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

Iron Distribution In Ortho-pyroxene - A Comparison of Mossbauer-spectroscopy and X-ray Refinement Results

The Fe-Mg distribution over the MI and M2 octahedral sites in five natural orthopyroxenes has been determined by single-crystal X-ray diffraction (XRD) and Mossbauer spectroscopy (MS). The results from the two methods are in good agreement for two Fe/Mg intermediate composition samples, provided that the MS data are thickness-corrected. For two Fe-poor and one Al-rich sample, the results diverge ; XRD gives a more ordered Fe-Mg distribution than MS, with up to 0.05 more Fe atoms per formula unit in the M2 position. The thickness effect on MS for ordered orthopyroxene is shown to cause considerable distortion of the spectra, resulting in an underestimate of the degree of ordering. For normally thick absorbers (5 mg Fe/cm2), MS data will allocate approximately 2% too much of total Fe to the M1 position. However, the Fe distribution obtained from MS data can be corrected by extrapolation to zero thickness according to the formula Fe(M1)/Fe(tot)corr = [Fe(M1)/Fe(tot)meas - 0.004085t]/(1 - 0.003031t), where t is the Fe > of the absorber in mg Fe/cm2

MAGNETIC DIPOLAR AND ELECTRIC QUADRUPOLE EFFECTS ON THE MÖSSBAUER SPECTRA OF MAGNETITE ABOVE THE VERWEY TRANSITION

La magnétite Fe3O4 est étudiée par spectrométrie Mössbauer entre 120 et 880 K. En-dessous de Tc les spectres sont analysés en 3 sextuplets : 2 pour les sites octaédriques B, et 1 pour les sites tétraédriques A. Les champs magnétiques sont comparés aux mesures d'aimantation par diffraction des neutrons. Dans l'état paramagnétique, on observe une correlation intéressante entre les dépendences thermiques de la résistivité électrique et des déplacements isomériques.Mössbauer spectroscopic studies of powdered Fe3O4 have been undertaken between 120 K and 880 K. Below the magnetic transition temperature (Tc = 839,5 K) three six line patterns have been fitted to the experimental spectra. Two patterns are ascribed to the octahedral B-site and one pattern is ascribed to the tetrahedral A-site. It is shown that the broadening of the B-pattern is caused by the presence of two unresolved components. The corresponding Mössbauer patterns have intensity ratio 3 : l arising from the different magnetic dipolar and electric quadrupolar interactions on the B-site iron ions. It can therefore be concluded that line broadening due to electron hopping between B-sites ions is negligible. The temperature variation of the magnetic fields is found to be proportional to the sublattice magnetization as measured by neutron diffraction. The difference in the magnetic fields at the two nonequivalent B-sites is measured to be 1.1. T at 310 K in good agreement with values found from NMR studies. In the paramagnetic state the electric quadrupole splittings of iron at A and B-site are found to be constant, independent of temperature, having the values zero and 0.16 mm/s, respectively. The centroid shifts, on the other hand show above 700 K large deviations from the calculated second order Doppler shift. It is proposed that the deviations arise from a variation in band overlap. The unusual variation of the centroid shifts can be correlated with the observed maximum of the resistivity found for magnetic at about 750 K. The isomer shift variation is most pronounced for A-site which indicates that a model describing the high temperature conductivity in magnetic has to take into account not only the B-sites but also the A-sites