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Surgical management of the diabetic foot:The current evidence

World Journal of Orthopedics 2024年第5期15卷 404-417页

作者： Richard Henry Randall Roberts Gareth Rhys Davies-Jones james Brock Vaishnav Satheesh Greg AJ Robertson Department of Trauma and Orthopaedics Wrexham Maelor HospitalWrexham LL137TDUnited Kingdom Department of Trauma and Orthopaedics The Robert Jones and Agnes Hunt Orthopaedic HospitalOswestry SY107AGUnited Kingdom

The prevalence of diabetes mellitus and its associated complications,particularly diabetic foot pathologies,poses significant healthcare challenges and economic burdens *** review synthesises current evidence on the surgical management of the diabetic foot,focusing on the interplay between neuropathy,ischemia,and infection that commonly culminates in ulcers,infections,and,in severe cases,*** escalating incidence of diabetes mellitus underscores the urgency for effective management strategies,as diabetic foot complications are a leading cause of hospital admissions among diabetic patients,significantly impacting morbidity and mortality *** review explores the pathophysiological mechanisms underlying diabetic foot complications and further examines diabetic foot ulcers,infections,and skeletal pathologies such as Charcot arthropathy,emphasising the critical role of early diagnosis,comprehensive management strategies,and interdisciplinary care in mitigating adverse *** addressing surgical interventions,this review evaluates conservative surgeries,amputations,and reconstructive procedures,highlighting the importance of tailored approaches based on individual patient profiles and the specific characteristics of foot *** integration of advanced diagnostic tools,novel surgical techniques,and postoperative care,including offloading and infection control,are discussed in the context of optimising healing and preserving limb function.

关键词： Diabetes Diabetic foot Charcot Osteomyelitis Amputation Diabetic foot attack Conservative surgery

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fully integrated and broadband Si-rich silicon nitride wavelength converter based on Bragg scattering intermodal four-wave mixing

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Photonics Research 2024年第3期12卷 I0001-I0010页

作者： VALERIO VITALI THALÍA DOMÍNGUEZ BUCIO HAO LIU JOSÉMANUEL LUQUE GONZÁLEZ fRANCISCO JURADO-ROMERO ALEJANDRO ORTEGA-MOÑUX GLENN CHURCHILL james C.GATES james HILLIER NIKOLAOS KALfAGIANNIS DANIELE MELATI JENS H.SCHMID ILARIA CRISTIANI PAVEL CHEBEN J.GONZALO WANGÜEMERT-PÉREZ ÑIGO MOLINA-fERNÁNDEZ fREDERIC GARDES COSIMO LACAVA PERIKLIS PETROPOULOS Optoelectronics Research Centre University of SouthamptonSouthampton SO171BJUK Electrical Computer and Biomedical Engineering DepartmentUniversity of PaviaPavia 27100Italy Telecommunication Research Institute(TELMA) Universidad de MálagaCEI Andalucı´a TECHE.T.S.I.Telecomunicación29010 MálagaSpain School of Science and Technology Nottingham Trent UniversityNottingham NG118NSUK Department of Electrical Engineering Eindhoven University of TechnologyEindhoven 5600 MBThe Netherlands Department of Materials Science and Engineering University of IoanninaIoannina 45110Greece Centre de Nanosciences et de Nanotechnologies UniversitéParis-SaclayCNRS91120 PalaiseauFrance Advanced Electronics and Photonics Research Center National Research Council CanadaOttawaOntario K1A 0R6Canada

Intermodal four-wave mixing(fWM)processes have recently attracted significant interest for all-optical signal processing applications thanks to the possibility to control the propagation properties of waves exciting distinct spatial modes of the same *** allows,in principle,to place signals in different spectral regions and satisfy the phase matching condition over considerably larger bandwidths compared to intramodal ***,the demonstrations reported so far have shown a limited bandwidth and suffered from the lack of on-chip components designed for broadband manipulation of different *** demonstrate here a silicon-rich silicon nitride wavelength converter based on Bragg scattering intermodal fWM,which integrates mode conversion,multiplexing and de-multiplexing functionalities *** system enables wavelength conversion between pump waves and a signal located in different telecommunication bands(separated by 60 nm)with a 3 dB bandwidth exceeding 70 nm,which represents,to our knowledge,the widest bandwidth ever achieved in an intermodal fWM-based system.

关键词： scattering pump modal

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Barosinusitis due to routine weather changes:A cross-sectional analysis of public websites

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 18-23页

作者： james C.Campbell Julia E.Canick Philip G.Chen Ralph Abi Hachem David W.Jang Department of Head and Neck Surgery&Communication Sciences Duke University School of MedicineDurhamNorth CarolinaUSA Duke University School of Medicine DurhamNorth CarolinaUSA Department of Otolaryngology-Head and Neck Surgery University of Texas Health Science Center San AntonioSan AntonioTexasUSA

Background:Sinusitis is a common diagnosis that can be erroneously associated with routine weather‐related barometric pressure *** actuality,these pressure changes likely exacerbate migraine headaches,which can cause facial pain and pressure rather than true sinus ***:The present study sought to characterize the representation of both sinusitis and migraine in association with barometric pressure changes across websites on the ***:An Internet search for relevant terms was conducted,and content of the resulting pages was assessed for associations between weather‐related pressure changes and either sinusitis or *** in reported results across different subtypes of Internet sources were *** primary outcomes measured were(1)whether a given media source associated barometric weather changes with sinusitis,(2)whether that source associated barometric weather changes with migraine,and(3)treatment options offered by that ***:Of the 116 included webpages,36(31.03%)associated sinusitis and routine barometric pressure *** these,10(27.77%)were otolaryngology practice ***‐seven webpages(57.76%)associated migraine and routine barometric pressure *** these,nonotolaryngology webpages were more likely to report this ***:Otolaryngology practice sites were observed to be the most frequent professional medical resource reporting the unsubstantiated claim that routine barometric pressure changes are associated with *** sources were more likely to link weather‐related pressure changes to *** results suggest that opportunities exist for otolaryngology practice sites to educate patients about nonrhinogenic headache etiologies.

关键词： acute rhinosinusitis balloon sinus dilation headache migraine sinusitis

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Using Circular Economics Strategies to Manage Tourism on Remote Islands:A SMART Approach

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Journal of Tourism and Hospitality Management 2024年第1期12卷 18-33页

作者： Colm Barcoe james Hanrahan Garvan Whelan Ballsbridge College and ATU SligoIreland ATU SligoIreland TU DublinIreland

Circular economics theory offers destination managers of remote islands a solution-oriented approach to environmental sustainability. This paper examines the practical benefits of this theory that will support the development of a circular economy regarding sustainable island tourism (SIT). The aim of this paper is to inform discussions regarding the feasibility of applying a practice theory that emphasises changes in the behaviours across three segments, visitors, residents, and enterprises using SMART technologies. To achieve this objective, a SMART indicator system (SIS) was used to identify current practices that would support a circular economy (CE). The key innovation of this study is the creation of a proposed framework that may inform best practices for SIT in the future. The findings highlight the potential opportunity of evidenced-based planning to deliver a circular economy strategy (CES) for remote islands in the future. These insights can potentially impact the way that local authorities and destination managers approach the planning of tourism for six islands along the west coast of Ireland.

关键词： circular economy SMART indicator system sustainable island tourism proposed framework

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Sim-to-Real: A Performance Comparison of PPO, TD3, and SAC Reinforcement Learning Algorithms for Quadruped Walking Gait Generation

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Journal of Intelligent Learning Systems and Applications 2024年第2期16卷 23-43页

作者： james W. Mock Suresh S. Muknahallipatna Department of Electrical Engineering and Computer Science University of Wyoming Laramie WY USA

The performance of the state-of-the-art Deep Reinforcement algorithms such as Proximal Policy Optimization, Twin Delayed Deep Deterministic Policy Gradient, and Soft Actor-Critic for generating a quadruped walking gait in a virtual environment was presented in previous research work titled “A Comparison of PPO, TD3, and SAC Reinforcement Algorithms for Quadruped Walking Gait Generation”. We demonstrated that the Soft Actor-Critic Reinforcement algorithm had the best performance generating the walking gait for a quadruped in certain instances of sensor configurations in the virtual environment. In this work, we present the performance analysis of the state-of-the-art Deep Reinforcement algorithms above for quadruped walking gait generation in a physical environment. The performance is determined in the physical environment by transfer learning augmented by real-time reinforcement learning for gait generation on a physical quadruped. The performance is analyzed on a quadruped equipped with a range of sensors such as position tracking using a stereo camera, contact sensing of each of the robot legs through force resistive sensors, and proprioceptive information of the robot body and legs using nine inertial measurement units. The performance comparison is presented using the metrics associated with the walking gait: average forward velocity (m/s), average forward velocity variance, average lateral velocity (m/s), average lateral velocity variance, and quaternion root mean square deviation. The strengths and weaknesses of each algorithm for the given task on the physical quadruped are discussed.

关键词： Reinforcement Learning Reality Gap Position Tracking Action Spaces Domain Randomization

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Application of Elzaki Transform Method to Market Volatility Using the Black-Scholes Model

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Journal of Applied Mathematics and Physics 2024年第3期12卷 819-828页

作者： Henrietta Ify Ojarikre Ideh Rapheal Ebimene james Mamadu Department of Mathematics Delta State University Abraka Nigeria

Black-Scholes Model (B-SM) simulates the dynamics of financial market and contains instruments such as options and puts which are major indices requiring solution. B-SM is known to estimate the correct prices of European Stock options and establish the theoretical foundation for Option pricing. Therefore, this paper evaluates the Black-Schole model in simulating the European call in a cash flow in the dependent drift and focuses on obtaining analytic and then approximate solution for the model. The work also examines fokker Planck Equation (fPE) and extracts the link between fPE and B-SM for non equilibrium systems. The B-SM is then solved via the Elzaki transform method (ETM). The computational procedures were obtained using MAPLE 18 with the solution provided in the form of convergent series.

关键词： Elzaki Transform Method European Call Black-Scholes Model fokker-Planck Equation Market Volatility

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Otolaryngology residency program factors associated with female resident representation

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 7-11页

作者： Julia E.Canick james C.Campbell Charles R.Woodard Lars J.Grimm Alissa M.Collins Duke University School of Medicine DurhamNorth CarolinaUSA Department of Head and Neck Surgery&Communication Sciences Duke University School of MedicineDurhamNorth CarolinaUSA Department of Radiology Duke University School of MedicineDurhamNorth CarolinaUSA

Objective:female representation in the field of otolaryngology is *** is the first point at which medical school graduates specialize in a chosen field and thus represents an opportunity to recruit and train more female *** study sought to identify program factors associated with greater female representation among resident ***:Departmental websites of all 124 otolaryngology residency programs in the United States and Puerto Rico were examined for a list of *** programs with a resident roster available,the genders of residents,faculty,program directors,and chairpersons were *** and city population for each program was also recorded,as was female resident *** were compared using Pearson Chi‐squared univariate ***:1,632 residents and 2,605 faculty were included in the analysis of 109 *** median female resident representation was 40%.Programs with larger faculty sizes,more female faculty,and urban location were associated with an above‐median female resident *** with a larger residency cohort approached significance regarding above‐median female resident *** female faculty representation,program director gender,chairperson gender,and US region were not associated with variation in female resident ***:Greater female otolaryngology residency representation was associated with programs having an urban location and greater numbers of female and total *** was also likely that a larger resident cohort size may affect female resident *** proportions of female faculty,program director,and chairperson gender,as well as the US region,were not associated with variation in female resident gender representation.

关键词： gender program director recruitment residency training

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Colorful facial markings are associated with foraging rates and affiliative relationships in a wild group-living cichlid fish

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Current Zoology 2024年第1期70卷 70-78页

作者： Brett M.Culbert james B.Barnett Isaac Y.Ligocki Matthew G.Salena Marian Y.L.Wong Ian M.Hamilton Sigal Balshine Department of Integrative Biology University of GuelphGuelphOntarioCanada Department of Psychology Neuroscience&BehaviourMcMaster UniversityHamiltonOntarioCanada Department of Evolution Ecologyand Organismal BiologyThe Ohio State UniversityColumbusOHUSA Department of Biology Millersville UniversityMillersvillePAUSA School of Earth Atmospheric and Life SciencesUniversity of WollongongWollongongNew South WalesAustralia Department of Mathematics The Ohio State UniversityColumbusOHUSA

Many animals use color to signal their quality and/or behavioral *** signals have been well studied in the contexts of competi-tion and mate choice;however,the role of these signals in nonsexual,affiliative relationships is not as well ***,we used wild social groups of the cichlid fish Neolamprologus pulcher to investigate whether the size of a brightly colored facial patch was related to 1)individual quality,2)social dominance,and/or 3)affiliative *** with larger patches spent more time foraging and tended to perform more aggressive acts against conspecific territory *** did not find any evidence that the size of these yellow patches was related to social rank or body size,but dominant males tended to have larger patches than dominant ***,patch size had a rank-specific relationship with the number of affiliative interactions that individuals engaged *** males with large patches received fewer affiliative acts from their groupmates compared to dominant males with small ***,subordinates with large patches tended to receive more affiliative acts from their groupmates while performing fewer affiliative acts *** together,our results suggest that patch size reflects interindividual variation in foraging effort in this cichlid fish and offer some of the first evidence that colorful signals may shape affiliative relationships withinwildsocialgroups.

关键词： affiliation foraging Lake Tanganyika Neolamprologus pulcher visual signals

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Diabetic cardiomyopathy:Emerging therapeutic options

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World Journal of Diabetes 2024年第8期15卷 1677-1682页

作者： Cornelius james fernandez Sahana Shetty Joseph M Pappachan Department of Endocrinology&Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Department of Endocrinology Kasturba Medical CollegeManipal Academy of Higher EducationManipal 576104KarnatakaIndia Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

Diabetic cardiomyopathy(DbCM)is a common but underrecognized complication of patients with diabetes mellitus(DM).Although the pathobiology of other cardiac complications of diabetes such as ischemic heart disease and cardiac autonomic neuropathy are mostly known with reasonable therapeutic options,the mechanisms and management options for DbCM are still not fully *** its early stages,DbCM presents with diastolic dysfunction followed by heart failure(Hf)with preserved ejection fraction that can progress to systolic dysfunction and Hf with reduced ejection fraction in its advanced stages unless appropriately *** from prompt control of DM with lifestyle changes and antidiabetic medications,disease-modifying therapy for DbCM includes prompt control of hypertension and dyslipidemia inherent to patients with DM as in other forms of heart diseases and the use of treatments with proven efficacy in Hf.A basic study by Zhang et al,in a recent issue of the World Journal of Diabetes elaborates the potential pathophysiological alterations and the therapeutic role of teneligliptin in diabetic mouse models with *** this preliminary basic study might help to improve our understanding of DbCM and offer a potential new management option for patients with the disease,the positive results from such animal models might not always translate to clinical practice as the pathobiology of DbCM in humans could be ***,such experimental studies can encourage more scientific efforts to find a better solution to treat patients with this enigmatic disease.

关键词： Diabetic cardiomyopathy Diabetic cardiomyopathy Heart failure Pathobiology Teneligliptin

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Headache that Never Went Away

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Journal of Biosciences and Medicines 2024年第1期12卷 161-172页

作者： Naveen Vithanage Cyrill james Nirojan Karunanathan Amandip Singh Rakkar General Medicine Tauranga Hospital Bay of Plenty Tauranga New Zealand Cardiology Department Wexford General Hospital Ireland Wexford Ireland School of Medicine University College Dublin Ireland Dublin Ireland

Central nervous system (CNS) vasculitis encompasses a broad range of diseases characterized by inflammation of blood vessels within the brain, spinal cord, and meninges. This review focuses on Primary Angiitis of the CNS (PACNS), a unique form affecting only the CNS without other organ involvement. PACNS primarily affects the small- and medium-sized arteries in the brain, leading to neurological symptoms. Early recognition and intervention are essential for optimal management. This case report of a 25-year-old male highlights the diagnostic challenges, where a multidisciplinary approach was necessary to diagnose PACNS, given initial negative results. The paper also explores the etiology and pathogenesis of PACNS and discusses the diagnostic criteria proposed by researchers. Medical professionals primarily base management strategies on induction and maintenance therapies, utilizing a combination of glucocorticoids and immunosuppressants as the standard treatment. However, the exact dosages and administration methods need further research due to the absence of randomized clinical trials. The review underscores the need for continued research to enhance diagnostic and treatment protocols, given the severity of PACNS.

关键词： Primary Angitis of Central Nervous System

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