bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Outcome With Correlation to Disseminated Tumor Cell (DTC) Status After DTC-Guided Secondary Adjuvant Treatment With Docetaxel in Early Breast Cancer
Authors: Naume Bjørn , Synnestvedt Marit , Falk Ragnhild Sørum , Wiedswang Gro , Weyde Kjetil , Risberg Terje , Kersten Christian , Mjaaland Ingvil , Vindi Lise , Sommer Hilde H. , Sætersdal Anna Barbro , Rypdal Maria Christine , Bendigtsen Schirmer Cecilie , Wist Erik Andreas , Borgen Elin
Published: November 2014

Purpose

The presence of disseminated tumor cells (DTCs) in bone marrow (BM) predicts survival in early breast cancer. This study explores the use of DTCs for identification of patients insufficiently treated with adjuvant therapy so they can be offered secondary adjuvant treatment and the subsequent surrogate marker potential of DTCs for outcome determination.

Patients and Methods

Patients with early breast cancer who had completed six cycles of adjuvant fluorouracil, epirubicin, and cyclophosphamide (FEC) chemotherapy underwent BM aspiration 2 to 3 months (BM1) and 8 to 9 months (BM2) after FEC. Presence of DTCs in BM was determined by immunocytochemistry using pan-cytokeratin monoclonal antibodies. If one or more DTCs were present at BM2, six cycles of docetaxel (100 mg/m2, once every 3 weeks) were administered, followed by DTC analysis 1 and 13 months after the last docetaxel infusion (after treatment). Cox regression analysis was used to evaluate disease-free interval (DFI).

Results

Of 1,066 patients with a DTC result at BM2 and available follow-up information (median follow-up, 71.9 months from the time of BM2), 7.2% were DTC positive. Of 72 docetaxel-treated patients analyzed for DTCs after treatment, 15 (20.8%) had persistent DTCs. Patients with remaining DTCs had markedly reduced DFI (46.7% experienced relapse) compared with patients with no DTCs after treatment (adjusted hazard ratio, 7.58; 95% CI, 2.3 to 24.7). The docetaxel-treated patients with no DTCs after treatment had comparable DFI (8.8% experienced relapse) compared with those with no DTCs both at BM1 and BM2 (12.7% experienced relapse; P = .377, log-rank test).

Conclusion

DTC status identifies high-risk patients after FEC chemotherapy, and DTC monitoring status after secondary treatment with docetaxel correlated strongly with survival. This emphasizes the potential for DTC analysis as a surrogate marker for adjuvant treatment effect in breast cancer.
Circadian Rhythm of Circulating Levels of the Endocannabinoid 2-Arachidonoylglycerol
Authors: Hanlon E. C. , Tasali E. , Leproult R. , Stuhr K. L. , Doncheck E. , de Wit H. , Hillard C. J. , Van Cauter E.
Published: November 2014

Context:

The endocannabinoid (eCB) system is involved in the regulation of food intake and of peripheral metabolism. Although the cross talk between energy metabolism and the circadian system is well documented, little is known about a potential circadian modulation of human eCB activity.

Objective:

The objective of the study was to define the 24-hour profile of circulating levels of the most abundant endogenous ligand of the CB1 receptor, 2-arachidonoylglycerol (2-AG), in healthy young nonobese adults studied under controlled bedtime, dietary, and activity conditions.

Methods:

Fourteen subjects participated in this 4-day laboratory study with fixed light-dark cycles, standardized meals, and bedtimes. Sleep was recorded each night. On the third day, blood sampling at 15- to 30-minute intervals began at 9:30 pm and continued for 24 hours. Cortisol, leptin, and ghrelin were assayed on all samples, whereas the levels of 2-AG and its structural analog, 2-oleoylglycerol (2-OG), were measured at 60-minute intervals.

Results:

All participants exhibited a large circadian variation of 2-AG serum concentrations with a nadir around midsleep, coincident with the middle of the overnight fast. Levels of 2-AG increased continually across the morning, peaking in the early to midafternoon. Peak values represented, on average, a nearly 3-fold increase above nocturnal nadir levels. Concentrations of 2-OG followed a similar pattern, although with a shorter morning increase and lower amplitude.

Conclusions:

The findings demonstrate that activity of the eCB system is profoundly modulated by circadian rhythmicity and suggest that its impact on the regulation of food intake is suppressed during sleep and is maximal during early to midafternoon.
Leaf development and morphogenesis
Authors: Bar Maya , Ori Naomi
Published: November 2014

The development of plant leaves follows a common basic program that is flexible and is adjusted according to species, developmental stage and environmental circumstances. Leaves initiate from the flanks of the shoot apical meristem and develop into flat structures of variable sizes and forms. This process is regulated by plant hormones, transcriptional regulators and mechanical properties of the tissue. Here, we review recent advances in the understanding of how these factors modulate leaf development to yield a substantial diversity of leaf forms. We discuss these issues in the context of leaf initiation, the balance between morphogenesis and differentiation, and patterning of the leaf margin.
The UNC-6/Netrin receptors UNC-40/DCC and UNC-5 inhibit growth cone filopodial protrusion via UNC-73/Trio, Rac-like GTPases and UNC-33/CRMP
Authors: Norris Adam D. , Sundararajan Lakshmi , Morgan Dyan E. , Roberts Zachary J. , Lundquist Erik A.
Published: November 2014

UNC-6/Netrin is a conserved axon guidance cue that can mediate both attraction and repulsion. We previously discovered that attractive UNC-40/DCC receptor signaling stimulates growth cone filopodial protrusion and that repulsive UNC-40–UNC-5 heterodimers inhibit filopodial protrusion in C. elegans. Here, we identify cytoplasmic signaling molecules required for UNC-6-mediated inhibition of filopodial protrusion involved in axon repulsion. We show that the Rac-like GTPases CED-10 and MIG-2, the Rac GTP exchange factor UNC-73/Trio, UNC-44/Ankyrin and UNC-33/CRMP act in inhibitory UNC-6 signaling. These molecules were required for the normal limitation of filopodial protrusion in developing growth cones and for inhibition of growth cone filopodial protrusion caused by activated MYR::UNC-40 and MYR::UNC-5 receptor signaling. Epistasis studies using activated CED-10 and MIG-2 indicated that UNC-44 and UNC-33 act downstream of the Rac-like GTPases in filopodial inhibition. UNC-73, UNC-33 and UNC-44 did not affect the accumulation of full-length UNC-5::GFP and UNC-40::GFP in growth cones, consistent with a model in which UNC-73, UNC-33 and UNC-44 influence cytoskeletal function during growth cone filopodial inhibition.
Symmetry breaking, germ layer specification and axial organisation in aggregates of mouse embryonic stem cells
Authors: van den Brink Susanne C. , Baillie-Johnson Peter , Balayo Tina , Hadjantonakis Anna-Katerina , Nowotschin Sonja , Turner David A. , Martinez Arias Alfonso
Published: November 2014

Mouse embryonic stem cells (mESCs) are clonal populations derived from preimplantation mouse embryos that can be propagated in vitro and, when placed into blastocysts, contribute to all tissues of the embryo and integrate into the normal morphogenetic processes, i.e. they are pluripotent. However, although they can be steered to differentiate in vitro into all cell types of the organism, they cannot organise themselves into structures that resemble embryos. When aggregated into embryoid bodies they develop disorganised masses of different cell types with little spatial coherence. An exception to this rule is the emergence of retinas and anterior cortex-like structures under minimal culture conditions. These structures emerge from the cultures without any axial organisation. Here, we report that small aggregates of mESCs, of about 300 cells, self-organise into polarised structures that exhibit collective behaviours reminiscent of those that cells exhibit in early mouse embryos, including symmetry breaking, axial organisation, germ layer specification and cell behaviour, as well as axis elongation. The responses are signal specific and uncouple processes that in the embryo are tightly associated, such as specification of the anteroposterior axis and anterior neural development, or endoderm specification and axial elongation. We discuss the meaning and implications of these observations and the potential uses of these structures which, because of their behaviour, we suggest to call ‘gastruloids’.
Dominant and context-specific control of endodermal organ allocation by Ptf1a
Authors: Willet Spencer G. , Hale Michael A. , Grapin-Botton Anne , Magnuson Mark A. , MacDonald Raymond J. , Wright Christopher V. E.
Published: November 2014

The timing and gene regulatory logic of organ-fate commitment from within the posterior foregut of the mammalian endoderm is largely unexplored. Transient misexpression of a presumed pancreatic-commitment transcription factor, Ptf1a, in embryonic mouse endoderm (Ptf1aEDD) dramatically expanded the pancreatic gene regulatory network within the foregut. Ptf1aEDD temporarily suppressed Sox2 broadly over the anterior endoderm. Pancreas-proximal organ territories underwent full tissue conversion. Early-stage Ptf1aEDD rapidly expanded the endogenous endodermal Pdx1-positive domain and recruited other pancreas-fate-instructive genes, thereby spatially enlarging the potential for pancreatic multipotency. Early Ptf1aEDD converted essentially the entire glandular stomach, rostral duodenum and extrahepatic biliary system to pancreas, with formation of many endocrine cell clusters of the type found in normal islets of Langerhans. Sliding the Ptf1aEDD expression window through embryogenesis revealed differential temporal competencies for stomach-pancreas respecification. The response to later-stage Ptf1aEDD changed radically towards unipotent, acinar-restricted conversion. We provide strong evidence, beyond previous Ptf1a inactivation or misexpression experiments in frog embryos, for spatiotemporally context-dependent activity of Ptf1a as a potent gain-of-function trigger of pro-pancreatic commitment.
Liquid-phase Oxidation of Benzene with Molecular Oxygen over Vanadium Complex Catalysts Encapsulated in Y-Zeolite
Authors: Okemoto Atsushi , Inoue Yoshiki , Ikeda Koichi , Tanaka Chiaki , Taniya Keita , Ichihashi Yuichi , Nishiyama Satoru
Published: November 2014

Vanadium complex catalysts encapsulated in Y-zeolite (VPA-Y), which are prepared by the “ship in a bottle” method, are investigated as heterogeneous catalysts for the liquid-phase oxidation of benzene to phenol with molecular oxygen. Phenol is the major product of the process, and the catalyst can be easily separated from the product solution after the reaction. These encapsulated catalysts are characterized by thermogravimetric analysis, demonstrating that the vanadium complexes are formed in the Y-zeolite cages.
Redefining the Modifiable Areal Unit Problem Within Spatial Econometrics, the Case of the Aggregation Problem
Authors: Pietrzak Michał Bernard
Published: November 2014

The paper focuses on the issue of the aggregation problem, which is frequently discussed within spatial econometrics. The aggregation problem is one of the two aspects of the modifiable areal unit problem (MAUP). The aggregation problem is connected with the volatility of the obtained results occurred when various compositions of territorial units for the same aggregation scale were applied. The objective of the present paper is to consider the redefinition of aggregation problem and showing positive solution of the aggregation problem based on the empirical example of determining agricultural macroregions. In the article the aggregation problem was defined as a problem of establishing a particular composition of territorial units at a selected aggregation scale in a such a way that is remains in the quasi composition of regions within the undertaken research problem. The paper also presented the procedure for determining agricultural macroregions where the analysis of the spatial volatility of the agrarian structure and the current knowledge on the agriculture in Poland were applied. In addition, the paper considered the final areal interpretation problem connected with the incorrect determination of the area in relation to which final conclusions are drawn. The problem was presented basing on the example of the establishment of the average concentration of the area of agricultural land in Poland with the use of the Gini index calculated for districts. The paper emphasised that ignoring the final areal interpretation problem in spatial analyses may lead to an apparent identification of the modifiable areal unit problem.
Oral cancer: improving early detection
Authors: Pigadas Nick , Jevon Phil
Published: November 2014

The aim of this article is to present an overview of oral cancer and highlight the importance of early detection
Career pathways and career aspiration of dental nurses
Authors: Stuart Russell
Published: November 2014

The third article in this series from the NEBDN discusses what discrepancies exist between research and practice in relation to delivering education and training
Making a mystery of it
Authors: Williams Brenda
Published: November 2014

The underpinning themes in myths and legends are relevant to a wide range of literature. Encourage children to identify them and use them in their own stories.
Go take a running jump!
Authors: Donohoe Tom
Published: November 2014

When it comes to athletics, chidren with a range of abilities can be encouraged to push themselves, beat their personal best and raise their self-esteem.
Discover the powerful role that drama can play
Authors: Donohoe Tom
Published: November 2014

Drama doesn't have to be just about trudging through classic texts. By using creative techniques and strategies you can increase its imaginative scope, and children are enriched through opportunities to explore characters, feelings, thoughts, ideas and much more.
Get involved in pond DIY
Authors: Rhodes Karen
Published: November 2014

Constructing a wildlife area and pond can provide a rich resource for studying the new science curriculum. Karen Rhodes provides a step-by-step guide.
Create a portrait of yourself and your life
Authors: Hart Karen
Published: November 2014

Use the styles of Picasso and Julian Opie to encourage children to paint or draw an image of themselves, that says a lot about the person they feel they are.
Subcapital osteotomy of the femoral neck for patients with healed slipped capital femoral epiphysis
Authors: Bali K. , Railton P. , Kiefer G. N. , Powell J. N.
Published: November 2014

We report the clinical and radiological outcome of subcapital osteotomy of the femoral neck in the management of symptomatic femoroacetabular impingement (FAI) resulting from a healed slipped capital femoral epiphysis (SCFE). We believe this is only the second such study in the literature.

We studied eight patients (eight hips) with symptomatic FAI after a moderate to severe healed SCFE. There were six male and two female patients, with a mean age of 17.8 years (13 to 29).

All patients underwent a subcapital intracapsular osteotomy of the femoral neck after surgical hip dislocation and creation of an extended retinacular soft-tissue flap. The mean follow-up was 41 months (20 to 84). Clinical assessment included measurement of range of movement, Harris Hip Score (HHS) and Western Ontario and McMaster Universities Osteoarthritis score (WOMAC). Radiological assessment included pre- and post-operative calculation of the anterior slip angle (ASA) and lateral slip angle (LSA), the anterior offset angle (AOA) and centre head–trochanteric distance (CTD). The mean HHS at final follow-up was 92.5 (85 to 100), and the mean WOMAC scores for pain, stiffness and function were 1.3 (0 to 4), 1.4 (0 to 6) and 3.6 (0 to 19) respectively. There was a statistically significant improvement in all the radiological measurements post-operatively. The mean ASA improved from 36.6° (29° to 44°) to 10.3° (5° to 17°) (p <  0.01). The mean LSA improved from 36.6° (31° to 43°) to 15.4° (8° to 21°) (p < 0.01). The mean AOA decreased from 64.4° (50° to 78°) 32.0° (25° to 39°) post-operatively (p < 0.01). The mean CTD improved from -8.2 mm (-13.8 to +3.1) to +2.8 mm (-7.6 to +11.0) (p < 0.01). Two patients underwent further surgery for nonunion. No patient suffered avascular necrosis of the femoral head.

Subcapital osteotomy for patients with a healed SCFE is more challenging than subcapital re-orientation in those with an acute or sub-acute SCFE and an open physis. An effective correction of the deformity, however, can be achieved with relief of symptoms related to impingement.

Cite this article: Bone Joint J 2014;96-B:1441–8.
Radiofrequency ablation in the treatment of cartilaginous lesions in the long bones
Authors: Dierselhuis E. F. , van den Eerden P. J. M. , Hoekstra H. J. , Bulstra S. K. , Suurmeijer A. J. H. , Jutte P. C.
Published: November 2014

Atypical cartilaginous tumours are usually treated by curettage. The purpose of this study was to show that radiofrequency ablation was an effective alternative treatment.

We enrolled 20 patients (two male, 18 female, mean age 56 years (36 to 72) in a proof-of-principle study. After inclusion, biopsy and radiofrequency ablation were performed, followed three months later by curettage and adjuvant phenolisation. The primary endpoint was the proportional necrosis in the retrieved material. Secondary endpoints were correlation with the findings on gadolinium enhanced MRI, functional outcome and complications.

Our results show that 95% to 100% necrosis was obtained in 14 of the 20 patients. MRI had a 91% sensitivity and 67% specificity for detecting residual tumour after curettage. The mean functional outcome (MSTS) score six weeks after radiofrequency ablation was 27.1 (23 to 30) compared with 18.1 (12 to 25) after curettage (p < 0.001). No complications occurred after ablation, while two patients developed a pathological fracture after curettage.

We have shown that radiofrequency ablation is capable of completely eradicating cartilaginous tumour cells in selective cases. MRI has a 91% sensitivity for detecting any residual tumour. Radiofrequency ablation can be performed on an outpatient basis allowing a rapid return to normal activities. If it can be made more effective, it has the potential to provide better local control, while improving functional outcome.

Cite this article: Bone Joint J 2014;96-B:1540–5.
The outcome at ten years of lateral closing-wedge high tibial osteotomy
Authors: Howells N. R. , Salmon L. , Waller A. , Scanelli J. , Pinczewski L. A.
Published: November 2014

The aim of this study was to examine the functional outcome at ten years following lateral closing wedge high tibial osteotomy for medial compartment osteoarthritis of the knee and to define pre-operative predictors of survival and determinants of functional outcome.

164 consecutive patients underwent high tibial osteotomy between 2000 and 2002. A total of 100 patients (100 knees) met the inclusion criteria and 95 were available for review at ten years. Data were collected prospectively and included patient demographics, surgical details, long leg alignment radiographs, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and Knee Society scores (KSS) pre-operatively and at five and ten years follow-up.

At ten years, 21 patients had been revised at a mean of five years. Overall Kaplan–Meier survival was 87% (95% confidence interval (CI) 81 to 94) and 79% (95% CI 71 to 87) at five and ten years, respectively. When compared with unrevised patients, those who had been revised had significantly lower mean pre-operative WOMAC Scores (47 (21 to 85) vs 65 (32 to 99), p < 0.001), higher mean age (54 yrs (42 to 61) vs 49 yrs (26 to 66), p = 0.006) and a higher mean BMI (30.2; 25 to 39 vs 27.9; 21 to 36, p = 0.005). Each were found to be risk factors for revision, with hazard ratios of 10.7 (95% CI 4 to 28.6; pre-operative WOMAC < 45), 6.5 (95% CI 2.4 to 17.7; age > 55) and 3.0 (95%CI 1.2 to 7.6; BMI > 30). Survival of patients with pre-operative WOMAC > 45, age < 55 and BMI < 30 was 97% at five and ten years. WOMAC and KSS in surviving patients improved significantly between pre-operative (mean 61; 32 to 99) and five (mean 88; 35 to 100, p = 0.001) and ten years (mean 84; 38 to 100, p = 0.001). Older patients had better functional outcomes overall, despite their higher revision rate.

This study has shown that improved survival is associated with age < 55 years, pre-operative WOMAC scores > 45 and, a BMI < 30. In patients over 55 years of age with adequate pre-operative functional scores, survival can be good and functional outcomes can be significantly better than their younger counterparts. We recommend the routine use of pre-operative functional outcome scores to guide decision-making when considering suitability for high tibial osteotomy.

Cite this article: Bone Joint J 2014;96-B:1491–7.
The anteroposterior axis of the tibia in Korean patients undergoing total knee replacement
Authors: Kim C. W. , Seo S. S. , Kim J. H. , Roh S. M. , Lee C. R.
Published: November 2014

The aim of this study was to find anatomical landmarks for rotational alignment of the tibial component in total knee replacement (TKR) in a CT-based study. Pre-operative CT scanning was performed on 94 South Korean patients (nine men, 85 women, 188 knees) with osteoarthritis of the knee joint prior to TKR. The tibial anteroposterior (AP) axis was defined as a line perpendicular to the femoral surgical transepicondylar axis and passing through the centre of the posterior cruciate ligament (PCL). The angles between the defined tibial AP axis and anatomical landmarks at various levels of the tibia were measured. The mean values of the angles between the defined tibial AP axis and the line connecting the anterior border of the proximal third of the tibia to the centre of the PCL was -0.2° (-17 to 14.1, sd 4.1). This was very close to the defined tibial axis, and remained so regardless of lower limb alignment and the degree of tibial bowing. Therefore, AP axis defined as described, is a reliable anatomical landmark for rotational alignment of tibial components.

Cite this article: Bone Joint J 2014; 96-B:1485–90.
Use of broth cultures peri-operatively to optimise the microbiological diagnosis of musculoskeletal implant infections
Authors: Blackmur J. P. , Tang E. Y. H. , Dave J. , Simpson A. H. R. W.
Published: November 2014

We compared the use of broth culture medium for samples taken in theatre with the standard practice of placing tissue samples in universal containers. A total of 67 consecutive patients had standard multiple samples of deep tissue harvested at surgery and distributed equally in theatre either to standard universal containers or to broth culture medium. These samples were cultured by direct and enrichment methods. The addition of broth in theatre to standard practice led to an increase in sensitivity from 83% to 95% and an increase in negative predictive value from 77% to 91%. Placing tissue samples directly into broth in the operating theatre is a simple, inexpensive way to increase the sensitivity of cultures from infected patients, and does not appear to compromise the specificity of these cultures.

Cite this article: Bone Joint J 2014;96-B:1566–70.
Clinical outcome following conversion of Girdlestone’s resection arthroplasty to total hip replacement
Authors: Garcia-Rey E. , Cruz-Pardos A. , Madero R.
Published: November 2014

A total of 31 patients, (20 women, 11 men; mean age 62.5 years old; 23 to 81), who underwent conversion of a Girdlestone resection-arthroplasty (RA) to a total hip replacement (THR) were compared with 93 patients, (60 women, 33 men; mean age 63.4 years old; 20 to 89), who had revision THR surgery for aseptic loosening in a retrospective matched case-control study. Age, gender and the extent of the pre-operative bone defect were similar in all patients. Mean follow-up was 9.3 years (5 to 18).

Pre-operative function and range of movement were better in the control group (p = 0.01 and 0.003, respectively) and pre-operative leg length discrepancy (LLD) was greater in the RA group (p < 0.001). The post-operative clinical outcome was similar in both groups except for mean post-operative LLD, which was greater in the study group (p = 0.003). There was a significant interaction effect for LLD in the study group (p < 0.001). A two-way analysis of variance showed that clinical outcome depended on patient age (patients older than 70 years old had worse pre-operative pain, p = 0.017) or bone defect (patients with a large acetabular bone defect had higher LLD, p = 0.006, worse post-operative function p = 0.009 and range of movement, p = 0.005), irrespective of the group.

Despite major acetabular and femoral bone defects requiring complex surgical reconstruction techniques, THR after RA shows a clinical outcome similar to those obtained in aseptic revision surgery for hips with similar sized bone defects.

Cite this article: Bone Joint J 2014;96-B:1478–84.
A comparison of the simplified olecranon and digital methods of assessment of skeletal maturity during the pubertal growth spurt
Authors: Canavese F. , Charles Y. P. , Dimeglio A. , Schuller S. , Rousset M. , Samba A. , Pereira B. , Steib J-P.
Published: November 2014

Assessment of skeletal age is important in children’s orthopaedics. We compared two simplified methods used in the assessment of skeletal age. Both methods have been described previously with one based on the appearance of the epiphysis at the olecranon and the other on the digital epiphyses. We also investigated the influence of assessor experience on applying these two methods.

Our investigation was based on the anteroposterior left hand and lateral elbow radiographs of 44 boys (mean: 14.4; 12.4 to 16.1 ) and 78 girls (mean: 13.0; 11.1 to14.9) obtained during the pubertal growth spurt. A total of nine observers examined the radiographs with the observers assigned to three groups based on their experience (experienced, intermediate and novice). These raters were required to determined skeletal ages twice at six-week intervals. The correlation between the two methods was determined per assessment and per observer groups. Interclass correlation coefficients (ICC) evaluated the reproducibility of the two methods.

The overall correlation between the two methods was r = 0.83 for boys and r = 0.84 for girls. The correlation was equal between first and second assessment, and between the observer groups (r ≥ 0.82). There was an equally strong ICC for the assessment effect (ICC ≤ 0.4%) and observer effect (ICC ≤ 3%) for each method. There was no significant (p < 0.05) difference between the levels of experience.

The two methods are equally reliable in assessing skeletal maturity. The olecranon method offers detailed information during the pubertal growth spurt, while the digital method is as accurate but less detailed, making it more useful after the pubertal growth spurt once the olecranon has ossified.

Cite this article: Bone Joint J 2014;3:1556–60
Classification of failure of limb salvage after reconstructive surgery for bone tumours
Authors: Henderson E. R. , O’Connor M. I. , Ruggieri P. , Windhager R. , Funovics P. T. , Gibbons C. L. , Guo W. , Hornicek F. J. , Temple H. T. , Letson G. D.
Published: November 2014

Previous classification systems of failure of limb salvage focused primarily on endoprosthetic failures and lacked sufficient depth for the effective study of the causes of failure. In order to address these inadequacies, the International Society of Limb Salvage (ISOLS) formed a committee to recommend revisions of the previous systems. The purpose of this study was to report on their recommendations. The modifications were prepared using an earlier, evidence-based model with subclassification based on the existing medical literature. Subclassification for all five primary types of failure of limb salvage following endoprosthetic reconstruction were formulated and a complementary system was derived for the failure of biological reconstruction. An additional classification of failure in paediatric patients was also described.

Limb salvage surgery presents a complex array of potential mechanisms of failure, and a complete and precise classification of types of failure is required. Earlier classification systems lacked specificity, and the evidence-based system outlined here is designed to correct these weaknesses and to provide a means of reporting failures of limb salvage in order to allow the interpretation of outcome following reconstructive surgery.

Cite this article: Bone Joint J 2014;96-B:1436–40.
Necrotising soft-tissue infections of the upper limb
Authors: Uehara K. , Yasunaga H. , Morizaki Y. , Horiguchi H. , Fushimi K. , Tanaka S.
Published: November 2014

Necrotising soft-tissue infections (NSTIs) of the upper limb are uncommon, but potentially life-threatening. We used a national database to investigate the risk factors for amputation of the limb and death.

We extracted data from the Japanese Diagnosis Procedure Combination database on 116 patients (79 men and 37 women) who had a NSTI of the upper extremity between 2007 and 2010.

The overall in-hospital mortality was 15.5%. Univariate analysis of in-hospital mortality showed that the significant variables were age (p = 0.015), liver dysfunction (p = 0.005), renal dysfunction (P < 0.001), altered consciousness (p = 0.049), and sepsis (p = 0.021). Logistic regression analysis showed that the factors associated with death in hospital were age over 70 years (Odds Ratio (OR) 6.6; 95% confidence interval (CI) 1.5 to 28.2; p = 0.011) and renal dysfunction (OR 15.4; 95% CI 3.8 to 62.8; p < 0.001).

Univariate analysis of limb amputation showed that the significant variables were diabetes (p = 0.017) mellitus and sepsis (p = 0.001). Multivariable logistic regression analysis showed that the factors related to limb amputation were sepsis (OR 1.8; 95% CI 1.5 to 24.0; p = 0.013) and diabetes mellitus (OR 1.6; 95% CI 1.1 to 21.1; p = 0.038).

For NSTIs of the upper extremity, advanced age and renal dysfunction are both associated with a higher rate of in-hospital mortality. Sepsis and diabetes mellitus are both associated with a higher rate of amputation.

Cite this article: Bone Joint J 2014;96-B:1530–4.
Can pain and function be distinguished in the Oxford Hip Score in a meaningful way?
Authors: Harris K. K. , Price A. J. , Beard D. J. , Fitzpatrick R. , Jenkinson C. , Dawson J.
Published: November 2014

Objective

The objective of this study was to explore dimensionality of the Oxford Hip Score (OHS) and examine whether self-reported pain and functioning can be distinguished in the form of subscales.

Methods

This was a secondary data analysis of the UK NHS hospital episode statistics/patient-reported outcome measures dataset containing pre-operative OHS scores on 97 487 patients who were undergoing hip replacement surgery.

Results

The proposed number of factors to extract depended on the method of extraction employed. Velicer’s Minimum Average Partial test and the Parallel Analysis suggested one factor, the Cattell’s scree test and Kaiser-over-1 rule suggested two factors. Exploratory factor analysis demonstrated that the two-factor OHS had most of the items saliently loading either of the two factors. These factors were named ‘Pain’ and ‘Function’ and their respective subscales were created. There was some cross-loading of items: 8 (pain on standing up from a chair) and 11 (pain during work). These items were assigned to the ‘Pain’ subscale. The final ‘Pain’ subscale consisted of items 1, 8, 9, 10, 11 and 12. The ‘Function’ subscale consisted of items 2, 3, 4, 5, 6 and 7, with the recommended scoring of the subscales being from 0 (worst) to 100 (best). Cronbach’s alpha was 0.855 for the ‘Pain’ subscale and 0.861 for the ‘Function’ subscale. A confirmatory factor analysis demonstrated that the two-factor model of the OHS had a better fit. However, none of the one-factor or two-factor models was rejected.

Conclusion

Factor analyses demonstrated that, in addition to current usage as a single summary scale, separate information on pain and self-reported function can be extracted from the OHS in a meaningful way in the form of subscales. Cite this article: Bone Joint Res 2014;3:305–9.
Privileging biological or residential obligations in separated families: child maintenance policy approaches in 12 countries
Authors: Meyer Daniel R. , Skinner Christine
Published: November 2014

Children’s living arrangements have become increasingly complex over the last decades, with more children born to parents who do not live together and, even among those born to parents who do live together, increasing numbers are experiencing their parents separating and one or both re-partnering. These changes raise questions about who has financial responsibility for the children. In this article we conceptualise how different child maintenance schemes might deal with six common family transitions, focusing on the extent to which responsibilities are organised according to biology or residence. We then investigate the child maintenance policies in place in 12 countries, and use the results to categorise countries into five child maintenance schemes. Finally, we compare the child maintenance scheme with the level of family complexity in each country to see if countries with the highest levels of complexity tend to organise responsibility differently.
Professional women’s thoughts about sustainable clothing: Eco-fashion goes business?
Authors: Eifler Christine
Published: November 2014

This article discusses the significant role of sustainable consumption in postmodern societies and the apparent ‘sustainable fashion gap’ in the priorities of consumers who are interested in sustainable issues in Germany. Drawing on the opinions of female academic employees from universities and managers from the private sector, this article will outline why consumers in Germany do not award sustainable clothing the same status as products in use in daily life in terms of sustainability. In the academic debate a negative image of eco-clothing, which developed in the 1970s, is considered to be responsible for such situation. The previous eco-clothing won a reputation by consumers as unfashionable and an ‘eco-frumpy-look’ and influenced its acceptance negatively. In spite of ecological textile innovations and the expansion of clothing ranges, consumption of sustainable clothing has not generally improved in recent decades. The survey fleshes out that the current low acceptance of sustainable fashion is not due to a supposedly negative image of ecological fashion but because of structural problems within the production and consumption processes as well as an inadequate product range which does not take gender constructs into account. The old clichés of eco-clothing no longer apply, but there are new problems relevant to the production and consumption of sustainable clothing. The article discusses furthermore the representation of sustainable clothing in the catalogues and fashion magazines of sustainable producers.
Tendencje w zarządzaniu długiem samorządowym w Polsce na podstawie wieloletnich prognoz finansowych jednostek samorządu terytorialnego
Authors: Wiśniewska Dorota , Wiśniewski Marcin
Published: November 2014

Znaczący w ostatnich latach wzrost zadłużenia polskich samorządów spowodował, że zarządzanie długiem stało się niezwykle istotnym elementem zarządzania finansami w jednostkach samorządu terytorialnego. Niezbędnym w tym procesie narzędziem jest obowiązkowa od 2010 r. wieloletnia prognoza finansowa. Począwszy od 2013 r., jednostki zobligowane zostały dodatkowo do raportowania w ujednoliconej formie swoich prognoz, które ostatecznie zostały zebrane i upublicznione w zbiorczym zestawieniu przez Ministerstwo Finansów. Dane te umożliwiły po raz pierwszy zbadanie tendencji w zarządzaniu długiem samorządowym w Polsce. W niniejszym artykule zbadano najważniejsze przejawy tego procesu, które zostały odzwierciedlone w planach finansowych jednostek. Przeanalizowano w szczególności wielkość planowanego zadłużenia oraz jego obsługę (w ujęciu bezwzględnym, jak i w relacji do dochodów jednostek), wskazano także na rozplanowanie spłaty długu w czasie oraz na wysokość jego kosztów.
Zwinne dostosowania przedsiębiorstw na rynkach z okazjonalną przewagą konkurencyjną
Authors: Banaszyk Piotr
Published: November 2014

Artykuł zawiera identyfikację i charakterystykę relacji między typem warunków konkurowania a pożądanym dostosowaniem działalności przedsiębiorstwa oraz rekonstrukcję współczesnych uwarunkowań konkurowania i wskazanie najlepiej do nich dostosowanych zachowań biznesowych. Tak zwana okazjonalna przewaga konkurencyjna dominuje we współczesnej gospodarce globalnej. Przedsiębiorstwa powinny zatem wdrożyć zwinne zachowania biznesowe. Koncepcja zwinnego przedsiębiorstwa jest nowym paradygmatem w zarządzaniu.
Studia nad bogactwem i ubóstwem narodów na przełomie mileniów – wkład Darona Acemoglu i Jamesa A. Robinsona
Authors: Matera Rafał
Published: November 2014

Na przełomie drugiego i trzeciego milenium ukazało się wiele nowych inspirujących prac, które podejmowały temat przyczyn bogactwa i ubóstwa na świecie. Wśród autorów znajdowali się zarówno wybitni historycy gospodarczy, jak i ekonomiści wykorzystujący analizę instytucjonalną. Celem artykułu jest przybliżenie najważniejszych prac opublikowanych w ostatnich latach podejmujących problem dysproporcji dochodowych na świecie i poszukujących przyczyn tego zjawiska. W przeglądzie uwzględniono ważniejsze pozycje z zakresu historii gospodarczej. Szczególne miejsce zostawiono na omówienie najnowszego dzieła Darona Acemoglu i Jamesa A. Robinsona „Why Nations Fail. The Origins of Power, Prosperity and Poverty” [Dlaczego narody upadają. Geneza potęgi, dostatku i ubóstwa], w którym autorzy, korzystając z dziesiątków przykładów historycznych, również starają się wyjaśnić, skąd biorą się różnice między bogatymi a biednymi krajami. Praca Acemoglu i Robinsona jest instytucjonalną interpretacją historii i próbuje odpowiedzieć na pytanie, w jaki sposób historia kształtuje instytucjonalne ścieżki rozwoju narodów. Historia nie jest według nich przeznaczeniem, nie determinują jej też czynniki geograficzne, kultura, przypadek, a nawet ignorancja rządzących, ale determinują ją instytucje. Obok przybliżenia podstaw teoretycznych, które wykorzystują instytucjonaliści, w artykule znajdują się komentarze autorskie, wspomagane przykładami zachowań instytucji również na gruncie polskim.
Mesencephalic GABA neuronal development: no more on the other side of oblivion
Authors: Li Suyan , Joshee Sampada , Vasudevan Anju
Published: November 2014

Midbrain GABA neurons, endowed with multiple morphological, physiological and molecular characteristics as well as projection patterns are key players interacting with diverse regions of the brain and capable of modulating several aspects of behavior. The diversity of these GABA neuronal populations based on their location and function in the dorsal, medial or ventral midbrain has challenged efforts to rapidly uncover their developmental regulation. Here we review recent developments that are beginning to illuminate transcriptional control of GABA neurons in the embryonic midbrain (mesencephalon) and discuss its implications for understanding and treatment of neurological and psychiatric illnesses.
Telocytes revisited
Authors: Cretoiu Sanda M. , Popescu Laurentiu M.
Published: November 2014

Telocytes (TCs) are a novel interstitial (stromal) cell type described in many tissues and organs (www.telocytes.com). A TC is characterized by a small cell body (9–15 μm) and a variable number (one to five) of extremely long and thin telopodes (Tps), with alternating regions of podomers (∼80 nm) and podoms (250–300 nm). Tps are interconnected by homo- and heterocellular junctions and form three-dimensional networks. Moreover, Tps release three types of extracellular vesicles: exosomes, ectosomes, and multivesicular cargos, which are involved in paracrine signaling. Different techniques have been used to characterize TCs, from classical methods (light microscopy, electron microscopy) to modern ‘omics’. It is considered that electron microscopy is essential for their identification, and CD34/PDGFRα double immunohistochemistry can orientate the diagnosis. Functional evidence is accumulating that TCs may be intimately involved in the maintenance of tissue homeostasis and renewal by short- and long-distance intercellular communication. This review focuses on the most recent findings regarding TC features and locations and the principal hypotheses about their functions in normal and diseased organs. TC involvement in regenerative medicine is also considered.
Open-source, high-throughput ultrasound treatment chamber
Authors: Yddal Torstein , Cochran Sandy , Gilja Odd Helge , Postema Michiel , Kotopoulis Spiros
Published: November 2014

Studying the effects of ultrasound on biological cells requires extensive knowledge of both the physical ultrasound and cellular biology. Translating knowledge between these fields can be complicated and time consuming. With the vast range of ultrasonic equipment available, nearly every research group uses different or unique devices. Hence, recreating the experimental conditions and results may be expensive or difficult. For this reason, we have developed devices to combat the common problems seen in state-of-the-art biomedical ultrasound research. In this paper, we present the design, fabrication, and characterisation of an open-source device that is easy to manufacture, allows for parallel sample sonication, and is highly reproducible, with complete acoustic calibration. This device is designed to act as a template for sample sonication experiments. We demonstrate the fabrication technique for devices designed to sonicate 24-well plates and OptiCell™ using three-dimensional (3D) printing and low-cost consumables. We increased the pressure output by electrical impedance matching of the transducers using transmission line transformers, resulting in an increase by a factor of 3.15. The devices cost approximately €220 in consumables, with a major portion attributed to the 3D printing, and can be fabricated in approximately 8 working hours. Our results show that, if our protocol is followed, the mean acoustic output between devices has a variance of <1%. We openly provide the 3D files and operation software allowing any laboratory to fabricate and use these devices at minimal cost and without substantial prior know-how.
Results of first proficiency test for KRAS testing with formalin-fixed, paraffin-embedded cell lines in China
Authors: Zhang Rui , Han Yanxi , Huang Jie , Ma Liang , Li Yulong , Li Jinming
Published: November 2014

Laboratory testing for

Artificial FFPE samples were prepared from cultured cell lines to construct a proficiency panel of 10 samples covering eight

The percentages of mutant
Progressive chromogenic anti-factor Xa assay and its use in the classification of antithrombin deficiencies
Authors: Kovács Bettina , Bereczky Zsuzsanna , Selmeczi Anna , Gindele Réka , Oláh Zsolt , Kerényi Adrienne , Boda Zoltán , Muszbek László
Published: November 2014

Antithrombin (AT) is a slow-acting progressive inhibitor of activated clotting factors, particularly thrombin and activated factor X (FXa). However, the presence of heparin or heparan sulfate accelerates its effect by several magnitudes. AT deficiency, a severe thrombophilia, is classified as type I (quantitative) and type II (qualitative) deficiency. In the latter case mutations may influence the reactive site, the heparin binding-site (HBS) and exert pleiotropic effect. Heterozygous type II-HBS deficiency is a less severe thrombophilia than other heterozygous subtypes. However, as opposed to other subtypes, it also exists in homozygous form which represents a very high risk of venous thromboembolism.

A modified anti-FXa chromogenic AT assay was developed which determines both the progressive (p) and the heparin cofactor (hc) activities, in parallel. The method was evaluated and reference intervals were established. The usefulness of the assay in detecting type II-HBS AT deficiency was tested on 78 AT deficient patients including 51 type II-HBS heterozygotes and 18 homozygotes.

Both p-anti-FXa and hc-anti-FXa assays showed excellent reproducibility and were not influenced by high concentrations of triglyceride, bilirubin and hemoglobin. Reference intervals for p-anti-FXa and hc-anti-FXa AT activities were 84%–117% and 81%–117%, respectively. Type II-HBS deficient patients demonstrated low (heterozygotes) or very low (homozygotes) hc-anti-FXa activity with normal or slightly decreased p-anti-FXa activity. The p/hc ratio clearly distinguished wild type controls, type II-HBS heterozygotes and homozygotes.

Concomitant determination of p-anti-FXa and hc-anti-FXa activities provides a reliable, clinically important diagnosis of type II-HBS AT deficiency and distinguishes between homozygotes and heterozygotes.
Serum reference intervals of homoarginine, ADMA, and SDMA in the Study of Health in Pomerania
Authors: Atzler Dorothee , Schwedhelm Edzard , Nauck Matthias , Ittermann Till , Böger Rainer H. , Friedrich Nele
Published: November 2014

Low circulating homoarginine as well as high levels of asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) have been associated with impaired cardiovascular (CV) outcome and mortality in patients at risk and in the general population. The present study aimed to formulate reference intervals for serum homoarginine, ADMA, and SDMA to improve risk stratification between healthy individuals and individuals at risk.

We determined age- and sex-specific reference intervals for homoarginine, ADMA, and SDMA in a subgroup of 1359 healthy participants (no diabetes mellitus, CV disease, increased blood pressure, elevated blood lipids, chronic kidney disease stadium III or IV, or a body mass index >30) of the Study of Health in Pomerania (SHIP) using quantile regression analyses. Homoarginine, ADMA, and SDMA serum concentrations were measured using liquid chromatography-tandem mass spectrometry.

Median age of the investigated cohort was 36 (25th; 75th percentile 28; 47) years, with 62% women. Median serum concentrations of homoarginine, ADMA, and SDMA were 2.63 (2.08; 3.32) μmol/L, 0.64 (0.57; 0.73) μmol/L, and 0.43 (0.37; 0.49) μmol/L, respectively. Serum levels of homoarginine, ADMA, and SDMA showed material age- and sex-related differences (p<0.05 for all). Overall reference ranges were 1.41–5.00 and 1.20–5.53 μmol/L (2.5th; 97.5th percentile; for men and women, respectively) for homoarginine, 0.41–0.95 and 0.43–0.96 μmol/L for ADMA, and 0.30–0.67 and 0.27–0.63 μmol/L for SDMA.

We formulated for the first time homoarginine, ADMA, and SDMA reference intervals in serum. These reference intervals might be useful for individual CV risk stratification.
Social media and the McDonaldization of friendship
Authors: Bakardjieva Maria
Published: November 2014

This article employs the concept of McDonaldization introduced by George Ritzer (1993) in his Weberian analysis of the processes of formal rationalization characteristic of late modern consumer society to reflect on the social and cultural implications of the most recent wave of communication technologies – social media. It argues that social media smuggle formal rationality into the elementary forms of social interaction, most clearly illustrated through the way they redefine the notion of friendship. In an attempt to lay the ground for a “multiperspectivist approach” (Kellner, 1999) to this phenomenon, the article enters the Weberian argument into a conversation with other styles of theorizing social media such as Marxism, Critical Theory and sociological phenomenology.