bluuebunny/crossref_metadata_2025 huggingface dataset:
Interferon at the crossroads of allergy and viral infections
Authors: Gonzales-van Horn Sarah R , Farrar J David
Published: May 2015

IFN-α/β was first described as a potent inhibitor of viral replication, but it is now appreciated that IFN signaling plays a pleiotropic role in regulating peripheral T cell functions. Recently, IFN-α/β was shown to block human Th2 development by suppressing the transcription factor GATA3. This effect is consistent with the role for IFN-α/β in suppressing allergic inflammatory processes by blocking granulocyte activation and IL-4-mediated B cell isotype switching to IgE. With the consideration of recent studies demonstrating a defect in IFN-α/β secretion in DCs and epithelial cells from individuals with severe atopic diseases, there is an apparent reciprocal negative regulatory loop in atopic individuals, whereby the lack of IFN-α/β secretion by innate cells contributes to the development of allergic Th2 cells. Is it possible to overcome these events by treating with IFN-α/β or by inducing its secretion in vivo? In support of this approach, case studies have documented the therapeutic potential of IFN-α/β in treating steroid-resistant allergic asthma and other atopic diseases. Additionally, individuals with asthma who are infected with HCV and respond to IFN therapy showed a reduction in symptoms and severity of asthma attacks. These findings support a model, whereby allergic and antiviral responses are able to cross-regulate each other, as IgER cross-linking of pDCs prevents IFN-α/β production in response to viral infection. The clinical importance of upper-respiratory viruses in the context of allergic asthma supports the need to understand how these pathways intersect and to identify potential therapeutic targets.
Learning and performance outcomes of mental health staff training in de-escalation techniques for the management of violence and aggression
Authors: Price Owen , Baker John , Bee Penny , Lovell Karina
Published: June 2015

Background

De-escalation techniques are a recommended non-physical intervention for the management of violence and aggression in mental health. Although taught as part of mandatory training for all National Health Service (NHS) mental health staff, there remains a lack of clarity around training effectiveness.

Aims

To conduct a systematic review of the learning, performance and clinical safety outcomes of de-escalation techniques training.

Method

The review process involved a systematic literature search of 20 electronic databases, eligibility screening of results, data extraction, quality appraisal and data synthesis.

Results

A total of 38 relevant studies were identified. The strongest impact of training appears to be on de-escalation-related knowledge, confidence to manage aggression and de-escalation performance (although limited to artificial training scenarios). No strong conclusions could be drawn about the impact of training on assaults, injuries, containment and organisational outcomes owing to the low quality of evidence and conflicting results.

Conclusions

It is assumed that de-escalation techniques training will improve staff's ability to de-escalate violent and aggressive behaviour and improve safety in practice. There is currently limited evidence that this training has these effects.
Specialist adult ADHD clinics in East Anglia: service evaluation and audit of NICE guideline compliance
Authors: Magon Rakesh Kumar , Latheesh Beena , Müller Ulrich
Published: June 2015

Aims and method

To measure compliance with National Institute for Health and Care Excellence (NICE) recommendations in two adult attention-deficit hyperactivity disorder (ADHD) clinics and to guide further service development. We audited the case notes of 150 patients referred to adult ADHD clinics in East Anglia in 2010–2011 against NICE standards using an adapted version of the ADHD audit support tool.

Results

We found good compliance with NICE standards for diagnosis, assessment and pharmacological treatment of adult ADHD. There was a failure in smooth transitional arrangements from child and adolescent mental health to adult ADHD services. Comprehensive treatment programmes addressing psychological, behavioural, educational and occupational needs were not well developed. Deficiencies were observed in conducting recommended physical examinations. Substance use was prevalent in almost half of ADHD patients.

Clinical implications

Greater attention is needed in delivering better transitional arrangements and comprehensive treatment programmes for adult ADHD. More structured training with emphasis on ADHD-specific psychological interventions, physical examination and treatment of complex cases, especially with comorbid substance misuse, should be offered to clinicians.
The neurology-psychiatry divide: a thought experiment
Authors: Reilly Thomas J.
Published: June 2015

Diseases of the brain are generally classified as either neurological or psychiatric. However, these two groups of illnesses cannot be readily separated on the basis of pathophysiology or symptomatology. It is difficult to rationally explain to someone with no prior frame of reference why we have the split between neurological and psychiatric illness. This demonstrates that the division is untenable, which has implications for training in both psychiatry and neurology.
Do psychiatry and neurology need a close partnership or a merger?
Authors: Fitzgerald Michael
Published: June 2015

Advances in neuroscience in recent years have blurred the boundaries between psychiatry and neurology. They now have more in common than what divides them and this signals a return to their origins. Many have called for a merger of the two disciplines, which would offer a more holistic approach, whereas others vigorously reject such a move. Limiting neurology to the study of the nervous system and psychiatry to the social brain or affect and its disorders is no longer sustainable. The ongoing separation of the disciplines has had an impact on diagnosis and treatment, on professional isolation and on funding psychiatric research.
The borderline of bipolar: opinions of patients and lessons for clinicians on the diagnostic conflict
Authors: Richardson Emma , Tracy Derek K.
Published: June 2015

Aims and method

It has been observed that some individuals self-diagnose with a bipolar affective disorder and many are later diagnosed with a borderline personality disorder. There is a background context of clinical and neurobiological overlap between these conditions, and fundamental debates on the validity of current diagnostic systems. This qualitative study is the first work to explore the views of patients caught at this diagnostic interface. We predicted that media exposure, stigma and attribution of responsibility would be key factors affecting patient understanding and opinion.

Results

Six core illness-differentiating themes emerged: public information, diagnosis delivery, illness causes, illness management, stigma, and relationship with others. Individuals did not ‘want’ to be diagnosed with a bipolar disorder, but wished for informed care.

Clinical implications

Understanding patient perspectives will allow clinical staff to better appreciate the difficulties faced by those we seek to help, identify gaps in care provision, and should stimulate thought on our attitudes to care and how we facilitate provision of information, including information about diagnosis.
Quality assurance of approved out of programme psychiatry training and research over the past 5 years
Authors: Osman-Hicks Victoria , Graham Hannah , Leadbetter Peter , Brittlebank Andrew
Published: June 2015

Aims and method

This paper intends to analyse the number of applications, trainee demographic and approval rate of those applying for out of programme training (OOPT) or out of programme research (OOPR) between January 2008 and April 2013 using the committee's anonymised database. We also describe the process of application and approval by the Quality Assurance Committee.

Results

There were 90 applications, including 10 resubmissions during the 64-month period. Most applicants (77%) were higher trainees; 53% of applicants were from the London deanery; 60% of applications were for research posts and higher degrees (OOPR). Overall, 64% were approved by the committee: 70% for OOPRs and 53% for OOPTs.

Clinical implications

This paper shows with transparency the breakdown of applications to the Quality Assurance Committee. Around two-thirds of applications to the committee are supported (64%). Relatively few psychiatry trainees (2.5%) have applied for an OOPT or an OOPR over the past 5 years.
Relationship between timeliness of contact and length of stay in older and younger patients of a consultation-liaison psychiatry service
Authors: Wood Rebecca , Wand Anne P. F. , Hunt Glenn E.
Published: June 2015

Aim and methods

The aims were to determine whether the timeliness of contact with a consultation–liaison psychiatry (CLP) service is associated with shorter lengths of stay (LOS), whether this relationship persists for stays greater than 4 days and whether this association varies with age. The length of stay was correlated with the time from admission to contact with the service (the referral lag (REFLAG)), and the REFLAG's proportion of length of stay (REFLAG/LOS) for all 140 in-patients, those with stays greater than 4 days, and for those under and over 65 years.

Results

The length of stay was significantly correlated with referral lag and logREFLAG/logLOS for all patients and for patients with stays greater than 4 days. The correlations remained significant for both age groups, but were stronger in the younger group.

Clinical implications

Timeliness of contact with CLP was associated with shorter length of stay, particularly in younger patients. Psychiatric factors influencing length of stay in older patients should be studied by CLP services.
Ambra1 at a glance
Authors: Cianfanelli Valentina , De Zio Daniela , Di Bartolomeo Sabrina , Nazio Francesca , Strappazzon Flavie , Cecconi Francesco
Published: June 2015

The activating molecule in Beclin-1-regulated autophagy (Ambra1), also known as autophagy/Beclin-1 regulator 1, is a highly intrinsically disordered and vertebrate-conserved adapter protein that is part of the autophagy signaling network. It acts in an early step of mammalian target of rapamycin complex 1 (mTORC1)-dependent autophagy by favouring formation of the autophagosome core complex. However, recent studies have revealed that Ambra1 can also coordinate a cell response upon starvation or other stresses that involve translocation of the autophagosome core complex to the endoplasmic reticulum (ER), regulative ubiquitylation and stabilization of the kinase ULK1, selective mitochondria removal and cell cycle downregulation. Moreover, Ambra1 itself appears to be targeted by a number of regulatory processes, such as cullin-dependent degradation, caspase cleavage and several modifications, ranging from phosphorylation to ubiquitylation. Altogether, this complex network of regulation highlights the importance of Ambra1 in crucial physiological events, including metabolism, cell death and cell division. In addition, Ambra1 is an important regulator of embryonic development, and its mutation or inactivation has been shown to correlate with several pathologies of the nervous system and to be involved in carcinogenesis. In this Cell Science at a Glance article and the accompanying poster, we discuss recent advances in the Ambra1 field, particularly the role of this pro-autophagic protein in cellular pathophysiology.
Daily temperature extremes play an important role in predicting thermal effects
Authors: Ma Gang , Hoffmann Ary A. , Ma Chun-Sen
Published: May 2015

Organisms in natural environments experience diel temperature fluctuations rather than constant temperatures, including sporadic extreme conditions. Studies based mainly on model organisms have tended to focus on responses to average temperatures or short-term heat stress, which overlooks the potential impact of daily fluctuations including stressful daytime periods and milder nighttime periods. Here we focus on daily maximum temperatures, while holding nighttime temperatures constant, to specifically investigate high temperature effects on demographic parameters and fitness in the English grain aphid, Sitobion avenae (Fabricius). We then compared the observed effects of different daily maximum temperatures with predictions from constant temperature-performance expectations. Moderate daily maximum temperatures depressed aphid performance while extreme conditions had dramatic effects even when mean temperatures were below the critical maximum. Predictions based on daily average temperature underestimated negative effects of temperature on performance by ignoring daily maximum temperature, while predictions based on daytime maximum temperatures overestimated detrimental impacts by ignoring recovery under mild nighttime temperatures. Our findings suggest that daily maximum temperature will play an important role in regulating natural population dynamics and should be considered in predictions. These findings have implications for natural population dynamics particularly when considering the expected increase in extreme temperature events under climate change.
The developmental transcriptome of contrasting Arctic charr (Salvelinus alpinus) morphs
Authors: Gudbrandsson Johannes , Ahi Ehsan P. , Franzdottir Sigridur R. , Kapralova Kalina H. , Kristjansson Bjarni K. , Steinhaeuser S. Sophie , Maier Valerie H. , Johannesson Isak M. , Snorrason Sigurdur S. , Jonsson Zophonias O. , Palsson Arnar
Published: June 2015

Species and populations with parallel evolution of specific traits can help illuminate how predictable adaptations and divergence are at the molecular and developmental level. Following the last glacial period, dwarfism and specialized bottom feeding morphology evolved rapidly in several landlocked Arctic charrSalvelinus alpinuspopulations in Iceland.  

To study the genetic divergence between small benthic morphs and limnetic morphs, we conducted RNA-sequencing charr embryos at four stages in early development. We studied two stocks with contrasting morphologies: the small benthic (SB) charr from Lake Thingvallavatn and Holar aquaculture (AC) charr.

The data reveal significant differences in expression of several biological pathways during charr development. There was also an expression difference between SB- and AC-charr in genes involved in energy metabolism and blood coagulation genes. We confirmed differing expression of five genes in whole embryos with qPCR, includinglysozymeandnatterin-likewhich was previously identified as a fish-toxin of a lectin family that may be a putative immunopeptide. We also verified differential expression of 7 genes in the developing head that associated consistently with benthic v.s.limnetic morphology (studied in 4 morphs). Comparison of single nucleotide polymorphism (SNP) frequencies reveals extensive genetic differentiation between the SB and AC-charr (~1300 with more than 50% frequency difference). Curiously, three derived alleles in the otherwise conserved 12s and 16s mitochondrial ribosomal RNA genes are found in benthic charr.

The data implicate multiple genes and molecular pathways in divergence of small benthic charr and/or the response of aquaculture charr to domestication. Functional, genetic and population genetic studies on more freshwater and anadromous populations are needed to confirm the specific loci and mutations relating to specific ecological traits in Arctic charr.
A resistant-starch enriched yogurt: fermentability, sensory characteristics, and a pilot study in children
Authors: Aryana Kayanush , Greenway Frank , Dhurandhar Nikhil , Tulley Richard , Finley John , Keenan Michael , Martin Roy , Pelkman Christine , Olson Douglas , Zheng Jolene
Published: June 2015

The rising prevalence of obesity and the vulnerability of the pediatric age group have highlighted the critical need for a careful consideration of effective, safe, remedial and preventive dietary interventions.  Amylose starch (RS2) from high-amylose maize (HAM) ferments in the gut and affects body weight.   One hundred and ten children, of 7-8 (n=91) or 13-14 (n=19) years of age scored the sensory qualities of a yogurt supplemented with either HAM-RS2 or an amylopectin starch.  The amylopectin starch yogurt was preferred to the HAM-RS2-enriched yogurt by 7-8 year old panelists (P<0.0001).  Appearance, taste, and sandiness scores given by 13- to 14-year-old panelists were more favorable for the amylopectin starch yogurt than for HAM-RS2-enriched yogurt (P<0.05).  HAM-RS2 supplementation resulted in acceptable (≥6 on a 1-9 scale) sensory and hedonic ratings of the yogurt in 74% of subjects.  Four children consumed a HAM-RS2-enriched yogurt for four weeks to test its fermentability in a clinical trial.  Three adolescents, but not the single pre-pubertal child, had reduced stool pH (P=0.1) and increased stool short-chain fatty acids (SCFAs) (P<0.05) including increased fecal acetate (P=0.02), and butyrate (P=0.089) from resistant starch (RS) fermentation and isobutyrate (P=0.01) from protein fermentation post-treatment suggesting a favorable change to the gut microbiota.  HAM-RS2 was not modified by pasteurization of the yogurt, and may be a palatable way to increase fiber intake and stimulate colonic fermentation in adolescents.  Future studies are planned to determine the concentration of HAM-RS2 that offers the optimal safe and effective strategy to prevent excessive fat gain in children.
A natural sense of calm
Authors: Jefferies Tina
Published: May 2015

Quiet gardens are outdoor spaces that are intentionally constructed and set aside for peace, reflection and contemplation; they can be incorporated in settings to help children maintain a sense of wellbeing.
Where next for childminders?
Authors: Heath Bea
Published: May 2015

The future of one particular section of the sector is at risk far more than others, although home-based childcarers rarely got mentioned in the election manifestos, they are the ones who could suffer most.
Indian aesthetics: balancing budgets for Bollywood beauty
Authors: Mendes Aysha
Published: May 2015

With both surgical and non-surgical cosmetic procedures on the rise worldwide, aesthetic nursing is becoming an increasingly popular profession. In this new series, Aysha Mendes examines aesthetic nursing practices and cultural perceptions of beauty across the globe by focusing on a different country every month. This article explores the impact of aesthetic surgery and Bollywood stars in India
Anyone considering aesthetic treatment? ‘Do it for you and never for anyone else’
Authors: Barton Cheryl , Mcgloin Claudia
Published: May 2015

In the field of medical aesthetics, it is common for nurses to work in isolation and meet only at annual conferences and association meetings. To get to know your peers, the Journal of Aesthetic Nursing's consultant editor Cheryl Barton has undertaken a series of ten interviews with both new and experienced aesthetic nurses, exploring their lives in and out of the clinic. This interview is with Claudia McGloin
Step Ahead seminar lives up to its name by offering a varied programme for success
Authors: Senior Yvonne
Published: May 2015

The latest Step Ahead in Aesthetics seminar was given in Huddersfield recently by the Private Independent Aesthetic Practices Association (PIAPA). The busy programme covered education, business and practical demonstrations. Yvonne Senior reports on a day that ‘involved people who are successful within the industry and were willing to help us all to succeed as well‘
It's not about the fish, but how you box it: people buy emotions, not features
Authors: Ratcliffe Jason
Published: May 2015

In this month's column, Jason Ratcliffe puts a fresh twist on an old proverb. He wonders why you would teach someone to fish when they would much rather be persuaded by you to sell it to them in a pretty package. Business owners should focus less on the particular products they sell, he says, and more on the benefits, making an emotional connection to the value their service provides
The value of the high-sensitivity modified Glasgow prognostic score in predicting the survival of patients with a soft-tissue sarcoma
Authors: Nakamura T. , Matsumine A. , Asanuma K. , Matsubara T. , Sudo A.
Published: June 2015

The aim of this study was to determine whether the high-sensitivity modified Glasgow prognostic score (Hs-mGPS) could predict the disease-specific survival and oncological outcome in adult patients with non-metastatic soft-tissue sarcoma before treatment. A total of 139 patients treated between 2001 and 2012 were retrospectively reviewed. The Hs-mGPS varied between 0 and 2. Patients with a score of 2 had a poorer disease-specific survival than patients with a score of 0 (p < 0.001). The estimated five-year rate of disease-specific survival for those with a score of 2 was 0%, compared with 85.4% (95% CI 77.3 to 93.5) for those with a score of 0. Those with a score of 2 also had a poorer disease-specific survival than those with a score of 1 (75.3%, 95% CI 55.8 to 94.8; p < 0.001). Patients with a score of 2 also had a poorer event-free rate than those with a score of 0 (p < 0.001). Those with a score of 2 also had a poorer event-free survival than did those with a score of 1 (p = 0.03). A multivariate analysis showed that the Hs-mGPS remained an independent predictor of survival and recurrence. The Hs-mGPS could be a useful prognostic marker in patients with a soft-tissue sarcoma.

Cite this article: Bone Joint J 2015; 97-B:847–52.
Management of infected nonunion of the long bones by a multidisciplinary team
Authors: Bose D. , Kugan R. , Stubbs D. , McNally M.
Published: June 2015

Infected nonunion of a long bone continues to present difficulties in management. In addition to treating the infection, it is necessary to establish bony stability, encourage fracture union and reconstruct the soft-tissue envelope.

We present a series of 67 infected nonunions of a long bone in 66 patients treated in a multidisciplinary unit. The operative treatment of patients suitable for limb salvage was performed as a single procedure. Antibiotic regimes were determined by the results of microbiological culture.

At a mean follow-up of 52 months (22 to 97), 59 patients (88%) had an infection-free united fracture in a functioning limb. Seven others required amputation (three as primary treatment, three after late failure of limb salvage and one for recalcitrant pain after union).

The initial operation achieved union in 54 (84%) of the salvaged limbs at a mean of nine months (three to 26), with recurrence of infection in 9%. Further surgery in those limbs that remained ununited increased the union rate to 62 (97%) of the 64 limbs treated by limb salvage at final follow-up. The use of internal fixation was associated with a higher risk of recurrent infection than external fixation.

Cite this article: Bone Joint J 2015; 97-B:814–17.
Is it time to revisit the AO classification of fractures of the distal radius?
Authors: Plant C. E. , Hickson C. , Hedley H. , Parsons N. R. , Costa M. L.
Published: June 2015

We conducted an observational radiographic study to determine the inter- and intra-observer reliability of the AO classification of fractures of the distal radius. Plain posteroanterior and lateral radiographs of 456 patients with an acute fracture of the distal radius were classified by a consultant orthopaedic hand specialist and two specialist trainees, and the k coefficient for the inter- and intra-observer reliability of the type, group and subgroup classification was calculated.

Only the type of fracture (A, B or C) was found to provide substantial intra-observer reliability (k type 0.65). The inclusion of ‘group’ and ‘subgroup’ into the classification reduced the inter-observer reliability to fair (kgroup 0.29, ksubgroup = 0.28) and the intra-observer reliability to moderate (kgroup 0.53, ksubgroup 0.49). Disagreement was found to arise between specific subgroups, which may be amenable to clarification.

Cite this article: Bone Joint J 2015; 97-B:818–23.
The outcome of femoral component revision arthroplasty with impaction allograft bone grafting and a cemented polished Exeter stem
Authors: te Stroet M. A. J. , Rijnen W. H. C. , Gardeniers J. W. M. , van Kampen A. , Schreurs B. W.
Published: June 2015

We report the clinical and radiographic outcomes of 208 consecutive femoral revision arthroplasties performed in 202 patients (119 women, 83 men) between March 1991 and December 2007 using the X-change Femoral Revision System, fresh-frozen morcellised allograft and a cemented polished Exeter stem. All patients were followed prospectively. The mean age of the patients at revision was 65 years (30 to 86). At final review in December 2013 a total of 130 patients with 135 reconstructions (64.9%) were alive and had a non re-revised femoral component after a mean follow-up of 10.6 years (4.7 to 20.9). One patient was lost to follow-up at six years, and their data were included up to this point. Re-operation for any reason was performed in 33 hips (15.9%), in 13 of which the femoral component was re-revised (6.3%). The mean pre-operative Harris hip score was 52 (19 to 95) (n = 73) and improved to 80 (22 to 100) (n = 161) by the last follow-up. Kaplan–Meier survival with femoral re-revision for any reason as the endpoint was 94.9% (95% confidence intervals (CI) 90.2 to 97.4) at ten years; with femoral re-revision for aseptic loosening as the endpoint it was 99.4% (95% CI 95.7 to 99.9); with femoral re-operation for any reason as the endpoint it was 84.5% (95% CI 78.3 to 89.1); and with subsidence ≥ 5 mm it was 87.3% (95% CI 80.5 to 91.8). Femoral revision with the use of impaction allograft bone grafting and a cemented polished stem results in a satisfying survival rate at a mean of ten years’ follow-up.

Cite this article: Bone Joint J 2015; 97-B:771–9.
Porous titanium granules are better than autograft bone as a bone void filler in lateral tibial plateau fractures
Authors: Jónsson B. Y. , Mjöberg B.
Published: June 2015

A total of 20 patients with a depressed fracture of the lateral tibial plateau (Schatzker II or III) who would undergo open reduction and internal fixation were randomised to have the metaphyseal void in the bone filled with either porous titanium granules or autograft bone. Radiographs were undertaken within one week, after six weeks, three months, six months, and after 12 months.

The primary outcome measure was recurrent depression of the joint surface: a secondary outcome was the duration of surgery.

The risk of recurrent depression of the joint surface was lower (p < 0.001) and the operating time less (p < 0.002) when titanium granules were used.

The indication is that it is therefore beneficial to use porous titanium granules than autograft bone to fill the void created by reducing a depressed fracture of the lateral tibial plateau. There is no donor site morbidity, the operating time is shorter and the risk of recurrent depression of the articular surface is less.

Cite this article: Bone Joint J 2015; 97-B:836–41
A new form of surgical treatment for patients with avascular necrosis of the talus and secondary osteoarthritis of the ankle
Authors: Kodama N. , Takemura Y. , Ueba H. , Imai S. , Matsusue Y.
Published: June 2015

A new method of vascularised tibial grafting has been developed for the treatment of avascular necrosis (AVN) of the talus and secondary osteoarthritis (OA) of the ankle. We used 40 cadavers to identify the vascular anatomy of the distal tibia in order to establish how to elevate a vascularised tibial graft safely. Between 2008 and 2012, eight patients (three male, five female, mean age 50 years; 26 to 68) with isolated AVN of the talus and 12 patients (four male, eight female, mean age 58 years; 23 to 76) with secondary OA underwent vascularised bone grafting from the distal tibia either to revascularise the talus or for arthrodesis. The radiological and clinical outcomes were evaluated at a mean follow-up of 31 months (24 to 62). The peri-malleolar arterial arch was confirmed in the cadaveric study. A vascularised bone graft could be elevated safely using the peri-malleolar pedicle. The clinical outcomes for the group with AVN of the talus assessed with the mean Mazur ankle grading scores, improved significantly from 39 points (21 to 48) pre-operatively to 81 points (73 to 90) at the final follow-up (p = 0.01). In all eight revascularisations, bone healing was obtained without progression to talar collapse, and union was established in 11 of 12 vascularised arthrodeses at a mean follow-up of 34 months (24 to 58). MRI showed revascularisation of the talus in all patients.

We conclude that a vascularised tibial graft can be used both for revascularisation of the talus and for the arthrodesis of the ankle in patients with OA secondary to AVN of the talus.

Cite this article: Bone Joint J 2015; 97-B:802–8.
Patient-reported outcomes after total and unicompartmental knee arthroplasty
Authors: Liddle A. D. , Pandit H. , Judge A. , Murray D. W.
Published: June 2015

Whether to use total or unicompartmental knee replacement (TKA/UKA) for end-stage knee osteoarthritis remains controversial. Although UKA results in a faster recovery, lower rates of morbidity and mortality and fewer complications, the long-term revision rate is substantially higher than that for TKA. The effect of each intervention on patient-reported outcome remains unclear. The aim of this study was to determine whether six-month patient-reported outcome measures (PROMs) are better in patients after TKA or UKA, using data from a large national joint registry (NJR).

We carried out a propensity score-matched cohort study which compared six-month PROMs after TKA and UKA in patients enrolled in the NJR for England and Wales, and the English national PROM collection programme. A total of 3519 UKA patients were matched to 10 557 TKAs.

The mean six-month PROMs favoured UKA: the Oxford Knee Score was 37.7 (95% confidence interval (CI) 37.4 to 38.0) for UKA and 36.1 (95% CI 35.9 to 36.3) for TKA; the mean EuroQol EQ-5D index was 0.772 (95% CI 0.764 to 0.780) for UKA and 0.751 (95% CI 0.747 to 0.756) for TKA. UKA patients were more likely to achieve excellent results (odds ratio (OR) 1.59, 95% CI 1.47 to 1.72, p < 0.001) and to be highly satisfied (OR 1.27, 95% CI 1.17 to 1.39, p <  0.001), and were less likely to report complications than those who had undergone TKA.

UKA gives better early patient-reported outcomes than TKA; these differences are most marked for the very best outcomes. Complications and readmission are more likely after TKA. Although the data presented reflect the short-term outcome, they suggest that the high revision rate for UKA may not be because of poorer clinical outcomes. These factors should inform decision-making in patients eligible for either procedure.

Cite this article: Bone Joint J 2015;97-B:793–801.
Dealing with the predicted increase in demand for revision total knee arthroplasty
Authors: Hamilton D. F. , Howie C. R. , Burnett R. , Simpson A. H. R. W. , Patton J. T.
Published: June 2015

Worldwide rates of primary and revision total knee arthroplasty (TKA) are rising due to increased longevity of the population and the burden of osteoarthritis.

Revision TKA is a technically demanding procedure generating outcomes which are reported to be inferior to those of primary knee arthroplasty, and with a higher risk of complication. Overall, the rate of revision after primary arthroplasty is low, but the number of patients currently living with a TKA suggests a large potential revision healthcare burden.

Many patients are now outliving their prosthesis, and consideration must be given to how we are to provide the necessary capacity to meet the rising demand for revision surgery and how to maximise patient outcomes.

The purpose of this review was to examine the epidemiology of, and risk factors for, revision knee arthroplasty, and to discuss factors that may enhance patient outcomes.

Cite this article: Bone Joint J 2015; 97-B:723–8.
Up-regulation of acid-sensing ion channels in the capsule of the joint in frozen shoulder
Authors: Cho C. H. , Lho Y. M. , Ha E. , Hwang I. , Song K. S. , Min B. W. , Bae K. C. , Kim D. H.
Published: June 2015

The purpose of this study was to evaluate the expression of acid-sensing ion channels (ASICs) in the capsule and synovial fluid of patients with frozen shoulder. Capsular tissue and synovial fluid were obtained from 18 patients with idiopathic frozen shoulder (FS group) and 18 patients with instability of the shoulder (control group). The expressions of ASIC1, ASIC2, and ASIC3 in the capsule were determined using the reverse transcriptase-polymerase chain reaction, immunoblot analysis, and immunohistochemistry (IHC). The concentrations in synovial fluid were evaluated using an enzyme-linked immunosorbent assay.

The mRNA expression of ASIC1, ASIC2 and ASIC3 in the capsule were significantly increased in the FS group compared with the control group. The protein levels of these three ASICs were also increased. The increased expressions were confirmed by IHC. Of the ASICs, ASIC3 showed the greatest increase in both mRNA and levels of expression compared with the control group. The levels of ASIC1 and ASIC3 in synovial fluid were significantly increased in the FS group.

This study suggests that ASICs may play a role as mediators of inflammatory pain and be involved in the pathogenesis of frozen shoulder.

Cite this article: Bone Joint J 2015;97-B:824–9.
A randomised trial of all-polyethylene and metal-backed tibial components in unicompartmental arthroplasty of the knee
Authors: Hutt J. R. B. , Farhadnia P. , Massé V. , Lavigne M. , Vendittoli P-A.
Published: June 2015

This randomised trial evaluated the outcome of a single design of unicompartmental arthroplasty of the knee (UKA) with either a cemented all-polyethylene or a metal-backed modular tibial component. A total of 63 knees in 45 patients (17 male, 28 female) were included, 27 in the all-polyethylene group and 36 in the metal-backed group. The mean age was 57.9 years (39.6 to 76.9). At a mean follow-up of 6.4 years (5 to 9.9), 11 all-polyethylene components (41%) were revised (at a mean of 5.8 years; 1.4 to 8.0) post-operatively and two metal-backed components were revised (at one and five years). One revision in both groups was for unexplained pain, one in the metal-backed group was for progression of osteoarthritis. The others in the all-polyethylene group were for aseptic loosening. The survivorship at seven years calculated by the Kaplan–Meier method for the all-polyethylene group was 56.5% (95% CI 31.9 to 75.2, number at risk 7) and for the metal-backed group was 93.8% (95% CI 77.3 to 98.4, number at risk 16) This difference was statistically significant (p <  0.001). At the most recent follow-up, significantly better mean Western Ontario and McMaster Universities Arthritis Index Scores were found in the all-polyethylene group (13.4 vs 23.0, p = 0.03) but there was no difference in the mean Knee injury and Osteoarthritis Outcome scores (68.8; 41.4 to 99.0 vs 62.6; 24.0 to 100.0), p = 0.36). There were no significant differences for range of movement (p = 0.36) or satisfaction (p = 0.23).

This randomised study demonstrates that all-polyethylene components in this design of fixed bearing UKA had unsatisfactory results with significantly higher rates of failure before ten years compared with the metal-back components.

Cite this article: Bone Joint J 2015;97-B:786–92.
Vitamin D
Authors: Sahota O.
Published: June 2015

Clinical studies evaluating the effects of vitamin D alone or in combination with calcium on physical function, falls and fractures have been inconsistent. Vitamin D has, however, been the focus of much orthopaedic, trauma and endocrine research. Playing a central role in muscle and bone metabolism, some studies on Vitamin D therapies offer the tantalising suggestion of a reduction in falls and fractures simply with vitamin D supplementation. We review the background and evidence behind vitamin D.
A reliability assessment of the age-sex data from 1991 and 2006 Nigeria population censuses
Authors: Ohaegbulem Emmanuel
Published: June 2015

This study assessed the quality of the age-sex data from 1991 and 2006 Nigeria population censuses using some conventional techniques of evaluating demographic data quality. Whipple and Myers indices were used to determine the extent of digit preference for the age-sex data presented in single years. There were very obvious preference for ages with end-digits 0 and 5 while other end-digits were avoided in the two censuses; and this was more pronounced with the females than males. From 1991 census to 2006 census, the Whipple index for both sexes declined from 294 to 251, while the Myers index declined from 60.8 to 49.9; indications of deficiencies in the Nigeria censuses data. The Joint scores computed for the five-year abridged distribution of the age-sex data yielded 54.83 and 38.52 for the 1991 and 2006 censuses, respectively. This showed that the data are poor in quality and not completely reliable as a result of misreporting. The 29.7% decline in Joint score from 1991 census to 2006 census was an indication of a modest improvement in quality over than fifteen years interval, even as the 2006 age-sex data are usable with adjustment.
An approach to measuring rotatability in central composite designs
Authors: Ohaegbulem Emmanuel , Chigbu Polycarp
Published: June 2015

An approach to measure design rotatability and a measure, that quantifies the percentage of rotatability (from 0 to 100) in the central composite designs are introduced. This new approach is quite different from the ones provided by previous authors which assessed design rotatability by the viewing of tediously obtained contour diagrams. This new approach has not practical limitations, and the measure is very easy to compute. Some examples were used to express this approach.
Notes from the Editors, June 2015
Authors: The Editors -
Published: June 2015

buy this issue
In two Monthly Review special issues, "Education Under Fire: The U.S. Corporate Attack on Students, Teachers, and Schools" (July-August 2011) and "Public School Teachers Fighting Back" (June 2013), we sounded an alarm regarding the rapid restructuring and privatization of U.S. K–12 public schools. In terms of the scale of nationwide restructuring, the corporate takeover of education is unprecedented in modern U.S. history. The closest comparison we can come up with is the destruction of the street car systems across the United States and the building of the interstate highway system—in which freeways went right through cities for the first time, often in the face of neighborhood and community resistance. With respect to K–12 education, unimaginable amounts of private funds have gone into pressuring and corrupting government at every level, while the control mechanisms of the new educational system are increasingly left in private, not public, hands. The Common Core Standards and related high-stakes tests are at the center of this new system, and are the product of private corporate groups outside the direct reach of government.

Click here to purchase a PDF version of this article at the Monthly Review website.
The "New Turkey": Fetishizing Growth with Fatal Results
Authors: Gündüz Zuhal Ye ilyurt
Published: June 2015

Turkey's ruling party has turned the country, which it calls "the new Turkey," into a capitalist nightmare: a triad of neoliberal economics, political despotism, and Islamist conservatism. This article provides an overview of neoliberalism in Turkey, then looks at the government's extraction policies, highlighting the Soma mine massacre as one tragic example of the destructive policies of the governing party, the Adalet ve Kalkınma Partisi (AKP, Justice and Development Party). It also examines the extreme authoritarianism of President Recep Tayyip Erdoğan (formerly prime minister), and the growing cultural-relgious conservatism, which the AKP has interlaced with Islamist rhetoric. This hegemonic triad of neoliberalism, despotism, and conservatism is an especially dangerous one. However, it is being increasingly criticized, and resistance movements against neoliberal policies are growing. All of this gives some hope for Turkey's future.

Click here to purchase a PDF version of this article at the Monthly Review website.
Boycott, Divestment, and Sanctions at Ten Years: Reflections on a Movement on the Rise
Authors: Ajl Max
Published: June 2015

Rich Wiles, editor, Generation Palestine (London: Pluto Press, 2013), 256 pages, $24, paperback.
When in March 2012, Barack Obama paused briefly from approving orders for drone killings of Pakistani and Yemeni villagers, in order to reassure the attendees at the annual gala of the AIPAC (American-Israel Public Affairs Committee) that, "when there are efforts to boycott or divest from Israel, we will stand against them," the real target of his declaration was elsewhere: the myriad grassroots organizers across the world who have made the global Boycott, Divestment, and Sanctions (BDS) campaigns unignorable. Their mounting influence has provoked efforts to declare them anti-Semitic or illegal from London to Long Beach. In fact, the series of victories across the University of California system has so annoyed its managers that they have hauled in the Caesar of domestic repression, Janet Napolitano, to deal with campus activists. Obama's declaration of support for Israeli colonialism had a simple message to those many activists: back down, because Washington will not.

Click here to purchase a PDF version of this article at the Monthly Review website.
PROFESSIONAL BEHAVIOR BASED ON THE DEVELOPMENT OF EMPLOYEES
Authors: Sudarma Ketut
Published: June 2015

The objective of the study was to analyze the impact of work discipline management, career management and profession ethics management toward Unnes staff’s behavior. The samples were taken by proportional random sampling. The variables of the research were work discipline management, career management, profession ethics management and professional behavior. The data were analyzed by multiple regression analysis. The result of this study showed that discipline work management, career management and profession ethics management gave positive influence toward staff’s professional behavior. Furthermore, the result of percentage descriptive analysis showed that the average of work discipline management, career management, profession ethics management and professional behavior were on enough category.

 

Tujuan penelitian ini adalah menganalisis dampak pembinaan disiplin kerja, pembinaan karir dan pembinaan etika profesi terhadap perilaku profesional tenaga kependidikan Sampel 50 orang tenaga kependidikan Unnes. Teknik pengambilan sampel menggunakan proporsional random sampling. Variabel penelitian adalah pembinaan disiplin kerja, pembinaan karir, pembinaan etika profesi dan perilaku profesional. Metode pengumpulan data menggunakan kuesioner. Analisis data menggunakan analisis regresi berganda. Hasil penelitian menunjukkan pembinaan disiplin kerja, pembinaan karir, pembinaan etika profesi berdampak positif terhadap perilaku profesional tenaga kependidikan Sedangkan dari hasil analisis deskriptif persentase tampak bahwa rata-rata pembinaan disiplin kerja, pembinaan karir, pembinaan etika profesi dan perilaku profesional termasuk kategori cukup.
BUDAYA MUTU DAN IMPLEMENTASI ISO 2008: 9001 SERTA DAMPAKNYA TERHADAP KOMITMEN ORGANISASIONAL
Authors: Muafi Muafi , Nilmawati Nilmawati
Published: June 2015

Tujuan penelitian ini adalah untuk menganalisis pengaruh budaya mutu terhadap proses implementasi ISO 9001: 2008 dan dampaknya terhadap komitmen organisasional. Peneliti akan menganalisis persepsi dosen dan karyawan Program
Manajemen Universitas Pembangunan Nasional “Veteran” Yogyakarta (MM UPNVY) pada pentingnya peran budaya mutu dalam proses implementasi ISO 9001:2008 dan dampaknya terhadap komitmen organisasional. Penelitian ini
diharapkan dapat memberikan manfaat pada pengelola MM dan UPNVY dalam implementasi ISO 2008: 9001, sehingga bisa diambil kebijakan dan keputusan yang terbaik dalam peningkatan kinerja Prodi. Teknik pengambilan sampel menggunakan sensus. Teknik statistik Partial Least Square (PLS) digunakan untuk analisis data. Hasil penelitian menunjukkan bahwa budaya mutu berpengaruh positif dan signifikan terhadap penerapan sistem manajemen mutu dan penerapan sistem manajemen mutu berpengaruh positif dan signifikan pada komitmen organisasional.

 

The objective of this research was to analyze the influence of quality culture toward the implementation process of ISO 9001:2008 and its impacts on organizational commitment. The researcher analyzed the lecturers’ and staff’s perception at Management Master Program, Universitas Pembangunan Nasional “Veteran” Yogyakarta (MM UPNVY) on the role importance of quality culture in the implementation process of ISO 9001:2008 and its impacts on organizational commitment. This study was expected to give benefits for MM and UPN “Veteran” Yogyakarta in implementing ISO 2008:9001, so the best policies and decision can be taken to improve the performance of MM UPNVY. The population of this
study was lecturers and staff at MM, UPNVY. The samples were taken by census. Then, the data were analyzed by Partial Least Square (PLS) statistical technique. The result showed that (1) quality culture gave positive and significant influence toward the implementation of quality management system, (2) the implementation of quality management system gave positive and significant influence toward organizational commitment.
FAKTOR-FAKTOR YANG MEMPENGARUHI AKTIVITAS HEDGING DENGAN INSTRUMEN DERIVATIF VALUTA ASING
Authors: Guniarti Fay
Published: June 2015

Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi aktivitas hedging dengan instrumen derivatif valuta asing pada perusahaan non keuangan yang terdaftar di BEI tahun 2010-2012. Data yang digunakan adalah
data sekunder yang diunduh dari website Bursa Efek Indonesia. Populasi dalam penelitian ini adalah seluruh perusahaan yang terdaftar di Bursa Efek Indonesia tahun 2010-2012. Sedangkan sampel penelitian ini sejumlah 77 perusahaan yang memiliki eksposur transaksi dan memiliki kelengkapan data untuk diteliti. Dari sampel tersebut sebanyak 28 perusahaan melakukan aktivitas hedging selama periode pengamatan dan 49 perusahaan tidak melakukan aktivitas hedging.Analisis Logistic Regression digunakan untuk menguji hipotesis. Hasil pengujian menunjukkan bahwa model analisis menghasilkan ketepatan 79.2% dan variabel leverage, liquidity, firm size dan financial distress berpengaruh signifikan terhadap prediksi probabilitas aktivitas hedging dengan tingkat signifikansi 5%, sedangkan variabel firm value dan growth opportunity berpengaruh tidak signifikan.

 

The objective of the study was to know the factors which influence the hedging activity with foreign currency derivative instruments at non-financial companies listed on the Indonesia Stock Exchange in 2010-2012. The data of the research were secondary data which was downloaded from the Indonesia Stock Exchange website. The population of the study was all companies listed in Indonesia Stock Exchange in the period of 2010-2012. There were 77 companies which had the transaction exposure andcomplete data for analysis. From those samples, only 28 companies did hedging activities during the period of observation and 49 companies did not do hedging activities.The data were analyzed by Logistic Regression Analysis to test the hypothesis. The test result showed that analysis model gave the accuracy 79.2% and the research variables; leverage, liquidity, firm size, and financial distress significantly influenced the probability prediction of hedging activity with 5% level of significancy, while the research variables; firm value and growth opportunity did not give significant influence.