bluuebunny/crossref_metadata_2025 huggingface dataset:
Standardized flow cytometry for highly sensitive MRD measurements in B-cell acute lymphoblastic leukemia
Authors: Theunissen Prisca , Mejstrikova Ester , Sedek Lukasz , van der Sluijs-Gelling Alita J. , Gaipa Giuseppe , Bartels Marius , Sobral da Costa Elaine , Kotrová Michaela , Novakova Michaela , Sonneveld Edwin , Buracchi Chiara , Bonaccorso Paola , Oliveira Elen , te Marvelde Jeroen G. , Szczepanski Tomasz , Lhermitte Ludovic , Hrusak Ondrej , Lecrevisse Quentin , Grigore Georgiana Emilia , Froňková Eva , Trka Jan , Brüggemann Monika , Orfao Alberto , van Dongen Jacques J. M. , van der Velden Vincent H. J.
Published: December 2016

Key Points

Standardized flow cytometry allows highly sensitive MRD measurements in virtually all BCP-ALL patients. If sufficient cells are measured (>4 million), flow cytometric MRD analysis is at least as sensitive as current PCR-based MRD methods.
Respiratory problems and management in people with spinal cord injury
Authors: Berlowitz David J. , Wadsworth Brooke , Ross Jack
Published: December 2016

Spinal cord injury (SCI) is characterised by profound respiratory compromise secondary to the level of loss of motor, sensory and autonomic control associated with the injury. This review aims to detail these anatomical and physiological changes after SCI, and outline their impact on respiratory function. Injury-related impairments in strength substantially alter pulmonary mechanics, which in turn affect respiratory management and care. Options for treatments must therefore be considered in light of these limitations.

Key points

Respiratory impairment following spinal cord injury (SCI) is more severe in high cervical injuries, and is characterised by low lung volumes and a weak cough secondary to respiratory muscle weakness.

Autonomic dysfunction and early-onset sleep disordered breathing compound this respiratory compromise.

The mainstays of management following acute high cervical SCI are tracheostomy and ventilation, with noninvasive ventilation and assisted coughing techniques being important in lower cervical and thoracic level injuries.

Prompt investigation to ascertain the extent of the SCI and associated injuries, and appropriate subsequent management are important to improve outcomes.

Educational aims

To describe the anatomical and physiological changes after SCI and their impact on respiratory function.

To describe the changes in respiratory mechanics seen in cervical SCI and how these changes affect treatments.

To discuss the relationship between injury level and respiratory compromise following SCI, and describe those at increased risk of respiratory complications.

To present the current treatment options available and their supporting evidence.
Factors affecting long-term efficacy of T regulatory cell-based therapy in type 1 diabetes
Authors: Marek-Trzonkowska Natalia , Myśliwiec Małgorzata , Iwaszkiewicz-Grześ Dorota , Gliwiński Mateusz , Derkowska Ilona , Żalińska Magdalena , Zieliński Maciej , Grabowska Marcelina , Zielińska Hanna , Piekarska Karolina , Jaźwińska-Curyłło Anna , Owczuk Radosław , Szadkowska Agnieszka , Wyka Krystyna , Witkowski Piotr , Młynarski Wojciech , Jarosz-Chobot Przemysława , Bossowski Artur , Siebert Janusz , Trzonkowski Piotr
Published: December 2016

Background

Recent studies suggest that immunotherapy using T regulatory cells (Tregs) prolongs remission in type 1 diabetes (T1DM). Here, we report factors that possibly affect the efficacy of this treatment.

Methods

The metabolic and immune background of 12 children with recently diagnosed T1DM, as well as that of untreated subjects, during a 2-year follow-up is presented. Patients were treated with up to 30 × 106/kg b.w. of autologous expanded CD3+CD4+CD25highCD127− Tregs.

Results

The disease progressed and all patients were insulin-dependent 2 years after inclusion. The β-cell function measured by c-peptide levels and the use of insulin were the best preserved in patients treated with two doses of Tregs (3/6 in remission), less so after one dose (1/6 in remission) and the worst in untreated controls (no remissions). Increased levels of Tregs could be seen in peripheral blood after their adoptive transfer together with the shift from naïve CD62L+CD45RA+ to memory CD62L+CD45RA− Tregs. Increasing serum levels of proinflammatory cytokines were found: IL6 increased in all subjects, while IL1 and TNFα increased only in untreated group. Therapeutic Tregs were dependent on IL2, and their survival could be improved by other lymphocytes.

Conclusions

The disease progression was associated with changing proportions of naïve and memory Tregs and slowly increasing proinflammatory activity, which was only partially controlled by the administered Tregs. The therapeutic cells were highly dependent on IL2. We conclude that the therapy should be administered at the earliest to protect the highest possible mass of islets and also to utilize the preserved content of Tregs in the earlier phases of T1DM.

Trial registrationhttp://www.controlled-trials.com/ISRCTN06128462; registered retrospectively
Clinical measures of static foot posture do not agree
Authors: Langley Ben , Cramp Mary , Morrison Stewart C.
Published: December 2016

Background

The aim of this study was to determine the level of agreement between common clinical foot classification measures.

Methods

Static foot assessment was undertaken using the Foot Posture Index (FPI‐6), rearfoot angle (RFA), medial longitudinal arch angle (MLAA) and navicular drop (ND) in 30 participants (29 ± 6 years, 1.72 ± 0.08 m, 75 ± 18 kg). The right foot was measured on two occasions by one rater within the same test environment. Agreement between the test sessions was initially determined for each measure using the Weighted Kappa. Agreement between the measures was determined using Fleiss Kappa.

Results

Foot classification across the two test occasions was almost perfect for MLAA (Kw = .92) and FPI‐6 (Kw = .92), moderate for RFA (Kw = .60) and fair for ND (Kw = .40) for comparison within the measures. Overall agreement between the measures for foot classification was moderate (Kf = .58).

Conclusion

The findings reported in this study highlight discrepancies between the chosen foot classification measures. The FPI‐6 was a reliable multi‐planar measure whereas navicular drop emerged as an unreliable measure with only fair agreement across test sessions. The use of this measure for foot assessment is discouraged. The lack of strong consensus between measures for foot classification underpins the need for a consensus on appropriate clinical measures of foot structure.
P311 induces the transdifferentiation of epidermal stem cells to myofibroblast-like cells by stimulating transforming growth factor β1 expression
Authors: Li Haisheng , Yao Zhihui , He Weifeng , Gao Hongyan , Bai Yang , Yang Sisi , Zhang Lu , Zhan Rixing , Tan Jianglin , Zhou Junyi , Takata Masao , Wu Jun , Luo Gaoxing
Published: December 2016

Background

Epithelial to mesenchymal transition, especially to myofibroblasts, plays an important role in wound healing, fibrosis, and carcinogenesis. Epidermal stem cells (EpSCs) are responsible for epidermal renewal and wound re-epithelialization. However, it remains unclear whether and how EpSCs transdifferentiate into myofibroblasts or myofibroblast-like cells (MFLCs). Here, we provide the first evidence showing that P311 induces EpSC to MFLC transdifferentiation (EpMyT) via TGFβ1/Smad signaling.

Methods

Wound healing and mesenchymal features were observed in the P311 KO and P311 WT mouse model of superficial second-degree burns. After the primary human or mouse EpSCs were forced to highly express P311 using an adenoviral vector, EpMyT was observed by immunofluorescence, real-time PCR, and western blot. The activity of TGFβ1 and Smad2/3 in EpSCs with different P311 levels was observed by western blot. The TβRI/II inhibitor LY2109761 and Smad3 siRNA were applied to block the EpMyT in P311-overexpressing EpSCs and exogenous TGFβ1 was to restore the EpMyT in P311 KO EpSCs. Furthermore, the mechanism of P311 regulating TGFβ1 was investigated by bisulfite sequencing PCR, luciferase activity assay, and real-time PCR.

Results

P311 KO mouse wounds showed delayed re-epithelialization and reduced mesenchymal features. The human or mouse EpSCs with overexpressed P311 exhibited fusiform morphological changes, upregulated expression of myofibroblast markers (α-SMA and vimentin), and downregulated expression of EpSC markers (β1-integrin and E-cadherin). P311-expressing EpSCs showed decreased TGFβ1 mRNA and increased TGFβ1 protein, TβRI/II mRNA, and activated Smad2/3. Moreover, LY2109761 and Smad3 siRNA reversed P311-induced EpMyT. Under the stimulation of exogenous TGFβ1, the phosphorylation of Smad2 and Smad3 in P311 KO EpSCs was significantly lower than that in P311 WT EpSCs and the EpMyT in P311 KO EpSCs was restored. Furthermore, P311 enhanced the methylation of TGFβ1 promoter and increased activities of TGFβ1 5′/3′ untranslated regions (UTRs) to stimulate TGFβ1 expression. P311+α-SMA+ cells and P311+vimentin+ cells were observed in the epidermis of human burn wounds. Also, P311 was upregulated by IL-1β, IL-6, TNFα, and hypoxia.

Conclusions

P311 is a novel TGFβ1/Smad signaling-mediated regulator of transdifferentiation in EpSCs during cutaneous wound healing. Furthermore, P311 might stimulate TGFβ1 expression by promoting TGFβ1 promoter methylation and by activating the TGFβ1 5′/3′ UTR.
Strong and weak convergence theorems for split equality generalized mixed equilibrium problem
Authors: Karahan Ibrahim
Published: December 2016

In this paper, we consider split equality generalized mixed equilibrium problem, which is more general than many problems such as split feasibility problem, split equality problem, split equilibrium problem, and so on. We propose a new modified algorithm to obtain strong and weak convergence theorems for split equality generalized mixed equilibrium problem for nonexpansive mappings in Hilbert spaces. Also, we give some applications to other problems. Our results extend some results in the literature.
Editorial: Blockade of PD-1 and PD-L1 restores defective innate immune responses in leukocytes from septic humans
Authors: Ward Peter A , Fattahi Fatemeh
Published: December 2016

Discussion of how humans with sepsis develop increased levels of PD-1 and PD-L1 on their blood leukocytes, which can be neutralized with antibodies and reversing leukocyte dysfunctions.
Increasing the robustness and applicability of full-waveform inversion: An optimal transport distance strategy
Authors: Métivier L. , Brossier R. , Mérigot Q. , Oudet E. , Virieux J.
Published: December 2016

Full-waveform inversion starts being used as a standard stage of the seismic-imaging workflow, at the exploration scale, for the reconstruction of high-resolution wave velocity models. However, its successful application still relies on the estimation of an accurate enough initial velocity model, as well as on the design of a suitable hierarchical workflow, allowing it to feed the inversion process progressively with data. These two requirements are mandatory to avoid the cycle-skipping or phase-ambiguity problem when comparing observed and synthetic data. This difficulty is due to the definition of the full-waveform inversion problem as the least-squares minimization of the data misfit. The resulting misfit function has local minima, which correspond to the interpretation of the seismic data up to one or several phase shifts. In this article, we review an alternative formulation of full-waveform inversion based on the optimal transport distance we have proposed in recent studies. We propose to use a particular instance of the optimal transport problem, which is adapted to the interpretation of real seismic data and for which we design an efficient low-complexity numerical strategy. Numerical results in 2D and 3D configurations (BP 2004, Chevron 2014 benchmark model, SEG/EAGE overthrust model) show that this reformulation should yield a more convex misfit function, less prone to cycle skipping. In this study, we present a simple illustration on the Marmousi model, which illustrates how this new distance strongly relaxes the requirement on the initial model design. Starting from a rather simplistic approximation of the initial model, the method is able to reconstruct a meaningful estimation of the Marmousi model, while the standard least-squares formulation is trapped into a local, meaningless minimum.
Perceptions of work stress causes and effective interventions in employees working in public, private and non-governmental organisations: a qualitative study
Authors: Bhui Kamaldeep , Dinos Sokratis , Galant-Miecznikowska Magdalena , de Jongh Bertine , Stansfeld Stephen
Published: December 2016

Aims and method

To identify causes of stress at work as well as individual, organisational and personal interventions used by employees to manage stress in public, private and non-governmental organizations (NGOs). Qualitative interviews were conducted with 51 employees from a range of organisations.

Results

Participants reported adverse working conditions and management practices as common causes of work stress. Stress-inducing management practices included unrealistic demands, lack of support, unfair treatment, low decision latitude, lack of appreciation, effort–reward imbalance, conflicting roles, lack of transparency and poor communication. Organisational interventions were perceived as effective if they improved management styles, and included physical exercise, taking breaks and ensuring adequate time for planning work tasks. Personal interventions used outside of work were important to prevent and remedy stress.

Clinical implications

Interventions should improve management practices as well as promoting personal interventions outside of the work setting.
The outcomes of home treatment for borderline personality disorder
Authors: Turhan Sibel , Taylor Mark
Published: December 2016

Aims and method

There is currently no trial or other scientific evidence informing the efficacy of any crisis intervention for people with borderline personality disorder (BPD). We aimed to assess the patterns of service use by patients with BPD taken on for crisis resolution and home treatment between 2010 and 2013. Patients with a diagnosis of BPD were identified and demographic and clinical data were collected.

Results

All patients were female, and a high proportion had recurrent presentations to crisis and home treatment services in Edinburgh. Many appeared to benefit from intensive home treatment, as measured by the Clinical Global Impression scale. A small number of patients (n = 5) were responsible for more than half of all referrals. Polypharmacy, or regular use of multiple medications, was common, with 62% of all patients receiving three or more regular medications.

Clinical implications

Crisis and home treatment services can be beneficial to most people with BPD in crisis. The high rate of polypharmacy seen in this study is of concern.
Sectioning on the street – futility or utility?
Authors: Timms Philip , Perry Jennifer
Published: December 2016

Aims and method

A service evaluation was undertaken to examine outcomes in patients who were street homeless (‘rough sleepers’) and who were compulsorily admitted to hospital under the Mental Health Act 1983. The data were collected from the patients' case notes.

Results

At 1-year follow-up, patients had positive outcomes in areas such as accommodation status, registration with a general practitioner and engagement with the clinical team.

Clinical implications

The study shows that the intervention of a Mental Health Act assessment and compulsory hospital admission in homeless people on the street is associated with positive outcomes at 1 year.
Mindfulness in psychiatry – where are we now?
Authors: Groves Paramabandhu
Published: December 2016

Mindfulness is an increasingly popular therapeutic approach. Mindfulness-based interventions have been tried out in a wide range of mental disorders, with the strongest evidence for use in depression and anxiety. Mindfulness operates by changing the person's relationship with unhelpful thoughts and emotions. The need for home practice is both a strength and a weakness. Some find home practice too demanding and a barrier to effective utilisation of mindfulness. Others discover a set of practical tools that, once learnt, can be applied to ongoing life difficulties; in this way mindfulness may have a place in promoting recovery beyond the acute treatment of a disorder. Additionally, mindfulness may be beneficial for clinicians to promote well-being and enhance the therapeutic relationship.
Psychiatric reform in Greece: an overview
Authors: Giannakopoulos George , Anagnostopoulos Dimitris C.
Published: December 2016

Leros became infamous worldwide in the 1980s because of a scandal in its mental institution, the Leros asylum. The scandal provoked universal outrage and the international pressure triggered the Greek mental health reform. Under the reform projects Leros I and Leros II (1990–1994), numerous interventions took place in the Leros asylum as part of deinstitutionalisation. Following that, the Psychargos programme advanced developments for community-based services. Deinstitutionalisation and development of community mental health services have advanced significantly since the 1980s. However, this reform is still incomplete, given that sectorisation, adequate primary care policies, inter-sectoral coordination and specialised services are under-developed. This problematic situation is further complicated by the severe impact of the current financial crisis.
Has the science of mindfulness lost its mind?
Authors: Farias Miguel , Wikholm Catherine
Published: December 2016

The excitement about the application of mindfulness meditation in mental health settings has led to the proliferation of a literature pervaded by a lack of conceptual and methodological self-criticism. In this article we raise two major concerns. First, we consider the range of individual differences within the experience of meditation; although some people may benefit from its practice, others will not be affected in any substantive way, and a number of individuals may suffer moderate to serious adverse effects. Second, we address the insufficient or inconclusive evidence for its benefits, particularly when mindfulness-based interventions are compared with other activities or treatments. We end with suggestions on how to improve the quality of research into mindfulness interventions and outline key issues for clinicians considering referring patients for these interventions.
Performance Assessment of Buried Pipelines at Fault Crossings
Authors: Melissianos Vasileios E. , Vamvatsikos Dimitrios , Gantes Charis J.
Published: December 2016

A methodology for seismic performance assessment of onshore buried steel pipelines at fault crossings is presented. Probabilistic fault displacement hazard analysis is performed at first to determine the magnitude of the three fault displacement components in space. Next, three-dimensional (3-D) structural analysis of the pipeline via a nonlinear beam-type finite element model allows accounting for the different effect of imposed displacements in each axis. Finally, convolving of seismic hazard and structural response results in joint hazard surfaces of compressive and tensile strains that can be used to estimate the mean annual rate of exceeding any limit-state of interest under the influence of demand and capacity uncertainty.
Can multi-generational exposure to ocean warming and acidification lead to the adaptation of life-history and physiology in a marine metazoan?
Authors: Gibbin Emma M. , Chakravarti Leela J. , Jarrold Michael D. , Christen Felix , Turpin Vincent , N'Siala Gloria Massamba , Blier Pierre U. , Calosi Piero
Published: December 2016

Ocean warming and acidification are concomitant global drivers that are currently threatening the survival of marine organisms. How species will respond to these changes depends on their capacity for plastic and adaptive responses. Little is known about the mechanisms that govern plasticity and adaptability or how global changes will influence these relationships across multiple generations. Here, we exposed the emerging model marine polychaete Ophryotrocha labronica to conditions simulating ocean warming and acidification, in isolation and in combination over five generations to identify: (i) how multiple versus single global change drivers alter both juvenile and adult life-traits; (ii) the mechanistic link between adult physiological and fitness-related life-history traits; (iii) whether observed phenotypic changes observed over multiple generations are of plastic and/or adaptive origin. Two juvenile (developmental rate; survival to sexual maturity) and two adult (average reproductive body size; fecundity) life-history traits were measured in each generation, in addition to three physiological (cellular reactive oxygen species content, mitochondrial density; mitochondrial capacity) traits. We found that multi-generational exposure to warming alone caused an increase in: juvenile developmental rate, reactive oxygen species production and mitochondrial density and decreases in: average reproductive body size, fecundity and fluctuations in mitochondrial capacity, relative to control conditions. While exposure to ocean acidification alone, had only minor effects on juvenile developmental rate. Remarkably, when both drivers of global change were present, only mitochondrial capacity was significantly affected, suggesting that ocean warming and acidification act as opposing vectors of stress across multiple generations.
Weighted fuzzy clustering for (fuzzy) constraints in multivariate image analysis–alternating least square of
hyperspectral images
Authors: Hugelier Siewert , Firmani Patrizia , Devos Olivier , Moreau Myriam , Pierlot Christel , Marini Federico , Ruckebusch Cyril
Published: December 2016

In order to investigate hyperspectral images, many techniques such as multivariate image analysis (MIA) or
multivariate curve resolution–alternating least squares (MCR–ALS) can be applied. When focusing on the use of
MCR–ALS, constraints are of the utmost importance for a correct resolution of the data into its individual contributions. In
this article, a fuzzy clustering pattern recognition method (fuzzy C-means) is applied on experimental data in order to
improve the results obtained within the MCR–ALS analysis. The big advantage of a fuzzy clustering technique over a hard
clustering technique, such as k-means, is that the algorithm determines the probability of a pixel to be assigned to a
component, indicating that a pixel can be part of multiple clusters (or components). This is, of course, an important property
for dealing with data in which a lot of overlap between the components in the spatial direction occurs. This article deals
briefly with the implementation of the constraint into the MCR–ALS algorithm and then shows the application of the
constraint on an oil-in-water emulsion obtained by Raman spectroscopy, in which the different components can be
decomposed in a clearer way and the interface between the oil and water bubbles becomes more visible.
Anastasia Sofia Alexiadou Social Protection: Historical and Philosophical dimension Thessaloniki: University Studio Press, 2015
Authors: Arvanitakis Constantine
Published: December 2016

No abstract
Ανδρέας Φερώνας Ο Εξευρωπαϊσμός της Κοινωνικής Πολιτικής. Θεωρητικό πλαίσιο, μεθοδολογικά προβλήματα και η ελληνική εμπειρία, Αθήνα: Διόνικος, 2013
Authors: Κουραχάνης Νίκος
Published: December 2016

No abstract
Evolutionary relations and population differentiation of Acipenser gueldenstaedtii Brandt, Acipenser persicus Borodin, and Acipenser baerii Brandt
Authors: Sergeev Alexey A.
Published: December 2016

Russian (Acipenser gueldenstaedtii), Persian (A. persicus) and Siberian (A. baerii) sturgeons are closely related ‘Ponto-Caspian’ species. Investigation of their population structure is an important problem, the solution of which determines measures for conservation of these species. According to previous studies, ‘baerii-like’ mitotypes were found in the Caspian Sea among 35% of Russian sturgeon specimens, but were not found in Persian sturgeons. This confirms genetic isolation of the Persian sturgeon from the Russian sturgeon in the Caspian Sea. However, in order to clarify the relationships of these species it is necessary to analyze nuclear DNA markers. The amplified fragment length polymorphism (method) allows estimating interpopulation and interspecific genetic distances using nuclear DNA markers. In the present study, four samples were compared: Persian sturgeons from the South Caspian Sea, Russian sturgeons from the Caspian Sea and the Sea of Azov, and Siberian sturgeons from the Ob’ River, which are close to these two species, but are also clearly morphologically and genetically distinct from them. For the AFLP method, eight pairs of selective primers were used. The analysis revealed that the Siberian sturgeon has formed a separate branch from the overall Persian-Russian sturgeons cluster, which was an expected result. In addition, the results showed that the Caspian Russian sturgeon is closer to the Persian sturgeon from the Caspian Sea than to the Russian Sturgeon from the Sea of Azov. The present DNA marker data confirm that despite the genetic isolation of the Persian sturgeon from the Russian sturgeon in the Caspian Sea, the Persian sturgeon is a young species.
Financial Consumer Protection and the Cost of Financial Intermediation: Evidence from Advanced and Developing Economies
Authors: Pasiouras Fotios
Published: December 2016

Using a data set of approximately 3,000 commercial banks from more than 100 countries, I examine the impact of financial consumer protection policies on the cost of financial intermediation. I find evidence that the existence of internal mechanisms for handling complaints, requirements for fair treatment, supervisory power related to consumer protection, and various disclosure requirements reduce the cost of financial intermediation in advanced countries. The results are different in the case of developing countries, where I observe that most financial consumer protection policies increase the cost of intermediation, suggesting that banks pass on regulatory burdens to their customers.

This paper was accepted by Amit Seru, finance.
Review on Mechanisms, Importance of Homeostasis and Fluid Imbalances in the Elderly
Authors: Bak Aggie , Tsiami Amalia
Published: December 2016

Water is considered an essential nutrient, but very often is overlooked in favour of nutrition. Due to age related changes, older people are more vulnerable to both, dehydration and overhydration. This article describes the principles of water homeostasis and provides a description of common age-related physiological changes related to water balance. Fluid homeostasis largely depends on osmo- and baro-receptors that respectively react to changes in osmolality and blood pressure, water-regulating hormone release, the subsequent response of kidneys to the hormonal stimulation and activation of thirst. These mechanisms diminish with age and put elderly at risk of dehydration. All involved in a care for the elderly should be informed and become vigilant to prevent dehydration from occurring.
Femoral impaction bone grafting in revision hip arthroplasty
Authors: Wilson M. J. , Hook S. , Whitehouse S. L. , Timperley A. J. , Gie G. A.
Published: December 2016

Aims

Femoral impaction bone grafting was first developed in 1987 using morselised cancellous bone graft impacted into the femoral canal in combination with a cemented, tapered, polished stem. We describe the evolution of this technique and instrumentation since that time.

Patients and Methods

Between 1987 and 2005, 705 revision total hip arthroplasties (56 bilateral) were performed with femoral impaction grafting using a cemented femoral stem. All surviving patients were prospectively followed for a mean of 14.7 years (9.8 to 28.3) with no loss to follow-up. By the time of the final review, 404 patients had died.

Results

There were 76 further revisions (10.8%) involving the stem; seven for aseptic loosening, 23 for periprosthetic fracture, 24 for infection, one for malposition, one for fracture of the stem and 19 cement-in-cement exchanges of the stem during acetabular revision. The 20-year survival rate for the entire series was 98.8% (95% confidence interval (CI) 97.8 to 99.8) with aseptic loosening as the endpoint, and 87.7% (95% CI 82.8 to 92.6) for revision for any reason. Survival improved with the evolution of the technique, although this was not statistically significant due to the overall low rate of further revision.

Conclusion

This is the largest series of revision total hip arthroplasties with femoral impaction grafting, and the results support the continued use of this technique. Cite this article: Bone Joint J 2016;98-B:1611–19.
The rate of wear of second-generation highly crosslinked polyethylene liners five years post-operatively does not increase if large femoral heads are used
Authors: Callary S. A. , Field J. R. , Campbell D. G.
Published: December 2016

Aims

The increased in vivo resistance to wear of highly crosslinked polyethylene (HXLPE) in total hip arthroplasty (THA) has led to an increased use of larger articulations which have been shown to reduce the incidence of early dislocation. To date, there are few reports of the wear of larger articulations using second generation HXLPE liners. Our prospective cohort study measured the bedding-in and early wear of large (36 mm and 40 mm diameter) articulations involving a second generation X3 HXLPE liner and compared our findings with previous clinical and in vitro studies of the same material.

Patients and Methods

The proximal penetration of the femoral head five years post-operatively was measured for 15 patients using radiostereometric analysis (RSA).

Results

The median proximal bedding-in within the first post-operative year was 0.022 mm (interquartile range (IQR) -0.050 to 0.091). The median proximal rate of wear between one and five years was -0.004 mm/year (IQR -0.021 to 0.022). The rates of proximal, medial, 2D or 3D wear between one and five years post-operatively of the X3 HXLPE liner did not increase with larger articulations compared with our previous study of 32 mm articulations.

Conclusion

Although reassuring, the use of larger articulations requires continued monitoring to determine whether the low wear observed in the short-term continues to the mid- to long-term. Cite this article: Bone Joint J 2016;98-B:1604–10.
Metallosis following implantation of magnetically controlled growing rods in the treatment of scoliosis
Authors: Teoh K. H. , von Ruhland C. , Evans S. L. , James S. H. , Jones A. , Howes J. , Davies P. R. , Ahuja S.
Published: December 2016

Aims

We present a case series of five patients who had revision surgery following magnetic controlled growing rods (MGCR) for early onset scoliosis. Metallosis was found during revision in four out of five patients and we postulated a mechanism for rod failure based on retrieval analysis.

Patients and Methods

Retrieval analysis was performed on the seven explanted rods. The mean duration of MCGR from implantation to revision was 35 months (17 to 46). The mean age at revision was 12 years (7 to 15; four boys, one girl).

Results

A total of six out of seven rods had tissue metallosis and pseudo-capsule surrounding the actuator. A total of four out of seven rods were pistoning. There were two rods which were broken. All rods had abrasive circumferential markings. A significant amount of metal debris was found when the actuators were carefully cut open. Analytical electron microscopy demonstrated metal fragments of predominantly titanium with a mean particle size of 3.36 microns (1.31 to 6.61).

Conclusion

This study highlights concerns with tissue metallosis in MCGR. We recommend careful follow-up of patients who have received this implant. Cite this article: Bone Joint J 2016;98-B:1662–7.
The use of the distal radius and ulna classification for the prediction of growth
Authors: Cheung J. P. Y. , Cheung P. W. H. , Samartzis D. , Cheung K. M. C. , Luk K. D. K.
Published: December 2016

Aims

We report the use of the distal radius and ulna (DRU) classification for the prediction of peak growth (PG) and growth cessation (GC) in 777 patients with idiopathic scoliosis. We compare this classification with other commonly used parameters of maturity.

Patients and Methods

The following data were extracted from the patients’ records and radiographs: chronological age, body height (BH), arm span (AS), date of menarche, Risser sign, DRU grade and status of the phalangeal and metacarpal physes. The mean rates of growth were recorded according to each parameter of maturity. PG was defined as the summit of the curve and GC as the plateau in deceleration of growth. The rates of growth at PG and GC were used for analysis using receiver operating characteristic (ROC) curves to determine the strength and cutoff values of the parameters of growth.

Results

The most specific grades for PG using the DRU classification were radial grade 6 and ulnar grade 5, and for GC were radial grade 9 and ulnar grade 7. The DRU classification spanned both PG and GC, enabling better prediction of these clinically relevant stages than other methods. The rate of PG (≥ 0.7 cm/month) and GC (≤ 0.15 cm/month) was the same for girls and boys, in BH and AS measurements.

Conclusion

This is the first study to note that the DRU classification can predict both PG and GC, providing evidence that it may aid the management of patients with idiopathic scoliosis. Cite this article: Bone Joint J 2016;98-B:1689–96.
The relative contribution of the medial and lateral femoral circumflex arteries to the vascularity of the head and neck of the femur
Authors: Dewar D. C. , Lazaro L. E. , Klinger C. E. , Sculco P. K. , Dyke J. P. , Ni A. Y. , Helfet D. L. , Lorich D. G.
Published: December 2016

Aims

We aimed to quantify the relative contributions of the medial femoral circumflex artery (MFCA) and lateral femoral circumflex artery (LFCA) to the arterial supply of the head and neck of the femur.

Materials and Methods

We acquired ten cadaveric pelvises. In each of these, one hip was randomly assigned as experimental and the other as a matched control. The MFCA and LFCA were cannulated bilaterally. The hips were designated LFCA-experimental or MFCA-experimental and underwent quantitative MRI using a 2 mm slice thickness before and after injection of MRI-contrast diluted 3:1 with saline (15 ml Gd-DTPA) into either the LFCA or MFCA. The contralateral control hips had 15 ml of contrast solution injected into the root of each artery. Next, the MFCA and LFCA were injected with a mixture of polyurethane and barium sulfate (33%) and their extra-and intra-arterial course identified by CT imaging and dissection.

Results

The MFCA made a greater contribution than the LFCA to the vascularity of the femoral head (MFCA 82%, LFCA 18%) and neck (MFCA 67%, LFCA 33%). However, the LFCA supplied 48% of the anteroinferior femoral neck overall.

Conclusion

This study clearly shows that the MFCA is the major arterial supply to the femoral head and neck. Despite this, the LFCA supplies almost half the anteroinferior aspect of the femoral neck. Cite this article: Bone Joint J 2016;98-B:1582–8.
The development of a quantitative scoring system to predict whether a large-to-massive rotator cuff tear can be arthroscopically repaired
Authors: Kim S-J. , Park J-S. , Lee K-H. , Lee B-G.
Published: December 2016

Aims

The aim of the study was to develop a quantitative scoring system to predict whether a large-to-massive rotator cuff tear was arthroscopically reparable prior to surgery.

Patients and Methods

We conducted a retrospective review of the pre-operative MR imaging and surgical records of 87 patients (87 shoulders) who underwent arthroscopic repair of a large-to-massive rotator cuff tear. Patients were divided into two groups, based on the surgical outcome of the repair. Of the 87 patients, 53 underwent complete repair (Group I) and 34 an incomplete repair (Group II). Pre-operative MR images were reviewed to quantify several variables. Between-group differences were evaluated and multiple logistic regression analysis was used to calculate the predictive value of significant variables. The reparability index (RI) was constructed using the odds ratios of significant variables and a receiver operating characteristic curve analysis performed to identify the optimal RI cutoff to differentiate between the two groups.

Results

The following variables were identified as independent predictors of arthroscopic reparability: the size of the defect with medial-lateral diameter (cutoff, 4.2 cm) and anterior-posterior diameter (cutoff, 3.7cm); Patte’s grade of muscle atrophy (cutoff, grade 3) and Goutallier grade of fatty degeneration (cutoff, grade 3). An RI cutoff value of 2.5 provided the highest differentiation between groups I and II, with an area under the curve of 0.964, and a sensitivity of 73.5% and specificity of 96.2%.

Conclusion

The RI developed in our study may prove to be an efficient clinical scoring system to predict whether a large-to-massive rotator cuff tear is arthroscopically reparable. Cite this article: Bone Joint J 2016;98-B:1656–61.
The use of ultra-low-dose CT scans for the evaluation of limb fractures
Authors: Konda S. R. , Goch A. M. , Leucht P. , Christiano A. , Gyftopoulos S. , Yoeli G. , Egol K. A.
Published: December 2016

Aims

To evaluate whether an ultra-low-dose CT protocol can diagnose selected limb fractures as well as conventional CT (C-CT).

Patients and Methods

We prospectively studied 40 consecutive patients with a limb fracture in whom a CT scan was indicated. These were scanned using an ultra-low-dose CT Reduced Effective Dose Using Computed Tomography In Orthopaedic Injury (REDUCTION) protocol. Studies from 16 selected cases were compared with 16 C-CT scans matched for age, gender and type of fracture. Studies were assessed for diagnosis and image quality. Descriptive and reliability statistics were calculated. The total effective radiation dose for each scanned site was compared.

Results

The mean estimated effective dose (ED) for the REDUCTION protocol was 0.03 milliSieverts (mSv) and 0.43 mSv (p < 0.005) for C-CT. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the REDUCTION protocol to detect fractures were 0.98, 0.89, 0.98 and 0.89 respectively when two occult fractures were excluded. Inter- and intra-observer reliability for diagnosis using the REDUCTION protocol (κ = 0.75, κ = 0.71) were similar to those of C-CT (κ = 0.85, κ = 0.82). Using the REDUCTION protocol, 3D CT reconstructions were equivalent in quality and diagnostic information to those generated by C-CT (κ = 0.87, κ = 0.94).

Conclusion

With a near 14-fold reduction in estimated ED compared with C-CT, the REDUCTION protocol reduces the amount of CT radiation substantially without significant diagnostic decay. It produces images that appear to be comparable with those of C-CT for evaluating fractures of the limbs. Cite this article: Bone Joint J 2016;98-B:1668-73.
Restoration of the centre of rotation in primary total hip arthroplasty
Authors: Meermans G. , Doorn J. Van , Kats J-J.
Published: December 2016

Aims

One goal of total hip arthroplasty is to restore normal hip anatomy. The aim of this study was to compare displacement of the centre of rotation (COR) using a standard reaming technique with a technique in which the acetabulum was reamed immediately peripherally and referenced off the rim.

Patients and Methods

In the first cohort the acetabulum was reamed to the floor followed by sequentially larger reamers. In the second cohort the acetabulum was only reamed peripherally, starting with a reamer the same size as the native femoral head. Anteroposterior pelvic radiographs were analysed for acetabular floor depth and vertical and horizontal position of the COR.

Results

Horizontally, the mean medial displacement of the COR was 0.8 mm (standard deviation (sd) 1.4) in the peripheral remaing group and 5.0 mm (sd 3.30) in the standard reaming group (p < 0.001). Vertically, the mean superior displacement of the COR was 0.7 mm (sd 1.3) in the peripheral reaming group and 3.7 mm (sd 2.6) in the standard reaming group (p <  0.001). In the standard reaming group, there was a strong correlation between the pre-operative acetabular floor depth and displacement of the COR (p < 0.001).

Conclusion

Reaming the acetabulum to the floor can lead to significant displacement of the COR medially and superiorly. This displacement is related to the pre-operative acetabular floor depth and cannot always be compensated by using a high offset stem. Cite this article: Bone Joint J 2016;98-B:1597–603.
Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age
Authors: Scott C. E. H. , Oliver W. M. , MacDonald D. , Wade F. A. , Moran M. , Breusch S. J.
Published: December 2016

Aims

Risk of revision following total knee arthroplasty (TKA) is higher in patients under 55 years, but little data are reported regarding non-revision outcomes. This study aims to identify predictors of dissatisfaction in these patients.

Patients and Methods

We prospectively assessed 177 TKAs (157 consecutive patients, 99 women, mean age 50 years; 17 to 54) from 2008 to 2013. Age, gender, implant, indication, body mass index (BMI), social deprivation, range of movement, Kellgren-Lawrence (KL) grade of osteoarthritis (OA) and prior knee surgery were recorded. Pre- and post-operative Oxford Knee Score (OKS) as well as Short Form-12 physical (PCS) and mental component scores were obtained. Post-operative range of movement, complications and satisfaction were measured at one year.

Results

Overall, 44 patients with 44 TKAs (24.9%) under 55 years of age were unsure or dissatisfied with their knee. Significant predictors of dissatisfaction on univariate analysis included: KL grade 1/2 OA (59% dissatisfied), poor pre-operative OKS, complications, poor improvements in PCS and OKS and indication (primary OA 19% dissatisfied, previous meniscectomy 41%, multiply operated 42%, other surgery 29%, BMI > 40 kg/m231%, post-traumatic OA 45%, and inflammatory arthropathy 5%). Poor pre-operative OKS, poor improvement in OKS and post-operative stiffness independently predicted dissatisfaction on multivariate analysis.

Conclusion

Patients receiving TKA younger than 55 years old should be informed about the increased risks of dissatisfaction. Offering TKA in KL 1/2 is questionable, with a dissatisfaction rate of 59%. Cite this article: Bone Joint J 2016;98-B:1625–34.
The pathology and management of lesser toe deformities
Authors: Malhotra Karan , Davda Kinner , Singh Dishan
Published: December 2016

Deformities of the lesser toes are common and can be associated with significant morbidity. These deformities are often multiple, and numerous treatment strategies have been described in the literature. The goal of surgical treatment is to improve symptoms by restoring alignment and function, and avoiding recurrence. In order to achieve this, it is essential for the treating surgeon to understand the normal anatomy and pathology of the various deformities. There is a paucity of prospective studies and randomised-controlled trials assessing the efficacy of specific interventions. We describe the normal anatomy and biomechanics of the lesser toes, and the pathology of commonly adult deformities. The rationale behind various treatment strategies is discussed and the results of published literature presented. Algorithms for the management of lesser toe deformities based on current literature are proposed.

Cite this article: Malhotra K, Davda K, Singh D. The pathology and management of lesser toe deformities. EFORT Open Rev 2016;1:409-419. DOI: 10.1302/2058-5241.1.160017.
Anterior cruciate ligament reconstruction: principles of treatment
Authors: Paschos Nikolaos K. , Howell Stephen M.
Published: December 2016

Anterior cruciate ligament (ACL) reconstruction is one of the most common procedures in sports medicine. Several areas of controversy exist in ACL tear management which have engaged surgeons and researchers in debates towards identifying an ideal approach for these patients. This instructional review discusses the principles of ACL reconstruction in an attempt to provide guidelines and initiate a critical thinking approach on the most common areas of controversy regarding ACL reconstruction. Using high-level evidence from the literature, as presented in randomised controlled trials, systematic reviews, and meta-analyses, operative versus conservative treatment, timing of surgery, and rehabilitation are discussed. Also, the advantages and disadvantages of the most common types of autografts, such as patellar tendon and hamstrings as well as allografts are presented. Key considerations for the anatomical, histological, biomechanical and clinical data (‘IDEAL’) graft positioning are reviewed.

Cite this article: Paschos NK, Howell SM. Anterior cruciate ligament reconstruction: principles of treatment. EFORT Open Rev 2016;398-408. DOI: 10.1302/2058-5241.1.160032.
Marx as a Food Theorist
Authors: Foster John Bellamy
Published: December 2016

Food has become a core contradiction of contemporary capitalism. Discussions of the economics and sociology of food and food regimes seem to be everywhere today, with some of the most important contributions made by Marxian theorists. Amid plentiful food production, hunger remains a chronic problem, and food security is now a pressing concern for many of the world's people.… Despite the severity of these problems and their integral relation to the capitalist commodity system, it is generally believed that Karl Marx himself contributed little to our understanding of food…. [Yet] food for Marx was far more than a "passing interest": in his work one finds analyses of the development of agriculture in different modes of production; climate and food cultivation; the chemistry of the soil; industrial agriculture; livestock conditions; new technologies in food production and preparation; toxic additives in food products; food security; and much more. Moreover, these issues are not peripheral, but organically connected to Marx's larger critique of capitalism.Click here to purchase a PDF version of this article at the Monthly Review website.
Vietnam and the Sixties: A Personal History
Authors: Ehrhart W. D.
Published: December 2016

In early 1970, Vice President Spiro Agnew had this to say about the so-called '60s Generation: "As for these deserters, malcontents, radicals, incendiaries, the civil and the uncivil disobedients among our youth, SDS, PLP, Weathermen I and Weathermen II, the revolutionary action movement, the Black United Front, Yippies, Hippies, Yahoos, Black Panthers, Lions, and Tigers alike—I would swap the whole damn zoo for a single platoon of the kind of young Americans I saw in Vietnam." This is a fascinating statement for multiple reasons and on multiple levels. To begin with, a single platoon of the kind of young Americans he saw in Vietnam went into a village we remember as My Lai and murdered 407 unarmed men, women, and children. On the same day, in the nearby village of My Khe, another unit of the same division murdered an estimated 97 additional Vietnamese civilians. While I personally did not participate in or witness killing on that scale, I and my fellow Marines routinely killed, maimed, and abused Vietnamese on a near-daily basis, destroying homes, fields, crops, and livestock with every weapon available to us, from rifles and grenades to heavy artillery and napalm.… It is no wonder, it turns out, that Agnew should be so fond of "the kind of young Americans" he saw in Vietnam, since he himself turned out to be a criminal who was forced to resign from his office in public disgrace.Click here to purchase a PDF version of this article at the Monthly Review website.