bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tantalum cones for major osteolysis in revision knee replacement
Authors: Rao B. M. , Kamal T. T. , Vafaye J. , Moss M. 
Published: August 2013

We report the results of revision total knee replacement (TKR) in 26 patients with major metaphyseal osteolytic defects using 29 trabecular metal cones in conjunction with a rotating hinged total knee prosthesis. The osteolytic defects were types II and III (A or B) according to the Anderson Orthopaedic Research Institute (AORI) classification. The mean age of the patients was 72 years (62 to 84) and there were 15 men and 11 women. In this series patients had undergone a mean of 2.34 previous total knee arthroplasties. The main objective was to restore anatomy along with stability and function of the knee joint to allow immediate full weight-bearing and active knee movement. Outcomes were measured using Knee Society scores, Oxford knee scores, range of movement of the knee and serial radiographs. Patients were followed for a mean of 36 months (24 to 49). The mean Oxford knee clinical scores improved from 12.83 (10 to 15) to 35.20 (32 to 38) (p < 0.001) and mean American Knee Society scores improved from 33.24 (13 to 36) to 81.12 (78 to 86) (p < 0.001). No radiolucent lines suggestive of loosening were seen around the trabecular metal cones, and by one year all the radiographs showed good osteo-integration. There was no evidence of any collapse or implant migration. Our early results confirm the findings of others that trabecular metal cones offer a useful way of managing severe bone loss in revision TKR.Cite this article: Bone Joint J 2013;95-B:1069–74.
The role of osteoblasts in peri-prosthetic osteolysis
Authors: O’Neill S. C. , Queally J. M. , Devitt B. M. , Doran P. P. , O’Byrne J. M. 
Published: August 2013

Peri-prosthetic osteolysis and subsequent aseptic loosening is the most common reason for revising total hip replacements. Wear particles originating from the prosthetic components interact with multiple cell types in the peri-prosthetic region resulting in an inflammatory process that ultimately leads to peri-prosthetic bone loss. These cells include macrophages, osteoclasts, osteoblasts and fibroblasts. The majority of research in peri-prosthetic osteolysis has concentrated on the role played by osteoclasts and macrophages. The purpose of this review is to assess the role of the osteoblast in peri-prosthetic osteolysis.In peri-prosthetic osteolysis, wear particles may affect osteoblasts and contribute to the osteolytic process by two mechanisms. First, particles and metallic ions have been shown to inhibit the osteoblast in terms of its ability to secrete mineralised bone matrix, by reducing calcium deposition, alkaline phosphatase activity and its ability to proliferate. Secondly, particles and metallic ions have been shown to stimulate osteoblasts to produce pro inflammatory mediators in vitro. In vivo, these mediators have the potential to attract pro-inflammatory cells to the peri-prosthetic area and stimulate osteoclasts to absorb bone. Further research is needed to fully define the role of the osteoblast in peri-prosthetic osteolysis and to explore its potential role as a therapeutic target in this condition.Cite this article: Bone Joint J 2013;95-B:1021–5.
Serial magnetic resonance imaging of metal-on-metal total hip replacements
Authors: Ebreo D. , Bell P. J. , Arshad H. , Donell S. T. , Toms A. , Nolan J. F. 
Published: August 2013

Metal artefact reduction (MAR) MRI is now widely considered to be the standard for imaging metal-on-metal (MoM) hip implants. The Medicines and Healthcare Products Regulatory Agency (MHRA) has recommended cross-sectional imaging for all patients with symptomatic MoM bearings. This paper describes the natural history of MoM disease in a 28 mm MoM total hip replacement (THR) using MAR MRI. Inclusion criteria were patients with MoM THRs who had not been revised and had at least two serial MAR MRI scans. All examinations were reported by an experienced observer and classified as A (normal), B (infection) or C1–C3 (mild, moderate, severe MoM-related abnormalities). Between 2002 and 2011 a total of 239 MRIs were performed on 80 patients (two to four scans per THR); 63 initial MRIs (61%) were normal. On subsequent MRIs, six initially normal scans (9.5%) showed progression to a disease state; 15 (15%) of 103 THRs with sequential scans demonstrated worsening disease on subsequent imaging. Most patients with a MoM THR who do not undergo early revision have normal MRI scans. Late progression (from normal to abnormal, or from mild to more severe MoM disease) is not common and takes place over several years. Cite this article: Bone Joint J 2013;95-B:1035–9.
Outcome of soft-tissue sarcoma patients who were alive and event-free more than five years after initial treatment
Authors: Nakamura T. , Grimer R. J. , Carter S. R. , Tillman R. M. , Abudu A. , Jeys L. , Sudo A. 
Published: August 2013

We evaluated the risk of late relapse and further outcome in patients with soft-tissue sarcomas who were alive and event-free more than five years after initial treatment. From our database we identified 1912 patients with these pathologies treated between 1980 and 2006. Of these 1912 patients, 603 were alive and event-free more than five years after initial treatment and we retrospectively reviewed them. The mean age of this group was 48 years (4 to 94) and 340 were men. The mean follow-up was 106 months (60 to 336). Of the original cohort, 582 (97%) were alive at final follow-up. The disease-specific survival was 96.4% (95% confidence interval (CI) 94.4 to 98.3) at ten years and 92.9% (95% CI 89 to 96.8) at 15 years. The rate of late relapse was 6.3% (38 of 603). The ten- and 15-year event-free rates were 93.2% (95% CI 90.8 to 95.7) and 86.1% (95% CI 80.2 to 92.1), respectively. Multivariate analysis showed that tumour size and tumour grade remained independent predictors of events. In spite of further treatment, 19 of the 38 patients died of sarcoma. The three- and five-year survival rates after the late relapse were 56.2% (95% CI 39.5 to 73.3) and 43.2% (95% CI 24.7 to 61.7), respectively, with a median survival time of 46 months. Patients with soft-tissue sarcoma, especially if large, require long-term follow-up, especially as they have moderate potential to have their disease controlled. Cite this article: Bone Joint J 2013;95-B:1139–43.
Do intervertebral discs degenerate before they herniate, or after?
Authors: Lama P. , Le Maitre C. L. , Dolan P. , Tarlton J. F. , Harding I. J. , Adams M. A. 
Published: August 2013

The belief that an intervertebral disc must degenerate before it can herniate has clinical and medicolegal significance, but lacks scientific validity. We hypothesised that tissue changes in herniated discs differ from those in discs that degenerate without herniation. Tissues were obtained at surgery from 21 herniated discs and 11 non-herniated discs of similar degeneration as assessed by the Pfirrmann grade. Thin sections were graded histologically, and certain features were quantified using immunofluorescence combined with confocal microscopy and image analysis. Herniated and degenerated tissues were compared separately for each tissue type: nucleus, inner annulus and outer annulus. Herniated tissues showed significantly greater proteoglycan loss (outer annulus), neovascularisation (annulus), innervation (annulus), cellularity/inflammation (annulus) and expression of matrix-degrading enzymes (inner annulus) than degenerated discs. No significant differences were seen in the nucleus tissue from herniated and degenerated discs. Degenerative changes start in the nucleus, so it seems unlikely that advanced degeneration caused herniation in 21 of these 32 discs. On the contrary, specific changes in the annulus can be interpreted as the consequences of herniation, when disruption allows local swelling, proteoglycan loss, and the ingrowth of blood vessels, nerves and inflammatory cells. In conclusion, it should not be assumed that degenerative changes always precede disc herniation. Cite this article: Bone Joint J 2013;95-B:1127–33.
Internal fixation of radiation-induced pathological fractures of the femur has a high rate of failure
Authors: Sternheim A. , Saidi K. , Lochab J. , O’Donnell P. W. , Eward W. C. , Griffin A. , Wunder J. S. , Ferguson P. 
Published: August 2013

We investigated the clinical outcome of internal fixation for pathological fracture of the femur after primary excision of a soft-tissue sarcoma that had been treated with adjuvant radiotherapy. A review of our database identified 22 radiation-induced fractures of the femur in 22 patients (seven men, 15 women). We noted the mechanism of injury, fracture pattern and any complications after internal fixation, including nonunion, hardware failure, secondary fracture or deep infection. The mean age of the patients at primary excision of the tumour was 58.3 years (39 to 86). The mean time from primary excision to fracture was 73.2 months (2 to 195). The mean follow-up after fracture fixation was 65.9 months (12 to 205). Complications occurred in 19 patients (86%). Nonunion developed in 18 patients (82%), of whom 11 had a radiological nonunion at 12 months, five a nonunion and hardware failure and two an infected nonunion. One patient developed a second radiation-associated fracture of the femur after internal fixation and union of the initial fracture. A total of 13 patients (59%) underwent 24 revision operations. Internal fixation of a pathological fracture of the femur after radiotherapy for a soft-tissue sarcoma has an extremely high rate of complication and requires specialist attention. Cite this article: Bone Joint J 2013;95-B:1144–8.
Analyzing City Hall, Villa and Tunnel in Amman: The Failures of Cultural Amalgamation at the Turn of the Twentieth Century
Authors: Sakr Yasir 
Published: August 2013

Abstract
This essay narrates the ‘cultural amalgamation’ of the Greater City of Amman, the capital of Jordan, undertaken by its municipality during the last two decades of the twentieth century. The study delineates the various dynamics, actors, agendas and tools that defined the amalgamation process as a ‘discourse’. Deconstructing this discourse, this study highlights the critical role of ‘monuments’ and architects in shaping the municipal endeavour in order to consolidate a civic identity and culture for the sprawling city of Amman. Particular emphasis is given to the peculiar interaction between the symbolic and the utilitarian tools of the amalgamation process, represented by the ‘City Hall’, ‘Villa’ and ‘Tunnel/Bridge intersection’, which lead to the problematic outcome investigated here.
Abu Dhabi Forms and Fragments: Muslim Space and the Modern City
Authors: El-Amrousi Mohamed , Biln John 
Published: August 2013

Abstract
The urban reshaping of Abu Dhabi incorporates monumental construction projects as part of a larger government-sponsored strategy of economic and cultural development outlined in the Abu Dhabi 2030 plan. Once the salient features of several of the most important recent monuments in Abu Dhabi are understood, however, it becomes clear that their power cannot be reduced to a simple effect of an urban development policy. Indeed, these works can be interpreted as examples of a conscious semiotic strategy of ‘gathering’ identifiable architectural forms of major Muslim monuments from around the world into a single location, a new ‘centre’ of a multi-ethnic community that incorporates ‘Islamic’ arts and crafts across geographic boundaries from Moorish Spain to Mughal India. In order to appreciate the implications of this building programme, attention must be given to the history and built heritage of Abu Dhabi as an emerging modern city seeking a unique identity among neighbouring Gulf State cities. This article investigates the emergence of revived forms in selected congregational mosques in Abu Dhabi that are open for visits to both Muslims and non-Muslims. The Qubbat As-Sakhrah Mosque in Abu Dhabi, which is an exact replica of the original in Jerusalem; the Sheikh Zayed Grand Mosque in Abu Dhabi with undeniable references to the Taj Mahal; and the Sheikh Zayed Mosque in Fujairah, which mimics the Sultan Ahmet Mosque in Istanbul, none of which were designed by star architects, are investigated in this article as manifestations of collagist practices that serve to reinforce a projected sense of community in the United Arab Emirates.
Reconstructing Afghanistan: An Architecture Curriculum for a ‘New Way of Life’
Authors: Sawruk Theodore 
Published: August 2013

Abstract
Afghanistan is a country rich in culture and history, but also one devastated by decades of war. The destruction extends beyond cities to include the social, economic and educational constructs of life. In 2008, the University of Hartford was awarded a $1.33 million grant to help re-establish the engineering facilities at Herat University. The grant mission also facilitated the creation of a new achitectural programme to address the growing needs of contemporary Afghanistan. Over the next three years, scholars worked to forge an innovative curriculum, one that melds the historic traditions of a centuries-old city with the contemporary needs of a western-style Islamic society.
When the ideally conceived curriculum was finally taken to Herat University for approval and implementation, a new and harsher reality emerged. This article chronicles the events that reshaped the proposed curriculum. It relays how the current state of the profession, cultural traditions, gender bias and economic realities came to bear on the development of this new programme, and how western preconceptions were revised by local realities. Finally, it documents how the melding of these realities supplanted initial utopian agendas in the creation of a more viable, integrated curriculum that supports an evolving, unique and contemporary architectural identity.
Exhibition Reviews
Authors: Hartmuth Maximilian , Forberg Corinna , Movassat Johanna Domela 
Published: August 2013

Abstract
‘The Closing of the Zemaljski Muzej’, Sarajevo, Bosnia-Herzegovina, Since October 15, 2012
‘Samarra: Centre of the World. 101 Years of Archaeological Research on the Tigris Museum’ Für Islamische Kunst, Staatliche Museen Zu Berlin, January 18–May 26, 2013
‘The Jameel Prize: Art Inspired by Islamic Tradition’, Cantor Arts Center at Stanford University, December 12, 2012–March 10, 2013
When Does Inter-School Competition Matter? Evidence from the Chilean “Voucher” System
Authors: Gallego Francisco 
Published: August 2013

Abstract
I investigate the effects of voucher-school competition on educational outcomes. I test whether voucher-school competition (1) improves student outcomes and (2) has stronger effects when public schools face a hard-budget constraint. Since both voucher-school competition and the degree of hardness of the budget constraint for public schools are endogenous to public school quality, I exploit (i) the interaction of the number of Catholic priests in 1950 and the institution of the voucher system in Chile in 1981 as a potentially exogenous determinant of the supply of voucher schools and (ii) a particular feature of the electoral system that affects the identity of the mayors of different counties (who manage public schools) as a source of exogenous variation in the degree of hardness of the public schools’ budget constraints. Using this information, I find that (1) an increase of one standard deviation of the ratio of voucher-to-public schools increases test scores by just around 0.10 standard deviations; and (2) the effects are significantly bigger for public schools facing more binding minimum enrollment levels.
Chemerin is expressed mainly in pancreas and liver, is regulated by energy deprivation, and lacks day/night variation in humans
Authors: Chamberland John P , Berman Reena L , Aronis Konstantinos N , Mantzoros Christos S 
Published: August 2013

ObjectiveChemerin is an adipocyte-secreted hormone and has recently been associated with obesity and the metabolic syndrome. Although studies in rodents have outlined the aspects of chemerin's function and expression, its physiology and expression patterns are still to be elucidated in humans.MethodsTo evaluate for any day/night variation in chemerin secretion, we analyzed hourly serum samples from six females in the fed state. To examine whether energy deprivation affects chemerin levels, and whether this could be mediated through leptin, we analyzed samples from the same subjects in the fasting state while administering either placebo or leptin. To evaluate for any potential dose–effect relationship between leptin and chemerin, we administered increasing metreleptin doses to five females. A tissue array was used to study the expression of chemerin in different human tissues. Ex vivo treatment of human fat explants from three subjects with leptin was carried out to evaluate for any direct effect of leptin on adipocyte chemerin secretion.ResultsChemerin does not display a day/night variation, while acute energy deprivation resulted in a significant drop in circulating chemerin levels by ∼42%. The latter was unaltered by metreleptin administration, and leptin administration did not affect the secretion of chemerin by human adipose tissue studied ex vivo. Chemerin was expressed primarily in the pancreas and liver. Chemerin receptor showed increased expression in the lymph nodes and the spleen.ConclusionsWe outline for the first time chemerin expression and physiology in humans, which are different from those in mice.
The Molecular Genetics of Insecticide Resistance
Authors: ffrench-Constant Richard H 
Published: August 2013

Abstract
The past 60 years have seen a revolution in our understanding of the molecular genetics of insecticide resistance. While at first the field was split by arguments about the relative importance of mono- vs. polygenic resistance and field- vs. laboratory-based selection, the application of molecular cloning to insecticide targets and to the metabolic enzymes that degrade insecticides before they reach those targets has brought out an exponential growth in our understanding of the mutations involved. Molecular analysis has confirmed the relative importance of single major genes in target-site resistance and has also revealed some interesting surprises about the multi-gene families, such as cytochrome P450s, involved in metabolic resistance. Identification of the mutations involved in resistance has also led to parallel advances in our understanding of the enzymes and receptors involved, often with implications for the role of these receptors in humans. This Review seeks to provide an historical perspective on the impact of molecular biology on our understanding of resistance and to begin to look forward to the likely impact of rapid advances in both sequencing and genome-wide association analysis.
The Influence of Implant Diameter on Its Survival: A Meta‐Analysis Based on Prospective Clinical Trials
Authors: Ortega‐Oller Inmaculada , Suárez Fernando , Galindo‐Moreno Pablo , Torrecillas‐Martínez Laura , Monje Alberto , Catena Andrés , Wang Hom‐Lay 
Published: August 2013

Background: The use of narrow‐diameter implants has been proposed to restore small edentulous spans, thus avoiding extensive bone augmentation procedures and reducing the surgical complexity of implant rehabilitations. Although success rates of narrow‐diameter implants have already been analyzed in the literature, to the best of the authors’ knowledge, no meta‐analysis based on prospective and randomized controlled trials has been performed. The aim of this study is to analyze the survival rates of narrow‐diameter implants compared with standard or wide‐diameter implants.Methods: An electronic search from three databases and a hand search in implant‐related journals of studies published in English before September 1, 2012 were performed. Prospective human clinical studies with at least 10 implants and a follow‐up period of 1 year were included in the meta‐analysis. Implants were divided into two groups based on their diameters.Results: The initial search yielded 484 articles, of which 49 were evaluated in full text for eligibility. Finally, 16 studies were chosen and separated into two groups: 1) implants of diameter <3.3 mm (group 1) and 2) implants of diameter ≥3.3 mm (group 2). A meta‐analysis performed for groups 1 and 2 showed survival rates of 75% and 87%, respectively.Conclusions: This meta‐analysis showed that narrower implants (<3.3 mm) had significantly lower survival rates compared with wider implants (≥3.3 mm). Other variables, such as type of prosthesis, implant surface, and timing of prosthetic loading, were found to have influenced the implant survival rates.
Morphology of Optic Disc Through Heidelberg Retina Tomograph in Retinal Vein Occlusions Alone or in Combination with Primary Open Angle Glaucoma§
Authors: Actis Alessandro Guido , Belli Luca , Dall’orto Laura , Penna Rachele , Brogliatti Beatrice , Rolle Teresa 
Published: August 2013

Purpose:
To evaluate the morphology of optic discs in eyes suffering from retinal vein occlusion (RVO) alone or in combination with primary open-angle glaucoma (POAG).

Methods:
Prospective, observational study. 48 consecutive patients were enrolled, 30 with unilateral RVO diagnosis, 18 with unilateral retinal vein occlusion (RVO) associated with POAG. We divided RVOs on the basis of occlusion site: arterio-venous crossing (AV-RVO), optic cup (OC-RVO), optic nerve (ON-RVO) with head nerve swelling (ONHS-RVO) or without it (NONHS-RVO). A control group of 25 patients who were sex and age matched was selected.

Results:
Comparing the fellow eyes of the patients with RVO and control healthy eyes, no differences emerged in cup/disc ratio but they came out for the HRT values in Rim Area, cup shape measure and height variation contour (p<0.05).
The most frequent occlusion site was at the level of an arteriovenous crossing in patients not suffering from POAG (36.7%) and at the level of the optic cup in patients with RVO and POAG (50%). In the RVO group without POAG, the OC-RVO subgroup has shown an higher cup area (0.366±0.094) and cup/disc area ratio (0.184±0.063), a lower rim volume (0.374±0.021) and a different cup shape measure (-0.221±0.066) (p<0.05) compared with the AV and NONHS sites. Compared with NONHS group differences emerged also for the fibres parameters and in the height variation contour (0.346±0.081). Also in the RVO group with POAG significant differences (p<0.05) have been surveyed between OC-RVO and other occlusion sites in cup area (0.119±0.029), cup/disc area ratio (0.532±0.09), rim volume (0.374±0.07), cup/shape measure (-0.079±0.013).

Conclusions:
Classification of the analyzed parameters on the basis of the occlusion site provides a basis for which clinical decisions and research on causal factors in future studies can be based on.