In Hamburg more than 300 people died as a result of a storm surge

In Hamburg more than 300 people died as a result of a storm surge as recently as February 1962, even though the city is 100 km from the sea. Since then, all the dikes along the German North Sea coast have been raised; thanks to this action, the highest storm surge ever recorded (January 1976) caused only minor damage. An analysis of all historical surges

(Hewer 1980) showed that these extreme events fall into two classes: • ‘Static’ type: low pressure track Iceland – northern North Sea – Scandinavia; extended, cold low; a long-lasting but not necessarily extreme wind pushes SP600125 purchase water into the German Bight. The most prominent example: 17 February 1962. In a numerical investigation both these historical surges were modified (by changing wind amplitudes and phases somewhat, but within what is physically possible) with the aim of achieving more dramatic effects (Hewer 1980). The results are shown in Figures 14 and 15. According to these studies, the maximum sea levels recorded in the inner German Bight up till now could 3-Methyladenine datasheet be exceeded by 2.54 m for the static type and 1.70 m for the dynamic type. The long-term heat budget of the North Sea has been analysed using decadal simulations of HAMSOM (Pohlmann 2003). First, the influence of wind and atmospheric heat fluxes was studied. Surprisingly, it turned

out that the correlation of maximum wind stress and maximum monthly total heat content is nearly zero. The logical expectation would be that a stronger wind deepens the upper thermal layer, thereby enlarging the heat content of the water body. This

is explained by the negative correlation of the wind stress and the maximum sea surface temperature SST. As a matter of fact, in the North Atlantic system a warm summer is connected with weak winds (and vice versa), which means a damping of interannual fluctuations 5-FU research buy in the heat content. Nevertheless, a clear correlation (0.75) exists between the maximum heat content in summer and the minimum SST of the preceding winter. This can be explained as follows. In winter the water column is vertically mixed resulting in an almost homogeneous temperature distribution (equal to SST). During the formation of a thermal upper layer in spring/summer the bottom water is decoupled from ongoing surface processes in broad regions of the North Sea. A real interaction happens again only in the following winter. In this way the winter SST can influence the heat content in the following summer. The conservation of the winter bottom water temperature in the central and northern North Sea is one of the rare hydrographical phenomena with a ‘memory’ scale of one year. Normally, typical spin-up periods (within these the preceding dynamic state is lost) amount to only a few days in the shallow North Sea. In the cited paper (Pohlmann 2003) the interannual variability of the North Sea’s heat content was also simulated for the years 1982–1998 (Figure 16).

Conventional gas was previously the main form of liquefied natura

Conventional gas was previously the main form of liquefied natural gas (LNG) but over the last several decades this has changed with the development of new technologies making extraction of newly

discovered unconventional gas resources feasible and economic. The main types of unconventional gas sources are coal seam gas (CSG, also known as coal bed methane), shale gas and tight gas. In Australia, CSG is the most exploited unconventional gas resource. During the last 15 years, the growth of exploration activity has been substantial, with the number of CSG wells drilled annually in Queensland increasing from 10 in the early 1990s to more than 600 in 2009–2010 (Queensland Government, 2011). Estimated CSG reserves in Australia now exceed conventional gas reserves (Day, 2009, RLMS, 2009 and Geoscience Australia and BREE, 2014). One of the areas with high CSG potential in Australia is the Galilee Basin, located in Selleck Oligomycin A central Queensland (Fig. 1). The Galilee Basin is overlain by, and in contact with, the Eromanga Basin, a component of the Great Artesian Basin (GAB) which covers approximately 22% of the Australian continent and is a significant groundwater resource

selleck products (Ransley and Smerdon, 2012). The Galilee Basin contains relatively thick Permian age coal beds which have not been exploited in the past for gas resources due to their significant depth and the distance to the principal markets (Holland et al., 2008). In order to enable CSG production, high volumes of groundwater need to be extracted to reduce the hydrostatic pressure that keeps the gas adsorbed on the coal. There are two fundamental concerns in regard to this procedure: (a) how will the brackish/saline water typically contained in coal-bearing formations (e.g. Van Voast, 2003) be disposed of or reused

at the surface and (b) will extraction of groundwater from the coal measures impact on water quality or groundwater pressures in adjacent artesian Etofibrate aquifers of the Great Artesian Basin. Prior to the production and development of CSG resources, it is essential to determine the hydrogeological characteristics of a basin and its setting, and in particular the potential impacts that extraction of groundwater and any depressurisation may have on vertical connectivity between aquifers and aquitards (Harrison et al., 2000, Rice et al., 2002 and Taulis and Milke, 2007). An important part of this assessment is the identification of faults, their influence on the geometry of aquifers/aquitards and their role as potential connectivity pathways. Fault zones can behave as possible conduits to regional groundwater flow, or as barriers or both (e.g. Caine et al., 1996, Rawling et al., 2001 and Bense and Person, 2006). Examples of faults acting as barriers have been reported from offshore hydrocarbon reservoirs (e.g. Bredehoeft et al., 1992 and Knott et al., 1996) but also from onshore sedimentary basins (e.g. Bense and Van Balen, 2004).

Despite achievement and maintenance of global hemodynamic and oxy

Despite achievement and maintenance of global hemodynamic and oxygenation goals, patients may develop microcirculatory dysfunction with associated organ failure. A thorough understanding of the microcirculatory system under physiologic conditions will assist the clinician in early recognition of microcirculatory dysfunction in impending and actual disease states. Penelope S. Benedik and Shannan K. Hamlin Erythrocytes are not just oxygen delivery devices but play

an active metabolic role in modulating microvascular blood flow. Hemoglobin and red blood cell morphology change as local oxygen levels fall, eliciting the release of adenosine triphosphate and nitric oxide to initiate local vasodilation. Aged erythrocytes Selleck GSK3 inhibitor undergo physical and functional selleck chemicals llc changes such that some of the red cell’s most physiologically helpful attributes are diminished. This article reviews the functional anatomy and applied physiology of the erythrocyte and the microcirculation with

an emphasis on how erythrocytes modulate microvascular function. The effects of cell storage on the metabolic functions of the erythrocyte are also briefly discussed. Shannan K. Hamlin and Penelope S. Benedik Blood rheology, or hemorheology, involves the flow and deformation behavior of blood and its formed elements (ie, erythrocytes, leukocytes, Benzatropine platelets). The adequacy of blood flow to meet metabolic demands through large circulatory vessels depends highly on vascular control mechanisms. However, the extent to which rheologic properties of blood contribute to vascular flow resistance,

particularly in the microcirculation, is becoming more appreciated. Current evidence suggests that microvascular blood flow is determined by local vessel resistance and hemorheologic factors such as blood viscosity, erythrocyte deformability, and erythrocyte aggregation. Such knowledge will aid clinicians caring for patients with hemodynamic alterations. Penelope S. Benedik This article describes promising emerging technologies developed for measuring tissue-level oxygenation or perfusion, each with its own inherent limitations. The end user must understand what the instrument measures and how to interpret the readings. Optical monitoring using near-infrared spectrometry, Doppler shift, and videomicroscopy are discussed in terms of their application at the tissue level. Assessment of the metabolic state of the extracellular space with existing technology and proxy indicators of metabolic status are discussed. Also addressed are potential sources of variation for each technique, and the role that the clinician plays in the proper interpretation of the data.

The 50 monogenic

The 50 monogenic Trichostatin A in vitro defects associated with IBD provide an initial filter to identify patients with monogenic disorders. Because of the greatly reduced costs of next-generation sequencing, it is probably cost effective in many cases to perform multiplex gene sequencing, WES, or whole-genome sequencing rather than sequential Sanger sequencing of multiple genes. A big advantage of WES is the potential to identify novel causal genetic variants once the initial candidate filter list of known disease-causing candidates has been analyzed. The number of gene variants associated with VEOIBD is indeed constantly increasing, largely

due to the new sequencing technologies, so data sets derived from WES allow updated analysis of candidates as well as novel genes. Because multiple genetic defects can lead to spontaneous or induced colitis in mice,1 and 139 assuming homology, it is likely that many additional human gene variants will be associated with IBD. Targeted sequencing of genes of interest is an alternative approach to exome-targeted sequencing. Initial studies to perform targeted next-generation parallel sequencing showed the potential power of this approach.140 Targeted next-generation sequencing of the 170 primary immunodeficiency (PID)-related genes accurately detected point mutations and exonic deletions.140 Only 9 of 170 PID-related

genes analyzed showed inadequate coverage. Four of 26 patients with PID without an established prescreening genetic diagnosis, despite routine ROCK inhibitor functional and genetic testing, were diagnosed, click here indicating the advantage of parallel genetic screening. Because a major group of VEOIBD-causing variants is associated with PID-related genes, it is obvious how this approach can be adapted and extended to monogenic IBD genes. Genetic approaches also offer practical advantages. Specialized functional immune assays are often only available in research laboratories and are not necessarily validated; functional tests often require rapid processing of peripheral blood mononuclear cells or biopsy specimens

in specialized laboratories. This means that handling of DNA and sequencing seems far less prone to error or variation. However, relying solely on genetic screening can be misleading, because computational mutation prediction can fail to detect functional damaging variants. For example, variants in the protein-coding region of the IL10RA gene were misclassified as “tolerated” by certain prediction tools, whereas other prediction tools and functional analysis reported defects in IL-10 signaling. 30 Although most studies report variants in protein-coding regions in monogenic diseases, there could be selection bias. It is indeed far more difficult to establish the biological effects of variants that affect processes such as splicing, gene expression, or messenger RNA stability. It should go without saying that novel genetic variants require appropriate functional validation.

2E) Foci of epidermal erosion and mild acute inflammatory infilt

2E). Foci of epidermal erosion and mild acute inflammatory infiltrate as well as round collections of cellular debris in the upper dermis and epidermis were present (Fig. 2F). No hemorrhage was verified and very few blood vessels showed thrombosis. Superficial epidermal bacterial infection was present in this website one of the samples. After 48 h of injection, coagulative necrosis of skin, subcutaneous and skeletal muscle tissue was evident (Fig. 3A). The epidermis and the dermis showed mild acute inflammatory infiltrate and collections of cellular debris, characterizing micro-abscesses (Fig. 3B). Few blood vessels in the

dermis and subcutaneous tissue presented thrombosis. No hemorrhage was verified. After 72 h of injection, the necrotic tissue presented cellular debris

in the form of numerous round collections or diffuse infiltration, constituting a necrotic plaque focally detached from the deep tissue (Fig. 3C). Regenerative hyperplasia of epidermal cells appeared at the lesion borders (Fig. 3D). A mild inflammatory infiltrate was observed around viable blood vessels in the deep subcutaneous tissue. After 96 h of injection, the regenerative hyperplasia of epidermal cells at the necrotic skin border was more evident (Fig. 4A). The coagulative necrosis of the tissue was clear, affecting the skeletal muscle and presenting cellular debris infiltration. In one of the samples the epidermis was missing in some areas and superficial bacterial infection appeared (Fig. 4B). No hemorrhage or blood vessel thrombosis was detected. In animals of the U0126 order Phosphatidylinositol diacylglycerol-lyase control group no evidence of necrosis was noted although mild edema and mononuclear cell infiltration of dermis and subcutaneous tissue were focally present. Moreover, control animals did not show any histological abnormalities in most of the skin, and subcutaneous and skeletal muscle tissue (Fig. 4C,D). There are few reports in literature on the toxic effects of freshwater

stingray venom. Under our experimental conditions, we verified that the tissue extract of P. falkneri could induce necrosis and an inflammatory reaction at the site of injection. These data are in agreement with reports of accidents in humans ( Haddad, 2000, Haddad et al., 2004 and Garrone Neto and Haddad, 2010). They are also in agreement with an experimental model ( Barbaro et al., 2007) demonstrating that necrosis and local inflammation are much more prominent in injuries caused by freshwater stingrays when compared with those caused by marine species. Our histological study demonstrated that necrosis occurs very soon after the exposure; foci of epidermal necrosis with initial detachment from the dermis were detected 3–6 h after extract injection. Moreover, at these times, signs of initial necrosis of skeletal muscle were observed.

Robin graduated from the British College of Naturopathy and Osteo

Robin graduated from the British College of Naturopathy and Osteopathy in the early 1970s, and questioned all aspects of osteopathy and naturopathy. He discussed and debated with most of the elder statesmen of the profession, at a time when enmity existed towards different alumni. Among his many friends and acquaintances were Tom Dummer, Margery Bloomfield and John Wernham, to name but a few who have influenced the profession. Robin was passionate see more about the development of osteopathy, but also about the education and professionalism of a wide range of disciplines. He taught osteopaths, physiotherapists, chiropractors, medics, and other health care

practitioners, across the UK and Europe, also

in Egypt and New Zealand. His varied career also saw him working with the All Blacks rugby and Black Caps cricket team; managing a health hydro; running practices in Tenerife and London. He was editor of the ‘British Osteopathic Journal’ and ‘Osteopathy Today’. He was a committee member of the OAGB/BOA; and Chair of the National Osteopathic Quizartinib price Archive History Group. For the last fourteen years he led the London School of Osteopathy as their Principal. True to his New Zealand roots, there was a bit of “the wild colonial boy” about him. In debating, he loved to throw in the ‘intellectual handgrenade’ and stand back to watch the results, and yet his forthright views were always disseminated with humour, often accompanied by an exchange about cricket or rugby. His intellect, his multitalented persona and his mischievous sense of the ridiculous covered an eclectic range of subjects. He had a connoisseur’s eye and ear for art, photography and music. Many people will have fond memories of an

evening of conversation with Robin over a beer, or a glass or two or three of heavy red wine. We have lost a dedicated colleague of 40 years but most of all, a true friend. “
“Figure options Download full-size image Download high-quality image (53 K) Download as PowerPoint slideThe osteopathic PRKACG world was greatly saddened to learn of the sudden passing of Adrian Barnes on 6th February, 2014. Adrian was appointed Principal of the ESO in 2007 during which time he worked diligently for the School and its development. He worked hard to increasingly develop the School’s reputation internationally while ensuring its position as one of the top osteopathic educational institutions in the United Kingdom. Adrian trained at the British School of Osteopathy and graduated in 1978. After graduation he returned to teach osteopathic technique and also acted as a clinic tutor. He continued to combine a career in osteopathic education, both nationally and internationally, with his clinical practice throughout his working life. He was awarded an MSc in Osteopathic Care in 2000.

5, 1 M MgCl2, 5 M NaCl, 0 1% Tween 20, 1 M levamisol) and then in

5, 1 M MgCl2, 5 M NaCl, 0.1% Tween 20, 1 M levamisol) and then incubated in reaction buffer with 1 × NBT/BCIP

substrate. In general, positive signals were obtained after 0.5–1 h incubation in substrate. Following the staining reaction, samples were washed in several changes of PBT, fixed in 4% paraformaldehyde in PBS, and then washed in five changes of PBT. The samples were then hydrated through methanol twice and transferred to 75% glycerol for observation and storage at − 4 °C. For Alectinib mouse each probe, approximately 10 samples were examined for expression at 24 and 48 hpf. The detailed immunoblotting procedure has been described previously (Yano et al., 2005). Briefly, the indicated tissues were minced PS-341 cell line and sonicated in lysis buffer

(10 mM Tris–HCl, pH 7.6, 100 mM NaCl, 1 mM EDTA, 1% Triton X-100, and protease inhibitor mixture) to obtain a protein lysate. After centrifugation, the concentrations of the supernatants were measured, and equal amounts of total protein were solubilized by boiling in loading buffer, separated by SDS-PAGE, and transferred to an Immobilon P-membrane (Millipore). The blots were probed with rat anti-mouse Msi1 (1:1000, clone 14H1) (Kaneko et al., 2000), rat monoclonal anti-HA antibody (1:2000 Roche), mouse anti-α-tubulin (1:5000 Sigma) or mouse anti-β-actin (1:2000, Sigma) primary antibodies and HRP-conjugated anti-rat and anti-mouse IgG secondary antibodies (1:1000, Jackson Immuno Res.). Antibody binding was visualized by ECL (GE healthcare), and detected and quantified using an LAS3000 imager (Fujifilm). The detailed procedure for immunohistochemistry has been described previously (Shibata et al., 2010). Briefly, at day 2 (48 hpf), embryos were fixed with 4% PFA, and 14-μm thick cryosections were prepared using a cryostat (CM3000, Etofibrate Leica). Antigen retrieval was performed by incubating the samples with 10 mM citric acid solution (pH 6.0) in an autoclave

at 105 °C for 10 min. The sections were incubated overnight at 4 °C with specific primary antibodies [rabbit polyclonal anti-mouse Msi1 (1:200) (Sakakibara et al., 1996), and mouse monoclonal anti-PCNA (1:200, NA03(Ab-1), Oncogene)], followed by a 1 h incubation at room temperature with the appropriate secondary antibodies conjugated with Alexa488 or Alexa555 (Invitrogen) together with Hoechst 33258 (10 μg/ml, Sigma) for nuclear staining. The samples were examined with a laser scanning confocal microscope (LSM700, Carl Zeiss). A specific antisense MOs used to knock down msi1 expression in zebrafish was designed and produced by Gene Tools, LLC (Philomath, OR). The sequences of MOs used in these experiments were zmsi1-1 MO, 5′-TACTTTGGCTGCCTTCCGATTCCAT-3′ and zmsi1-2 MO, 5′-TCCCGTCCGAGTCTGGTGCGAGAAA-3′. Standard control MOs were also obtained from Gene Tools. The MOs were dissolved to a final concentration of 0.3 mM in distilled water and mixed with 0.05% phenol red solution (P0290, Sigma).

Nearly every topographic region of the left and

right hem

Nearly every topographic region of the left and

right hemisphere contributes to the control of space-based Daporinad cost attention across the visual field by generating a spatial bias, or ‘attentional weight’ [9] in favor of the contralateral hemifield. The sum of the weights contributed by all areas within a hemisphere constitutes the overall spatial bias exerted over contralateral space, and the net output of the two hemispheres is similar, resulting in a balanced system. This balance of attentional weights across the hemispheres may be achieved through reciprocal interhemispheric inhibition of corresponding areas [10]. However, the higher-order control system appears to be somewhat complicated by right SPL1′s unique role in spatial attention, as the attentional weight generated by this area was not found to be counteracted by left SPL1. Instead, the left frontal eye field (FEF) and left intraparietal sulcus (IPS) areas IPS1-2 generated stronger attentional weights than the corresponding regions in the right hemisphere. Thus, the control system likely requires the cooperation of several distributed subcomponents in order to achieve balance across the two hemispheres. The interhemispheric competition account of

space-based attentional control is in stark contrast to the prevailing hemispatial theory [11], which assumes that GPCR Compound Library concentration the right hemisphere controls attention in both visual hemifields, whereas the left hemisphere controls attention in the contralateral visual field only. This hypothesized asymmetry across hemispheres received a groundswell of support primarily from patient studies with unilateral lesions in the inferior parietal lobule and/or the temporoparietal

junction 12 and 13]. These patients typically exhibit symptoms of visuo-spatial hemi-neglect to the contralesional side of space, but such deficits manifest with an overwhelmingly higher rate following right, rather than left, hemispheric damage. Verteporfin purchase A similar breadth of clinical evidence in favor of interhemispheric competition is largely lacking, presumably due to the unlikely occurrence of focal lesions contained within IPS. Recently, however, two such cases were reported 14 and 15]. Patients H.H. and N.V. have a focal lesion confined to left posterior IPS and right middle IPS (extending into SPL), respectively, and both exhibited attention-related deficits examined in a modified Posner cuing task. Here, subjects reported the orientation of a grating following an endogenous precue; on a proportion of trials, a competing distractor appeared in the uncued location. Behavioral deficits attributed to stimulus competition were present for both H.H. and N.V. despite having lesions in opposite hemispheres. Importantly, deficits were restricted to trials in which the target appeared in the contralesional side of space.

3 μM of the copper-DEDTC complex added on cell medium (Viola-Rhen

3 μM of the copper-DEDTC complex added on cell medium (Viola-Rhenals et al., 2006 and Viola-Rhenals et al., 2007), and the copper-DEDTC complex was suggested to be the toxicological agent. When DEDTC was used without the presence of copper ions

in the same concentration (0.3 μM) in a cell medium complemented with fetal bovine serum (a source of copper ions) no effects on carcinoma cells were observed. Disulfiram (DSF) also have been show to facilitate the copper entrance in cells by the formation of copper-DEDTC complex (Cen et al., 2004), the active form of DSF in the presence of copper, which the induction of apoptosis in neuronal cells remains unclear. In order to contribute Lumacaftor to the elucidation of DEDTC toxicology in neuronal cells, we performed in vitro studies to elucidate the molecular effects of DEDTC and its correlation with copper chelation and concentration. Unless otherwise stated, the chemicals were obtained from Sigma–Aldrich and were of analytical grade. The solutions were prepared using Milli-Q water (Millipore, Bedford, MA, USA). The cell media were prepared with DNase- and RNase-free water and filtered through 0.22-μm filter membranes (Millex GV, Millipore) prior to use. The cell cultures were manipulated using sterile, disposable non-pyrogenic plastic ware and were maintained at 37 °C in an atmosphere of 5% CO2 in air at a relative humidity of 80%. Human neuroblastoma SH-SY5Y cells were purchased from

the American Type Culture Collection (ATCC) and grown in Dulbecco’s Modified Eagle F12 Medium (DMEM/F12) supplemented with 10% heat-inactivated fetal bovine selleck inhibitor serum (Gibco), 100 U/ml penicillin and 10.0 μg/ml streptomycin. The cells were routinely trypsinized and seeded at a density of 4 × 104 cells/cm2.

Every month, the cells were cultivated in the absence of antibiotics for control purposes and subjected to a routine assay using a MycoAlert Mycoplasma selleck compound Detection kit (Lonza Rockland) to ensure that they had not become contaminated with mycoplasma. All SH-SY5Y cells used in this study were used at a low passage number (<15). To determine the levels of DEDTC that would promote maximum cell death, concentration-dependent cytotoxicity studies were performed. Typically, viability of neuroblastoma cells was assessed by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assays, as previously reported (Mosmann, 1983). SH-SY5Y cells were inoculated in 96 well plates at a density of 1 × 105 cell/well and incubated for 24 h under the conditions described above. Aliquots of freshly prepared solutions of DEDTC (5.0 mM) were added to the culture medium to attain final concentrations in the 1.0–100.0 μM range, and the plates were then incubated for an additional 4, 12, 24, 48 and 96 h. The plates were also incubated in the presence of sodium bathocuproine (BCS, 2,9-Dimethyl-4,7-diphenyl-1,10-phenanthroline) and in copper free conditions.

The recent guidelines of the European Society of Vascular Surgery

The recent guidelines of the European Society of Vascular Surgery recommend at least using the ankle brachial index to select patients who should be sent for a Doppler ultrasonography examination [155]. In the case of percutaneous

revascularisation, the follow-up criteria are uncertain. Given that extreme revascularisation of the infra-popliteal arteries is burdened by early restenoses (70% after 3 months) [131], an exclusively vascular follow-up aimed at identifying and treating such restenoses could lead to an incessant re-treatment without reflecting the clinical reality. The occurrence of restenosis is not always an indication for re-treatment per se, but re-treatment should be considered in patients with recurrent clinical symptoms or patients in whom the process of wound healing has been interrupted. However, it is important to recognise that in some patients percutaneous revascularisation E7080 chemical structure enables the reopening of extended segments of multi-level vessels, often with extreme difficulty. It allows the reconstruction of a fragile flow line up to the foot, to which the maintenance

in time through a close vascular follow-up protocol, the same way as for distal bypasses, can be deemed necessary. A focal restenosis can be simply, rapidly and often lastingly treated, whereas its subsequent evolution into occlusion (and the consequent extension of the upstream and downstream thrombosis of the original lesion) needs more complex treatment, especially in the case of intra-stent occlusions, and is burdened by ERK inhibitors a high rate of recurrence. A follow-up based on vascular criteria should therefore be personalised for

each individual patient and based on the type of revascularisation. By ‘perfusional Selleck Obeticholic Acid criteria’, we mean TcPO2 measurements that indicate the real degree of tissue perfusion regardless of whether it occurs through patent native vessels, revascularised vessels or collateral circulation. Given the relationship between healing potential and oximetry values, periodic oximetric evaluations are surely helpful, especially in patients whose skin lesions show little sign of healing notwithstanding revascularisation. Oximetry values of <30 mm Hg are indicative of low tissue perfusion, but it might be useful to repeat the measurement after a few days before considering the revascularisation a failure because it has been observed that TcPO2 values gradually increase 1 month after successful revascularisation, whereas they remain low in the case of ineffective revascularisation [156]. These criteria include limb salvage (the avoidance of major amputation of the leg or thigh), wound healing (the complete closure of skin lesions) and healing after ‘minor amputation’ of the toes, rays or tarsal region. Clinical criteria such as the healing time of foot lesions, the restoration of walking capacity and the time needed for this restoration (time to walking) are currently underestimated in the literature and should be reconsidered as primary criteria.