High-entropy alloys (HEAs), based on equiatomic or near-equiatomic mixture of usually four or more elements, have attracted considerable attention as there are indications that along with surprising ...microstructural simplicity of some alloys, they may also offer intriguing combinations of mechanical and other properties. Amongst these properties, there is growing interest in the irradiation response of HEAs and their potential to withstand the neutron bombardment environment of future civil nuclear power plants. One of the first proposed HEAs is face-centred cubic CrMnFeCoNi, also known as the Cantor alloy, and the irradiation response of the Cantor alloy and its sub-systems are the focus of this review. Using irradiation analogues (electrons, heavy ions and He) to neutron bombardment and considering simulations, advanced microstructural analysis and property measurement, the Cantor alloy and its derivatives are shown to exhibit encouraging irradiation resistance that, in many instances, is superior to more traditional dilute alloys of the same elements. The beneficial aspects are high phase stability and resistance to radiation-induced segregation, smaller size but higher number density of dislocation loops, significantly lower extent of swelling and improved resistance to He bubble growth. The future research directions for irradiation resistant HEAs are also suggested.
Hybrid solid electrolytes, composed of 3D ordered bicontinuous conducting ceramic and insulating polymer microchannels are reported. The ceramic channels provide continuous, uninterrupted pathways, ...maintaining high ionic conductivity between the electrodes, while the polymer channels permit improvement of the mechanical properties from that of the ceramic alone, in particular mitigation of the ceramic brittleness. The conductivity of a ceramic electrolyte is usually limited by resistance at the grain boundaries, necessitating dense ceramics. The conductivity of the 3D ordered hybrid is reduced by only the volume fraction occupied by the ceramic, demonstrating that the ceramic channels can be sintered to high density similar to a dense ceramic disk. The hybrid electrolytes are demonstrated using the ceramic lithium ion conductor Li 1.4 Al 0.4 Ge 1.6 (PO 4 ) 3 (LAGP). Structured LAGP 3D scaffolds with empty channels were prepared by negative replication of a 3D printed polymer template. Filling the empty channels with non-conducting polypropylene (PP) or epoxy polymer (epoxy) creates the structured hybrid electrolytes with 3D bicontinuous ceramic and polymer microchannels. Printed templating permits precise control of the ceramic to polymer ratio and the microarchitecture; as demonstrated by the formation of cubic, gyroidal, diamond and spinodal (bijel) structures. The electrical and mechanical properties depend on the microarchitecture, the gyroid filled with epoxy giving the best combination of conductivity and mechanical properties. An ionic conductivity of 1.6 × 10 −4 S cm −1 at room temperature was obtained, reduced from the conductivity of a sintered LAGP pellet only by the volume fraction occupied by the ceramic. The mechanical properties of the gyroid LAGP–epoxy electrolyte demonstrate up to 28% higher compressive failure strain and up to five times the flexural failure strain of a LAGP pellet before rupture. Notably, this demonstrates that ordered ceramic and polymer hybrid electrolytes can have superior mechanical properties without significantly compromising ionic conductivity, which addresses one of the key challenges for all-solid-state batteries.
Ever-harsher service conditions in the future will call for materials with increasing ability to undergo deformation without sustaining damage while retaining high strength. Prime candidates for ...these conditions are certain high-entropy alloys (HEAs), which have extraordinary work-hardening ability and toughness. By subjecting the equiatomic CrMnFeCoNi HEA to severe plastic deformation through swaging followed by either quasi-static compression or dynamic deformation in shear, we observe a dense structure comprising stacking faults, twins, transformation from the face-centered cubic to the hexagonal close-packed structure, and, of particular note, amorphization. The coordinated propagation of stacking faults and twins along {111} planes generates high-deformation regions, which can reorganize into hexagonal packets; when the defect density in these regions reaches a critical level, they generate islands of amorphous material. These regions can have outstanding mechanical properties, which provide additional strengthening and/or toughening mechanisms to enhance the capability of these alloys to withstand extreme loading conditions.
Background
In 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.
Methods
We 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.
Results
Five 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.
Conclusion
Diabetic 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.
Diabetes-related foot disease (DFD), which includes foot ulcers, infection and gangrene, is a leading cause of the global disability burden. About half of people who develop DFD experience a ...recurrence within one year. Long-term medical management to reduce the risk of recurrence is therefore important to reduce the global DFD burden. This review describes research assessing the value of sensors, wearables and telehealth in preventing DFD. Sensors and wearables have been developed to monitor foot temperature, plantar pressures, glucose, blood pressure and lipids. The monitoring of these risk factors along with telehealth consultations has promise as a method for remotely managing people who are at risk of DFD. This approach can potentially avoid or reduce the need for face-to-face consultations. Home foot temperature monitoring, continuous glucose monitoring and telehealth consultations are the approaches for which the most highly developed and user-friendly technology has been developed. A number of clinical studies in people at risk of DFD have demonstrated benefits when using one of these remote monitoring methods. Further development and evidence are needed for some of the other approaches, such as home plantar pressure and footwear adherence monitoring. As yet, no composite remote management program incorporating remote monitoring and the management of all the key risk factors for DFD has been developed and implemented. Further research assessing the feasibility and value of combining these remote monitoring approaches as a holistic way of preventing DFD is needed.
ABSTRACT
Over 30 per cent of the $\sim$4000 known exoplanets to date have been discovered using ‘validation’, where the statistical likelihood of a transit arising from a false positive (FP), ...non-planetary scenario is calculated. For the large majority of these validated planets calculations were performed using the vespa algorithm. Regardless of the strengths and weaknesses of vespa, it is highly desirable for the catalogue of known planets not to be dependent on a single method. We demonstrate the use of machine learning algorithms, specifically a Gaussian process classifier (GPC) reinforced by other models, to perform probabilistic planet validation incorporating prior probabilities for possible FP scenarios. The GPC can attain a mean log-loss per sample of 0.54 when separating confirmed planets from FPs in the Kepler Threshold-Crossing Event (TCE) catalogue. Our models can validate thousands of unseen candidates in seconds once applicable vetting metrics are calculated, and can be adapted to work with the active Transiting Exoplanet Survey Satellite (TESS) mission, where the large number of observed targets necessitate the use of automated algorithms. We discuss the limitations and caveats of this methodology, and after accounting for possible failure modes newly validate 50 Kepler candidates as planets, sanity checking the validations by confirming them with vespa using up to date stellar information. Concerning discrepancies with vespa arise for many other candidates, which typically resolve in favour of our models. Given such issues, we caution against using single-method planet validation with either method until the discrepancies are fully understood.
The stability and resilience of the Earth system and human well-being are inseparably linked
, yet their interdependencies are generally under-recognized; consequently, they are often treated ...independently
. Here, we use modelling and literature assessment to quantify safe and just Earth system boundaries (ESBs) for climate, the biosphere, water and nutrient cycles, and aerosols at global and subglobal scales. We propose ESBs for maintaining the resilience and stability of the Earth system (safe ESBs) and minimizing exposure to significant harm to humans from Earth system change (a necessary but not sufficient condition for justice)
. The stricter of the safe or just boundaries sets the integrated safe and just ESB. Our findings show that justice considerations constrain the integrated ESBs more than safety considerations for climate and atmospheric aerosol loading. Seven of eight globally quantified safe and just ESBs and at least two regional safe and just ESBs in over half of global land area are already exceeded. We propose that our assessment provides a quantitative foundation for safeguarding the global commons for all people now and into the future.
Three-electrode studies coupled with tomographic imaging of the Na/Na-β″-alumina interface reveal that voids form in the Na metal at the interface on stripping and they accumulate on cycling, leading ...to increasing interfacial current density, dendrite formation on plating, short circuit, and cell failure. The process occurs above a critical current for stripping (CCS) for a given stack pressure, which sets the upper limit on current density that avoids cell failure, in line with results for the Li/solid-electrolyte interface. The pressure required to avoid cell failure varies linearly with current density, indicating that Na creep rather than diffusion per se dominates Na transport to the interface and that significant pressures are required to prevent cell death, >9 MPa at 2.5 mA·cm–2.
Critical limb ischemia, first defined in 1982, was intended to delineate a subgroup of patients with a threatened lower extremity primarily because of chronic ischemia. It was the intent of the ...original authors that patients with diabetes be excluded or analyzed separately. The Fontaine and Rutherford Systems have been used to classify risk of amputation and likelihood of benefit from revascularization by subcategorizing patients into two groups: ischemic rest pain and tissue loss. Due to demographic shifts over the last 40 years, especially a dramatic rise in the incidence of diabetes mellitus and rapidly expanding techniques of revascularization, it has become increasingly difficult to perform meaningful outcomes analysis for patients with threatened limbs using these existing classification systems. Particularly in patients with diabetes, limb threat is part of a broad disease spectrum. Perfusion is only one determinant of outcome; wound extent and the presence and severity of infection also greatly impact the threat to a limb. Therefore, the Society for Vascular Surgery Lower Extremity Guidelines Committee undertook the task of creating a new classification of the threatened lower extremity that reflects these important considerations. We term this new framework, the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System. Risk stratification is based on three major factors that impact amputation risk and clinical management: Wound, Ischemia, and foot Infection (WIfI). The implementation of this classification system is intended to permit more meaningful analysis of outcomes for various forms of therapy in this challenging, but heterogeneous population.
Foot ulcers are one of the most common and severe complication of diabetes mellitus with significant resultant morbidity and mortality. Multiple factors impair wound healing include skin injury, ...diabetic neuropathy, ischemia, infection, inadequate glycemic control, poor nutritional status, and severe morbidity. It is currently believed that oxidative stress plays a vital role in diabetic wound healing. An imbalance of free radicals and antioxidants in the body results in overproduction of reactive oxygen species which lead to cell, tissue damage, and delayed wound healing. Therefore, decreasing ROS levels through antioxidative systems may reduce oxidative stress-induced damage to improve healing. In this context, we provide an update on the role of oxidative stress and antioxidants in diabetic wound healing through following four perspectives. We then discuss several therapeutic strategies especially dietary bioactive compounds by targeting oxidative stress to improve wounds healing.
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