proteins and nucleic acids. However, not all species of interest are large biologics that can be targeted by highly specific capture agents. For smaller organic chemicals, including many toxic and regulated species, a general approach to improving sensitivity would be desirable. By functionalizing the surface of silicon photonic microring resonators with polymer brushes, small molecules can selectively partition into the surface‐confined sensing region of the optical resonators. This in turn leads to response enhancements in excess of 1000% percent, relative to non‐functionalized sensors, for representative targets including 4‐methylumbelliferyl phosphate, a simulant for highly toxic organophosphates, Bisphenol A, an industrial pollutant, as well as other small organic analytes of interest. There are many polymer brush chemistries compatible with silicon resonators, making this a general strategy towards tuning sensor selectivity and specificity by optimizing interactions between the agent(s) of interest and the polymer construct.Polymer brush‐modified microring resonators sensors can be utilized to enhance sensitivity and specificity for the detection of small molecule organic chemicals.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136268/1/slct201700082.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136268/2/slct201700082-sup-0001-misc_information.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136268/3/slct201700082_am.pd