bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of Total Plasma Glycosaminoglycan Levels in Healthy Volunteers Following Oral Administration of a Novel Antithrombotic Odiparcil With Aspirin or Enoxaparin
Authors: Myers Alan L. , Upreti Vijay V. , Khurana Manoj , Eddington Natalie D.
Published: August 2008

Odiparcil is a novel, orally active β‐d‐thioxyloside analog with antithrombotic activity associated with a reduced risk of adverse bleeding events. Its unique mechanism of action is postulated by means of an elevation in circulating endogenous chondroitin sulfate‐related glycosaminoglycans (GAGs) levels. The purpose of these 2 separate clinical studies was to evaluate plasma GAG levels in healthy subjects administered odiparcil with either aspirin (ASA) or enoxaparin. Clinical plasma samples were processed and analyzed using validated HPLC bioassays that indirectly estimate GAG levels based on the simultaneous detection of the chondroitin disaccharide derivatives. The concomitant administration of odiparcil with or without ASA resulted in a significant elevation in GAG levels over baseline for both treatment groups. In the other clinical study, the concomitant administration of odiparcil with or without enoxaparin displayed significant increases in plasma ΔDi‐OS, ΔDi‐4S, and total disaccharide levels versus control group. Neither plasma GAG levels nor odiparcil plasma levels were correlated with a rise in hepatic transaminases, an adverse drug event observed in several subjects; and plasma odiparcil levels were indirectly correlated with plasma GAG levels. These clinical studies were proof of concept of preclinical rat studies indicating that chronic odiparcil treatment elevates endogenous GAG levels in human subjects.
State Differences and Facility Differences in Nursing Home Staff Turnover
Authors: Castle Nicholas G.
Published: August 2008

The author uses data from 8,023 nursing homes to examine state differences in turnover and vacancy rates and organizational characteristics associated with turnover rates. The analyses focus on nurse aides, licensed practical nurses, and registered nurses as caregivers. Findings show that the 2004 turnover and vacancy rates for these caregivers were high and that there were differences across states for turnover and vacancy rates. The author shows that staffing levels of caregivers, quality of care, and top management turnover are associated with caregiver turnover.
Comparison of in vitro and in vivo Bioactivity of SrO—CaO—ZnO—SiO2 Glass Grafts
Authors: Towler M.R. , Boyd D. , Freeman C. , Brook I.M. , Farthing P.
Published: August 2008

A range of calcium—strontium—zinc—silicate glass grafts are developed. Following characterization, their ability to form an apatite layer in simulated body fluid (SBF) is evaluated. Concurrently, their in vivo biocompatibility is determined. These glasses are incapable of forming an apatite layer in SBF. However, in vivo, each glass is well tolerated with new bone formation apparent in close apposition to implanted particles and no evidence of an inflammatory response. Such results are contrary to much of the literature and indicate that forecasting a materials ability to bond to bone based on SBF experiments may provide a false negative result.
Bioactive Composites Consisting of PEEK and Calcium Silicate Powders
Authors: Ill Yong Kim  , Sugino Atsushi , Kikuta Koichi , Ohtsuki Chikara , Sung Baek Cho
Published: August 2008

Bioactive bone-repairing materials with mechanical properties analogous to those of natural bone can be obtained through the combination of bioactive ceramic fillers with organic polymers. Previously, we developed novel bioactive microspheres in a binary CaO—SiO2 system produced through a sol—gel process as filler for the fabrication of composites. In this study, we fabricate bioactive composites in which polyetheretherketone is reinforced with 0—50 vol% 30CaO · 70SiO2 (CS) microspheres. The prepared composites reinforced with CS particles form hydroxyapatite on their surfaces in simulated body fluid. The induction periods of hydroxyapatite formation on the composites decrease with increasing amount of CS particles. The mechanical properties of the composites are evaluated by three-point bending test. The composites reinforced with 20 vol% CS particles show 123.5 MPa and 6.43 GPa in bending strength and Young’s modulus, respectively.
“Room to Grow”
Authors: Johnson Katherine M. , Schmidt Charles G.
Published: August 2008

This study reconsiders the political conditions behind the geographically extensive pattern of urbanization in the United States by focusing on a rapidly urbanizing county on the northeast fringe of the Denver metropolitan area. Unusual for Colorado but typical of the industrialized northeast where this pattern first emerged, Weld County has a high concentration of small towns, the primary repository of statutory authority and ideological legitimacy to convert agricultural land to urban use. The urbanization of Weld County in the 1990s was amplified by the expansion of the towns into their surrounding farmland, which flooded the market with newly urbanized land. The study goes on to consider the prospects of this distinctively American political form in the wake of the property tax revolts of the late 1970s and early 1980s and the structural changes in the American economy during the past 30 years.
Prenatal Diagnosis of Chiari III Malformation by 2D and 3D Sonography
Authors: Auckland Amanda , Davies Jill K.
Published: August 2008

Chiari III malformation is the most rare and severe form of the four types of Chiari malformations. It is characterized by a high cervical meningoencephalocele and caudal displacement of the cerebellum and brainstem. The encephalocele may contain cerebellum, brainstem, cerebrospinal fluid, and rarely the occipital lobe. This case describes a fetus with a large posterior occipitocervical encephalocele diagnosed by sonography at 21 weeks' gestation. We believe this is the first reported Chiari III malformation diagnosed prenatally by sonography alone, as well as the first to describe the diagnosis using 3D sonography.
Aluminosilicate coating prepared by low pressure chemical vapour deposition using TEOS and AlCl3 as precursors
Authors: Chen Z. F.
Published: August 2008

Aluminosilicate coating was prepared by low pressure chemical vapour deposition using tetraethoxysilane and Al trichloride as precursors at temperature in the range of 300–850°C. The effect of the deposition temperature on deposition rate was studied by weight gain of a graphite substrate before and after deposition. The chemical composition and phase identification of the coating were confirmed by EDS and XRD. The morphology of the surface of the coating was observed by SEM. The optimal deposition temperature was 600°C which was lower than the optimal temperature of SiO2 deposition. Both an esterlysis reaction and a hydrolysis reaction must take place between tetraethoxysilane and Al trichloride during deposition. The dense aluminosilicate coating composed of the crystalline γ-Al2O3 and amorphous compound of Al2O3 with SiO2.
Tribological characteristics of nanocrystalline diamond films grown on titanium
Authors: Jawid Askari S.
Published: August 2008

Nanocrystalline diamond (NCD) films on titanium alloys are of importance for tribology and biomedical implants. However, due to the different thermal expansion coefficients of the two materials, the complex nature of the interlayer formed during diamond deposition, and the difficulty in achieving very high nucleation density, it is difficult to deposit adherent thin NCD films on titanium and its alloys. In the present study smooth NCD films were successfully deposited in microwave chemical vapour deposition plasma from CH4/H2 mixtures, for the purpose of improving the film's adhesion and the wear resistance of the titanium. An exceptional adhesion of NCD film to the titanium substrate was observed by indentation testing up to 150 kg load. The friction coefficient against a cemented carbide ball of 10 mm in diameter with 20 N load was estimated to be ∼0·05 in dry air. Detailed experimental results of the preparation, characterisation and successful deposition of the NCD film on pure Ti are discussed.
Influence of laser surface texturing on surface microstructure and mechanical properties of adhesive joined steel sheets
Authors: Sakata F. Y. , Santo A. M. E. , Miyakawa W. , Riva R. , Lima M. S. F.
Published: August 2008

This work discusses the resultant microstructure of laser surface treated galvanised steel and the mechanical properties of adhesively bonded surfaces therein. The surface microstructure obtained at laser intensities between 170 and 1700 MW cm−2 exhibit zinc melting and cavity formation. The wavy surface morphology of the treated surface exhibits an average roughness Ra between 1·0 and 1·5 μm, and a mean roughness depth Rz of 8·6 μm. Atomic force microscopic analyses revealed that the Rz inside the laser shot cavities increased from 68 to 243 nm when the incident laser intensity was increased from 170 to 1700 MW cm−2. X-ray fluorescence analyses were used to measure Zn coating thicknesses as a function of process parameters. Both X-ray fluorescence and X-ray diffraction analyses demonstrated that the protective coating remains at the material surface, and the steel structure beneath was not affected by the laser treatment. Tensile tests under peel strength conditions demonstrated that the laser treated adhesively joined samples had resistance strength up to 88 MPa, compared to a maximum of only 23 MPa for the untreated surfaces. The maximum deformation for rupture was also greatly increased from 0·07%, for the original surface, to 0·90% for the laser treated surfaces.
Characterisation and corrosion properties of novel hydroxyapatite niobium plasma sprayed coating
Authors: Enayati M. H. , Fathi M. H. , Zomorodian A.
Published: August 2008

A novel hydroxyapatite niobium (HA–Nb) composite coating was deposited on 316L SS substrate to improve the corrosion properties and functional compatibility of 316L SS alloy. HA–Nb coatings were applied by air plasma spray under electrical current intensities of 400, 600 and 800 A. X-ray diffraction and scanning electron microscopy techniques were utilised to investigate the characteristics of coatings. Corrosion properties were evaluated by electrochemical polarisation test in Ringer solution. Results indicated that optimum electrical current intensity for deposition of the HA–Nb composite coating on 316L SS substrate was 600 A. The composite coating improved corrosion resistance and exhibited good structural properties which in turn increased biocompatibility of 316L SS substrate.
Electrodeposition of hyaluronic acid and composite films
Authors: Sun F. , Zhitomirsky I.
Published: August 2008

The electrodeposition method has been developed for the fabrication of hyaluronic acid films from sodium hyaluronate solutions. The amount of the deposited material increased with increasing deposition time, resulting in the formation of 0·1–3 μm thick films. The co-deposition of hyaluronic acid and hydroxyapatite (HA) resulted in the fabrication of novel nanocomposite films by electrodeposition. In the proposed method, hyaluronate provided electrosteric stabilisation and charging of HA particles. Deposit composition can be varied by the variation of HA concentration in the sodium hyaluronate solutions. The method enabled the formation of composite films of different thicknesses in the range of 0·1–100 μm. Obtained films were studied by X-ray diffraction, thermogravimetric and differential thermal analysis, scanning electron microscopy and Fourier transform infrared spectroscopy. Composite films showed corrosion protection of stainless steel substrates in Ringer's physiological solutions. The mechanism of deposition is discussed.
Effect of pulse parameter on pulsed electrodeposition of copper on stainless steel
Authors: Balasubramanian A. , Srikumar D. S. , Raja G. , Saravanan G. , Mohan S.
Published: August 2008

The pulsed electrodeposition of copper on stainless steel has been studied in copper sulphate bath and the effect of duty cycle and frequency on the thickness and current efficiencies were compared at 50°C and at room temperature with average current density of 4 A dm−2. A new strike bath based on cupric chloride and hydrochloric acid was developed for the first time. The Cu coatings were characterised by SEM, AFM and XRD. Crystallite sizes of Cu coatings were calculated for various duty cycles from the Scherer's equation. The deposits were smaller nodules and fine grained.
Computerised cognitive-behavioural therapy for depression: systematic review
Authors: Kaltenthaler Eva , Parry Glenys , Beverley Catherine , Ferriter Michael
Published: August 2008

Background

Computerised cognitive–behavioural therapy (CCBT) is used for treating depression and provides a potentially useful alternative to therapist cognitive–behavioural therapy (CBT).

Aims

To systematically review the evidence for the effectiveness of CCBT for the treatment of mild to moderate depression.

Method

Electronic databases were searched to identify randomised controlled trials. Selected studies were quality assessed and data extracted by two reviewers.

Results

Four studies of three computer software packages met the inclusion criteria. Comparators were treatment as usual, using a depression education website and an attention placebo.

Conclusions

There is some evidence to support the effectiveness of CCBT for the treatment of depression. However, all studies were associated with considerable drop-out rates and little evidence was presented regarding participants' preferences and the acceptability of the therapy. More research is needed to determine the place of CCBT in the potential range of treatment options offered to individuals with depression.
Ethnic density, physical illness, social deprivation and antidepressant prescribing in primary care: ecological study
Authors: Walters Paul , Ashworth Mark , Tylee André
Published: August 2008

Background

Antidepressant prescribing should reflect need. The Quality and Outcomes Framework has provided an opportunity to explore factors affecting antidepressant prescribing in UK general practice.

Aims

To explore the relationship between physical illness, social deprivation, ethnicity, practice characteristics and the volume of antidepressants prescribed in primary care.

Method

This was an ecological study using data derived from the Quality and Outcomes Framework, the Informatics Collaboratory of the Social Sciences, and Prescribing Analyses and CosT data for 2004-2005. Associations were examined using linear regression modelling.

Results

Socio-economic status, ethnic density, asthma, chronic obstructive pulmonary disease and epilepsy explained 44% of the variance in the volume of antidepressants prescribed.

Conclusions

Lower volumes of antidepressants are prescribed in areas with high densities of Black or Asian people. This may suggest disparities in provision of care. Chronic respiratory disease and epilepsy may have a more important association with depression in primary care than previously thought.
Executive function and in-patient violence in forensic patients with schizophrenia
Authors: Fullam Rachael S. , Dolan Mairead C.
Published: August 2008

Background

The literature on the association between neuropsychological deficits and in-patient violence in schizophrenia is limited and the findings inconsistent.

Aims

To examine the role of executive function deficits in in-patient violence using measures of dorsolateral (DLPFC) and ventrolateral prefrontal cortical (VLPFC) function.

Methods

Thirty-three violent and forty-nine non-violent male forensic in-patients with schizophrenia were assessed using neuropsychological tasks probing DLPFC and VLPFC function and on measures of symptoms and psychopathy.

Results

There were no significant group differences in neuropsychological task performance. Higher rates of violence were significantly associated with lower current IQ scores and higher excitement symptom scores. The ‘violent’ group had significantly higher interpersonal and antisocial domain psychopathy scores. In a logistic regression analysis, IQ and the interpersonal domain of psychopathy were significant discriminators of violent v. non-violent status.

Conclusions

Personality factors rather than symptoms and neuropsychological function may be important in understanding in-patient violence in forensic patients with schizophrenia.
Serotonin 5-HT1A receptor binding in people with panic disorder: positron emission tomography study
Authors: Nash Jon R. , Sargent Peter A. , Rabiner Eugenii A. , Hood Sean D. , Argyropoulos Spilios V. , Potokar John P. , Grasby Paul M. , Nutt David J.
Published: August 2008

Background

The importance of the neurotransmitter serotonin (5-HT) in the pathophysiology of anxiety is well known. A key role for postsynaptic 5-HT1A receptors has recently been suggested in studies of genetic knockout mice.

Aims

To measure 5-HT1A receptor binding in patients with panic disorder in the untreated state and after recovery on treatment with selective serotonin reuptake inhibitors (SSRIs).

Method

Nine symptomatic untreated patients with panic disorder, seven patients recovered on SSRI medication and nineteen healthy volunteers underwent a single positron emission tomography (PET) scan using the 5-HT1A tracer [11C]WAY-100635.

Results

In comparison with controls, both presynaptic and postsynaptic 5-HT1A receptor binding was reduced in untreated patients, with the most significant reductions being in the raphe, orbitofrontal cortex, temporal cortex and amygdala. In recovered patients presynaptic binding was reduced, but there was no significant reduction in postsynaptic binding.

Conclusions

Panic disorder is associated with reduced 5-HT1A receptor availability, which is also known to have a key role in depression.
White matter volume changes in people who develop psychosis
Authors: Walterfang Mark , McGuire Philip K. , Yung Alison R. , Phillips Lisa J. , Velakoulis Dennis , Wood Stephen J. , Suckling John , Bullmore Edward T. , Brewer Warrick , Soulsby Bridget , Desmond Patricia , McGorry Patrick D. , Pantelis Christos
Published: August 2008

Background

Grey matter changes have been described in individuals who are pre- and peri-psychotic, but it is unclear if these changes are accompanied by changes in white matter structures.

Aims

To determine whether changes in white matter occur prior to and with the transition to psychosis in individuals who are pre-psychotic who had previously demonstrated grey matter reductions in frontotemporal regions.

Method

We used magnetic resonance imaging (MRI) to examine regional white matter volume in 75 people with prodromal symptoms. A subset of the original group (n=21) were rescanned at 12–18 months to determine white matter volume changes. Participants were retrospectively categorised according to whether they had or had not developed psychosis at follow-up.

Results

Comparison of the baseline MRI data from these two subgroups revealed that individuals who later developed psychosis had larger volumes of white matter in the frontal lobe, particularly in the left hemisphere. Longitudinal comparison of data in individuals who developed psychosis revealed a reduction in white matter volume in the region of the left fronto-occipital fasciculus. Participants who had not developed psychosis showed no reductions in white matter volume but increases in a region subjacent to the right inferior parietal lobule.

Discussion

The reduction in volume of white matter near the left fronto-occipital fasciculus may reflect a change in this tract in association with the onset of frank psychosis.
Cerebral and autonomic responses to emotional facial expressions in depersonalisation disorder
Authors: Lemche Erwin , Anilkumar Ananthapadmanabha , Giampietro Vincent P. , Brammer Michael J. , Surguladze Simon A. , Lawrence Natalia S. , Gasston David , Chitnis Xavier , Williams Steven C. R. , Sierra Mauricio , Joraschky Peter , Phillips Mary L.
Published: August 2008

Background

Depersonalisation disorder is characterised by emotion suppression, but the cerebral mechanisms of this symptom are not yet fully understood.

Aims

To compare brain activation and autonomic responses of individuals with the disorder and healthy controls.

Method

Happy and sad emotion expressions in increasing intensities (neutral to intense) were presented in an implicit event-related functional magnetic resonance imaging (fMRI) design with simultaneous measurement of autonomic responses.

Results

Participants with depersonalisation disorder showed fMRI signal decreases, whereas the control group showed signal increases in response to emotion intensity increases in both happy and sad expressions. The analysis of evoked haemodynamic responses from regions exhibiting functional connectivity between central and autonomic nervous systems indicated that in depersonalisation disorder initial modulations of haemodynamic response occurred significantly earlier (2s post-stimulus) than in the control group (4–6s post-stimulus).

Conclusions

The results suggest that fMRI signal decreases are possible correlates of emotion suppression in depersonalisation disorder.
Attitudes and support needs of Black Caribbean, south Asian and White British carers of people with dementia in the UK
Authors: Lawrence Vanessa , Murray Joanna , Samsi Kritika , Banerjee Sube
Published: August 2008

Background

Family carers are the most important source of dementia care, especially among ethnic minority populations, who are less likely to access health or social services. The evidence base on the carer experience in these communities is profoundly limited.

Aims

To explore the caregiving attitudes, experiences and needs of family carers of people with dementia from the three largest ethnic groups in the UK.

Method

A qualitative study, using a grounded theory approach. In-depth individual interviews were conducted with 32 carers of people with dementia (10 Black Caribbean, 10 south Asian, 12 White British).

Results

Carers were identified as holding a ‘traditional’ or ‘non-traditional’ caregiver ideology, according to whether they conceptualised caregiving as natural, expected and virtuous. This informed feelings of fulfilment, strain, carers' fears and attitudes towards formal services. The majority of the south Asian, half of the Black Caribbean and a minority of the White British participants were found to possess a traditional ideology.

Conclusions

The findings suggest that specific cultural attitudes towards the caregiving role have important implications for how carers can best be supported.
Neurological abnormalities and cognitive ability in first-episode psychosis
Authors: Dazzan Paola , Lloyd Tuhina , Morgan Kevin D. , Zanelli Jolanta , Morgan Craig , Orr Ken , Hutchinson Gerard , Fearon Paul , Allin Matthew , Rifkin Larry , McGuire Philip K. , Doody Gillian A. , Holloway John , Leff Julian , Harrison Glynn , Jones Peter B. , Murray Robin M.
Published: August 2008

Background

It remains unclear if the excess of neurological soft signs, or of certain types of neurological soft signs, is common to all psychoses, and whether this excess is simply an epiphenomenon of the lower general cognitive ability present in psychosis.

Aims

To investigate whether an excess of neurological soft signs is independent of diagnosis (schizophreniav.affective psychosis) and cognitive ability (IQ).

Method

Evaluation of types of neurological soft signs in a prospective cohort of all individuals presenting with psychoses over 2 years (n=310), and in a control group from the general population (n=239).

Results

Primary (P<0.001), motor coordination (P<0.001), and motor sequencing (P<0.001) sign scores were significantly higher in people with any psychosis than in the control group. However, only primary and motor coordination scores remained higher when individuals with psychosis and controls were matched for premorbid and current IQ.

Conclusions

Higher rates of primary and motor coordination signs are not associated with lower cognitive ability, and are specific to the presence of psychosis.
Verbal memory and treatment response in post-traumatic stress disorder
Authors: Wild Jennifer , Gur Ruben C.
Published: August 2008

Post-traumatic stress disorder (PTSD) is often associated with verbal memory deficits, which could influence treatment outcome. We assessed neuropsychological functioning in individuals with PTSD and their response to cognitive– behavioural therapy (CBT). Treatment non-responders had significantly poorer performance on measures of verbal memory compared with responders and demonstrated narrative encoding deficits. Differences were not explained by IQ, performance on tasks of attention, initial PTSD severity, depression, time since trauma, or alcohol/substance misuse. Verbal memory deficits seem to diminish the effectiveness of CBT and should be considered in its implementation.
Grey matter abnormalities in trichotillomania: morphometric magnetic resonance imaging study
Authors: Chamberlain Samuel R. , Menzies Lara A. , Fineberg Naomi A. , del Campo Natalia , Suckling John , Craig Kevin , Müller Ulrich , Robbins Trevor W. , Bullmore Edward T. , Sahakian Barbara J.
Published: August 2008

Background

Trichotillomania (repetitive hair-pulling) is an Axis I psychiatric disorder whose neurobiological basis is incompletely understood. Whole-brain trichotillomania neuroimaging studies are lacking.

Aims

To investigate grey and white matter abnormalities over the whole brain in patients with trichotillomania.

Method

Eighteen patients with DSM–IV trichotillomania and 19 healthy controls undertook structural magnetic resonance imaging after providing written informed consent. Differences in grey and white matter were investigated using computational morphometry.

Results

Patients with trichotillomania showed increased grey matter densities in the left striatum, left amygdalo-hippocampal formation, and multiple (including cingulate, supplementary motor, and frontal) cortical regions bilaterally.

Conclusions

Trichotillomania was associated with structural grey matter changes in neural circuitry implicated in habit learning, cognition and affect regulation. These findings inform animal models of the disorder and highlight key regions of interest for future translational research.
Duration of untreated psychosis and social function: 1-year follow-up study of first-episode schizophrenia
Authors: Barnes Thomas R. E. , Leeson Verity C. , Mutsatsa Stanley H. , Watt Hilary C. , Hutton Sam B. , Joyce Eileen M.
Published: August 2008

Background

In first-episode schizophrenia, longer duration of untreated psychosis (DUP) predicts poorer outcomes.

Aims

To address whether the relationship between DUP and outcome is a direct causal one or the result of association between symptoms and/or cognitive functioning and social functioning at the same time point.

Method

Symptoms, social function and cognitive function were assessed in 98 patients with first-episode schizphrenia at presentation and 1 year later.

Results

There was no significant clinical difference between participants with short and long DUP at presentation. Linear regression analyses revealed that longer DUP significantly predicted more severe positive and negative symptoms and poorer social function at 1 year, independent of scores at presentation. Path analyses revealed independent direct relationships between DUP and social function, core negative symptoms and positive symptoms. There was no significant association between DUP and cognition.

Conclusions

Longer DUP predicts poor social function independently of symptoms. The findings underline the importance of taking account of the phenomenological overlap between measures of negative symptoms and social function when investigating the effects of DUP.
IQ and non-clinical psychotic symptoms in 12-year-olds: results from the ALSPAC birth cohort
Authors: Horwood Jeremy , Salvi Giovanni , Thomas Kate , Duffy Larisa , Gunnell David , Hollis Chris , Lewis Glyn , Menezes Paulo , Thompson Andrew , Wolke Dieter , Zammit Stanley , Harrison Glynn
Published: August 2008

Background

Non-clinical psychotic symptoms appear common in children, but it is possible that a proportion of reported symptoms result from misinterpretation. There is a well-established association between pre-morbid low IQ score and schizophrenia. Psychosis-like symptoms in children may also be a risk factor for psychotic disorder but their relationship with IQ is unclear.

Aims

To investigate the prevalence, nature and frequency of psychosis-like symptoms in 12-year-old children and study their relationship with IQ.

Method

Longitudinal study using the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. A total of 6455 children completed screening questions for 12 psychotic symptoms followed by a semi-structured clinical assessment. IQ was assessed at 8 years of age using the Wechsler Intelligence Scale for Children (3rd UK edition).

Results

The 6-month period prevalence for one or more symptoms was 13.7% (95% CI 12.8–14.5). After adjustment for confounding variables, there was a non-linear association between IQ score and psychosis-like symptoms, such that only those with below average IQ score had an increased risk of reporting such symptoms.

Conclusions

Non-clinical psychotic symptoms occur in a significant proportion of 12-year-olds. Symptoms are associated with low IQ and also less strongly with a high IQ score. The pattern of association with IQ differs from that observed in schizophrenia.
Can pharmacology help enhance human morality?
Authors: Spence Sean A.
Published: August 2008

A responsible person, a moral agent, takes account of their future behaviour and its likely impact upon others. Such an agent may choose to influence their future by exogenous means. If so, might pharmacology help them to do this? Is it doing so already? I argue that it is.
Middle-ear disease and schizophrenia: case–control study
Authors: Mason Peter , Rimmer Michael , Richman Anna , Garg Gagan , Johnson Joe , Mottram Patricia G.
Published: August 2008

Background

One hundred years ago psychiatrists thought that ear disease could cause insanity by irritation of the brain. Current understanding of the role of the temporal lobes in schizophrenia and their proximity to the middle ear supports this hypothesis.

Aims

To establish the rate of middle-ear disease pre-dating the onset of schizophrenia.

Method

Eighty-four patients with schizophrenia were each matched to four non-psychiatric controls by age, gender and season of birth. History of ear disease was obtained from general practice records. Additional information on symptoms was collected for participants in the case group, who also had audiometry.

Results

The odds ratio of recorded middle-ear disease pre-dating schizophrenia was 3.68 (95% CI 1.86–7.28). This excess was particularly marked on the left (OR=4.15, 95% CI 2.08–8.29). Auditory hallucinations were associated with middle-ear disease but not with hearing loss.

Conclusions

There is an association between middle-ear disease and schizophrenia which may have aetiological significance.
Revision of metal-on-metal resurfacing arthroplasty of the hip
Authors: De Haan R. , Campbell P. A. , Su E. P. , De Smet K. A.
Published: August 2008

We have reviewed 42 patients who had revision of metal-on-metal resurfacing procedures, mostly because of problems with the acetabular component. The revisions were carried out a mean of 26.2 months (1 to 76) after the initial operation and most of the patients (30) were female.

Malpositioning of the acetabular component resulted in 27 revisions, mostly because of excessive abduction (mean 69.9°; 56° to 98°) or insufficient or excessive anteversion. Seven patients had more than one reason for revision. The mean increase in the diameter of the component was 1.8 mm (0 to 4) when exchange was needed.

Malpositioning of the components was associated with metallosis and a high level of serum ions. The results of revision of the femoral component to a component with a modular head were excellent, but four patients had dislocation after revision and four required a further revision.
Total elbow replacement for the management of the ankylosed or fused elbow
Authors: Peden J. P. , Morrey B. F.
Published: August 2008

This study reports our experience with total elbow replacement for fused elbows.

Between 1982 and 2004, 13 patients with spontaneously ankylosed elbows were treated with a linked semi-constrained non-custom total elbow implant. The mean age at operation was 54 years (24 to 80). The stiffness was a result of trauma in ten elbows, juvenile rheumatoid arthritis in one, and rheumatoid arthritis in two. The patients were followed for a mean of 12 years (2 to 26) and were evaluated clinically using the Mayo Elbow Performance Score, as well as radiologically.

A mean arc from 37° of extension to 118° of flexion was achieved. Outcomes were good or excellent for seven elbows at final review. Ten patients felt better or much better after total elbow replacement. However, there was a high complication rate and re-operation was required in over half of patients. Two developed peri-operative soft-tissue breakdown requiring debridement. A muscle flap with skin grafting was used for soft-tissue cover in one. Revision was undertaken in one elbow following fracture of the ulnar component. Three patients developed a deep infection. Three elbows were manipulated under anaesthesia for post-operative stiffness. Prophylactic measures for heterotopic ossification were unsuccessful.

Total elbow replacement for the ankylosed elbow should be performed with caution. However, the outcome can be reliable in the long term and have a markedly positive impact on patient function and satisfaction. The high potential for complications must be considered. We consider total elbow replacement to be an acceptable procedure in selected patients with reasonable expectations.
Steroid-induced osteonecrosis
Authors: Zhang N.-F. , Li Z. R. , Wei H.-Y. , Liu Z.-H. , Hernigou P.
Published: August 2008

Severe acute respiratory syndrome (SARS) is a newly described infectious disease caused by the SARS coronavirus which attacks the immune system and pulmonary epithelium. It is treated with regular high doses of corticosteroids. Our aim was to determine the relationship between the dosage of steroids and the number and distribution of osteonecrotic lesions in patients treated with steroids during the SARS epidemic in Beijing, China in 2003.

We identified 114 patients for inclusion in the study. Of these, 43 with osteonecrosis received a significantly higher cumulative and peak methylprednisolone-equivalent dose than 71 patients with no osteonecrosis identified by MRI. We confirmed that the number of osteonecrotic lesions was directly related to the dosage of steroids and that a very high dose, a peak dose of more than 200 mg or a cumulative methylprednisolone-equivalent dose of more than 4000 mg, is a significant risk factor for multifocal osteonecrosis with both epiphyseal and diaphyseal lesions. Patients with diaphyseal osteonecrosis received a significantly higher cumulative methylprednisolone-equivalent dose than those with epiphyseal osteonecrosis. Multifocal osteonecrosis should be suspected if a patient is diagnosed with osteonecrosis in the shaft of a long bone.
The exercise-related rise in plasma cobalt levels after metal-on-metal hip resurfacing arthroplasty
Authors: Khan M. , Kuiper J.-H. , Richardson J. B.
Published: August 2008

Wear of metal-on-metal bearings causes elevated levels of cobalt and chromium in blood and body fluids. Metal-on-metal bearings have two distinct wear phases. In the early phase, the wear rate is high. Later, it decreases and the bearing enters a steady-state phase. It is expected that as the wear rates decline, the level of cobalt detected in plasma will also decrease. We studied the baseline and exercise-related cobalt rise in 21 patients (13 men and eight women) with a mean age of 54 years (38 to 80) who had undergone successful hip resurfacing at a mean of 44 months (10 to 96) earlier. Our results showed that circulating baseline cobalt levels were not significantly correlated with the time since implantation (r = 0.08, p = 0.650). By contrast, the exercise-related cobalt rise was directly correlated with the inclination angle of the acetabular component (r = 0.47, p = 0.032) and inversely correlated with the time since implantation (r = −0.5, p = 0.020).

Inclination of the acetabular component should be kept less than 40° to decrease the production of wear debris.
Evaluation of impingement of the anterior tibial post during gait in a posteriorly-stabilised total knee replacement
Authors: Hamai S. , Miura H. , Higaki H. , Shimoto T. , Matsuda S. , Iwamoto Y.
Published: August 2008

Mechanical failure because of wear or fracture of the polyethylene tibial post in posteriorly-stabilised total knee replacements has been extensively described. In this study of 12 patients with a clinically and radiologically successful NexGen LPS posteriorly-stabilised prosthesis impingement of the anterior tibial post was evaluated in vivo in three dimensions during gait using radiologically-based image-matching techniques.

Impingement was observed in all images of the patients during the stance phase, although the NexGen LPS was designed to accommodate 14° of hyperextension of the component before impingement occurred. Impingement arises as a result of posterior translation of the femur during the stance phase. Further attention must therefore be given to the configuration of the anterior portion of the femoral component and the polyethylene post when designing posteriorly-stabilised total knee replacements.
Early magnetic resonance imaging compared with bone scintigraphy in suspected scaphoid fractures
Authors: Beeres F. J. P. , Rhemrev S. J. , den Hollander P. , Kingma L. M. , Meylaerts S. A. G. , le Cessie S. , Bartlema K. A. , Hamming J. F. , Hogervorst M.
Published: August 2008

We evaluated 100 consecutive patients with a suspected scaphoid fracture but without evidence of a fracture on plain radiographs using MRI within 24 hours of injury, and bone scintigraphy three to five days after injury. The reference standard for a true radiologically-occult scaphoid fracture was either a diagnosis of fracture on both MRI and bone scintigraphy, or, in the case of discrepancy, clinical and/or radiological evidence of a fracture.

MRI revealed 16 scaphoid and 24 other fractures. Bone scintigraphy showed 28 scaphoid and 40 other fractures. According to the reference standard there were 20 scaphoid fractures. MRI was falsely negative for scaphoid fracture in four patients and bone scintigraphy falsely positive in eight. MRI had a sensitivity of 80% and a specificity of 100%. Bone scintigraphy had a sensitivity of 100% and a specificity of 90%.

This study did not confirm that early, short-sequence MRI was superior to bone scintigraphy for the diagnosis of a suspected scaphoid fracture. Bone scintigraphy remains a highly sensitive and reasonably specific investigation for the diagnosis of an occult scaphoid fracture.
Acetabular bone reconstruction in revision arthroplasty
Authors: Ochs B. G. , Schmid U. , Rieth J. , Ateschrang A. , Weise K. , Ochs U.
Published: August 2008

Deficiencies of acetabular bone stock at revision hip replacement were reconstructed with two different types of allograft using impaction bone grafting and a Burch-Schneider reinforcement ring. We compared a standard frozen non-irradiated bone bank allograft (group A) with a freeze-dried irradiated bone allograft, vitalised with autologous marrow (group B). We studied 78 patients (79 hips), of whom 87% (69 hips) had type III acetabular defects according to the American Academy of Orthopaedic Surgeons classification at a mean of 31.4 months (14 to 51) after surgery. At the latest follow-up, the mean Harris hip score was 69.9 points (13.5 to 97.1) in group A and 71.0 points (11.5 to 96.5) in group B. Each hip showed evidence of trabeculation and incorporation of the allograft with no acetabular loosening.

These results suggest that the use of an acetabular reinforcement ring and a living composite of sterile allograft and autologous marrow appears to be a method of reconstructing acetabular deficiencies which gives comparable results to current forms of treatment.
A simple performance test for quantifying the severity of cervical myelopathy
Authors: Hosono N. , Sakaura H. , Mukai Y. , Kaito T. , Makino T. , Yoshikawa H.
Published: August 2008

We evaluated 30 patients with cervical myelopathy before and after decompressive surgery and compared them with 42 healthy controls. All were asked to grip and release their fingers as rapidly as possible for 15 seconds. Films recorded with a digital camera were divided into three files of five seconds each. Three doctors independently counted the number of grip and release cycles in a blinded manner (N1 represents the number of cycles for the first five-second segment, N2 for the second and N3 for the third). N2 and N3 of the pre-operative group were significantly fewer than those of the control group, and the postoperative group’s results were significantly greater than those of the pre-operative group. In the control group, the numbers decreased significantly with each succeeding five-second interval (fatigue phenomenon). In the pre-operative myelopathy group there was no significant difference between N1 and N2 (freezing phenomenon).

The 15-second test is shown to be reliable in the quantitative evaluation of cervical myelopathy. Although it requires a camera and animation files, it can detect small changes in neurological status because of its precise and objective nature.
Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius
Authors: Egol K. , Walsh M. , Tejwani N. , McLaurin T. , Wynn C. , Paksima N.
Published: August 2008

We performed a prospective, randomised trial to evaluate the outcome after surgery of displaced, unstable fractures of the distal radius. A total of 280 consecutive patients were enrolled in a prospective database and 88 identified who met the inclusion criteria for surgery. They were randomised to receive either bridging external fixation with supplementary Kirschner-wire fixation or volar-locked plating with screws. Both groups were similar in terms of age, gender, hand dominance, fracture pattern, socio-economic status and medical co-morbidities.

Although the patients treated by volar plating had a statistically significant early improvement in the range of movement of the wrist, this advantage diminished with time and in absolute terms the difference in range of movement was clinically unimportant. Radiologically, there were no clinically significant differences in the reductions, although more patients with AO/OTA (Orthopaedic Trauma Association) type C fractures were allocated to the external fixation group. The function at one year was similar in the two groups.

No clear advantage could be demonstrated with either treatment but fewer re-operations were required in the external fixation group.
Birmingham hip resurfacing arthroplasty
Authors: Heilpern G. N. A. , Shah N. N. , Fordyce M. J. F.
Published: August 2008

We report the outcome at a minimum of five years of 110 consecutive metal-on-metal Birmingham Hip Resurfacing arthroplasties in 98 patients. The procedures were performed between October 1999 and June 2002 by one surgeon. All patients were followed up clinically and radiologically. The mean follow-up was 71 months (60 to 93). Revision of either component was defined as failure.

The mean Harris Hip score at follow-up was 96.4 (53 to 100). The mean Oxford hip score was 41.9 (16 to 57) pre-operatively and 15.4 (12 to 49) post-operatively (p < 0.001). The mean University of California Los Angeles activity score was 3.91 (1 to 10) pre-operatively and 7.5 (4 to 10) post-operatively (p < 0.001).

There were four failures giving a survival at five years of 96.3% (95% confidence interval 92.8 to 99.8). When applying a new method to estimate narrowing of the femoral neck we identified a 10% thinning of the femoral neck in 16 hips (14.5%), but the relevance of this finding to the long-term outcome remains unclear.

These good medium-term results from an independent centre confirm the original data from Birmingham.
Arthroscopic medial release for medial compartment osteoarthritis of the knee
Authors: Lyu S.-R.
Published: August 2008

The outcome of arthroscopic medial release of 255 knees in 173 patients for varying grades of osteoarthritis involving the medial compartment is reported. All operations were performed by a single surgeon between January 2001 and May 2003. The Knee Society score for pain and the patient’s subjective satisfaction were used for the outcome evaluation. Overall, satisfactory outcome was reported for 197 knees (77.3%) and the mean Knee Society score for pain improved from 17.6 (95% confidence interval, 16.7 to 18.5), pre-operatively to 39.4 (95% confidence interval, 37.9 to 41.1) (p < 0.001). There were minor manageable complications of persistent effusion in 16 knees and prolonged wound discomfort in 11. In total, 15 of the 21 knees with poor results were converted to total knee replacements and two other patients (three knees) were offered this option after a mean period of 16 months.

Based on these observations arthroscopic medial release is an effective treatment for osteoarthritis of the medial compartment of the knee joint and can be expected to reduce the pain in the majority of patients for at least four years post-operatively.
Humeral head translation during glenohumeral abduction following computer-assisted shoulder hemiarthroplasty
Authors: Kedgley A. E. , DeLude J. A. , Drosdowech D. S. , Johnson J. A. , Bicknell R. T.
Published: August 2008

This study compared the effect of a computer-assisted and a traditional surgical technique on the kinematics of the glenohumeral joint during passive abduction after hemiarthroplasty of the shoulder for the treatment of fractures. We used seven pairs of fresh-frozen cadaver shoulders to create simulated four-part fractures of the proximal humerus, which were then reconstructed with hemiarthroplasty and reattachment of the tuberosities. The specimens were randomised, so that one from each pair was repaired using the computer-assisted technique, whereas a traditional hemiarthroplasty without navigation was performed in the contralateral shoulder. Kinematic data were obtained using an electromagnetic tracking device.

The traditional technique resulted in posterior and inferior translation of the humeral head. No statistical differences were observed before or after computer-assisted surgery.

Although it requires further improvement, the computer-assisted approach appears to allow glenohumeral kinematics to more closely replicate those of the native joint, potentially improving the function of the shoulder and extending the longevity of the prosthesis.
Residual pelvic rotation after single-event multilevel surgery in spastic hemiplegia
Authors: Chung C. Y. , Lee S. H. , Choi I. H. , Cho T.-J. , Yoo W. J. , Park M. S.
Published: August 2008

Our aim in this retrospective study of 52 children with spastic hemiplegia was to determine the factors which affected the amount of residual pelvic rotation after single-event multilevel surgery.

The patients were divided into two groups, those who had undergone femoral derotation osteotomy and those who had not. Pelvic rotation improved significantly after surgery in the femoral osteotomy group (p < 0.001) but not in the non-femoral osteotomy group. Multiple regressions identified the following three independent variables, which significantly affected residual pelvic rotation: the performance of femoral derotation osteotomy (p = 0.049), the pre-operative pelvic rotation (p = 0.003) and the post-operative internal rotation of the hip (p = 0.001).

We concluded that there is a decrease in the amount of pelvic rotation after single-event multilevel surgery with femoral derotation osteotomy. However, some residual rotation may persist when patients have severe rotation before surgery.