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Background Diabetic foot infections are a common precursor to lower extremity amputations. The treatment of diabetic foot infections involves both medical and surgical management, of which limb-sparing surgeries are increasingly preferred over amputations at or above the ankle to preserve mobility and quality of life. The outcomes following these limb-sparing surgeries are not well described. Methods This was a single-center, retrospective cohort study of 90 Veterans with moderate-to-severe diabetic foot infections between 2017 and 2019 from the Veterans Affairs Maryland Health Care System. The exposure was foot surgery with bone resection (ie, toe amputation, metatarsal resection, transmetatarsal amputation) vs debridement alone. The outcome was healing within 1 year. We used log-binomial regression to assess the association between foot surgery type and healing, stratify by infection location, and evaluate potential confounding variables. Results The cumulative incidence of healing after foot surgery with bone resection was greater than that following debridement (risk ratio [RR], 1.80 [95% confidence interval {CI}, 1.17–2.77]). This association was modified by infection location and greater for toe infections (RR, 4.52 [95% CI, 1.30–15.7]) than other foot infections (RR, 1.19 [95% CI,.69–2.02]). We found no evidence of confounding by comorbidities or infection severity. Conclusions For patients with toe infections, foot surgery with bone resection was associated with better healing than debridement alone. The multiple specialties caring for patients with diabetic foot infections need a stronger common knowledge base—from studies like this and future studies—to better counsel patients about their treatment and prognosis. [ABSTRACT FROM AUTHOR]

In 2010, a construction project for a new water pumping station on the west side of Tell Timai (Egyptian Delta) encountered a limestone structure. This discovery triggered a salvage excavation that exposed a rare example of a well-preserved Delta nilometer. The architectural features of the nilometer reveal some specific and even unique adaptations consonant with the hydrological situation of the Graeco-Roman city of Thmouis. Unlike other examples of nilometers, an aqueduct runs from the north, spilling into the stairwell leading down into the stilling well. A dam stone in the aqueduct appears to have regulated the release of water. The nilometer was also articulated with an adjacent hill by a staircase. Folk tradition memorialised the stair and nilometer location in local fertility and healing rituals performed during Nile flood-related festivals; this tradition preserved the sacred space long after the nilometer and its associated architecture were buried and forgotten. The multifaceted role of the Thmouis nilometer in the cultural and economic life of the city and nome carries wider implications for the political organisation of the nome and the dynamic between syncretic forces and imperial appropriation in Graeco-Roman Egypt. Here we review the shape, function, archaeological context, ideological significance and hydrography of the nilometer and consider the implications of the nilometer for the history of the Mendesian nome and its sacred relationship with the Nile River. [ABSTRACT FROM AUTHOR]

Cleopatra VII, the last of the Ptolemaic rulers of Egypt, reveled in perfume (Plutarch, Life of Marcus Antonius 26.2). She even used it in her seduction of the Roman general Marc Antony. Sailing up the river Cydnus to meet him, she reclined in a canopy spangled with gold, adorned like Venus in a painting. Boys dressed as cupids fanned her and wondrous scents from incense offerings wafted along the riverbanks. Not long after her death in August 30 BCE, a book circulated under her name called Cleopatra's Cosmetic, full of recipes for fragrant oils and cleansers (Totelin 2017 : 114–18). [ABSTRACT FROM AUTHOR]

Background: Understanding physical activity (PA) after discharge from the military can inform theory on the role of habit and reinforcement in behavior maintenance and has implications for this population's future health. Methods: Using data from 28.866 Millennium Cohort Study participants (n = 3782 of whom were discharged during the years between assessments), we 1) investigated changes in meeting federal PA guidelines for moderate-to-vigorous activity (MVPA) following military discharge and 2) determined predictors of meeting these guidelines after discharge. Results: MVPA declined more in those who were discharged than in those who were not (–17.8 percentage points vs. –2.7 percentage points), with greater declines in former active-duty personnel, those who had deployed with combat exposures, had 14 to 25 years of service, and had been discharged more recently (>2 years prior). In those who were discharged, being normal or overweight (vs. obese), and a nonsmoker or former smoker (vs. current smoker) were positively associated with meeting MVPA Guidelines at follow-up, while meeting MVPA Guidelines at baseline and depression were inversely associated. Conclusions: Reductions in MVPA were substantial and unexpected. Increased understanding of transitional periods that may benefit from interventions to mitigate declines in PA will help prevent excess weight gain and physical inactivity-associated health consequences. [ABSTRACT FROM AUTHOR]

Abstract Background RRM1 and ERCC1 overexpression has been extensively investigated as potential predictive markers of tumor sensitivity to conventional chemotherapy agents, most thoroughly in lung cancer. However, data in pancreatic cancer are scarce. Methods We investigated the mRNA and protein expression of ERCC1 and RRM1 by RT-PCR and immunohistochemistry (IHC) in formalin-fixed, paraffin-embedded pancreatic ductal carcinoma (PDA) tissues. The primary outcome investigated was the association between RRM1 and ERCC1 expression and overall survival (OS) or disease-free survival (DFS). Results A total of 94 patients with resected PDA were included in this study. Most of them (87%) received gemcitabine based chemotherapy. Data for OS analysis was available in all cases but only 68% had enough information to estimate DFS. IHC analysis revealed information for 99% (93/94) and 100% of the cases for RRM1 and ERCC1 expression respectively. However, PCR data interpretation was possible in only 49 (52%) and 79 (84%) cases respectively. There was no significant association between high or low expression of either RRM1 or ERCC1, detected by IHC and OS (14.4 vs. 19.9 months; P = 0.5 and 17.1 vs. 19.9; P = 0.83 respectively) or PCR and OS (48.0 vs. 24.1 months; P = 0.21 and 22.0 vs. 16.0 months; P = 0.39 respectively). Similar results were obtained for DFS. Conclusions RRM1 and ERCC1 expression does not seem to have a clear predictive or prognostic value in pancreatic cancer. Our data raise some questions regarding the real clinical and practical significance of analyzing these molecules as predictors of outcomes.