The relationship between trapezium union, CMC joint instability and function following pollicisation

Forty-four pollicisations were assessed radiologically for union and stability of the trapezium as well as for stability of the carpometacarpal (CMC) joint. These parameters were compared with conventional clinical measures for strength, range of motion and function. The union rate of the trapezium was 82%. For those with non-union, the relative risk of trapezial instability was 35.0. Patients with trapezial union demonstrated significantly higher grip strength. For those with union, the relative risk of instability at the CMC joint was 1.4. Those with a stable CMC joint demonstrated significantly higher grip strength and functional results. This study suggests that the aim of obtaining union of the new trapezium is of benefit in the procedure of pollicisation

A novel radiochemical approach to 1-(2 '-deoxy-2 '-[F-18] fluoro-beta-D-arabinofuranosyl)cytosine (F-18-FAC)

18F-FAC (1-(2'-deoxy-2'-[18F]fluoro-β-D-arabinofuranosyl)-cytosine) is an important 2'-fluoro-nucleoside-based positron emission tomography (PET) tracer that has been used for in vivo prediction of response to the widely used cancer chemotherapy drug gemcitabine. Previously reported synthetic routes to 18F-FAC have relied on early introduction of the 18F radiolabel prior to attachment to protected cytosine base. Considering the 18F radiochemical half-life (110 min) and the technical challenges of multi-step syntheses on PET radiochemistry modular systems, late-stage radiofluorination is preferred for reproducible and reliable radiosynthesis with in vivo applications. Herein, we report the first late-stage radiosynthesis of 18F-FAC. Cytidine derivatives with leaving groups at the 2'-position are particularly prone to undergo anhydro side-product formation upon heating because of their electron density at the 2-carbonyl pyrimidone oxygen. Our rationally developed fluorination precursor showed an improved reactivity-to-stability ratio at elevated temperatures. 18F-FAC was obtained in radiochemical yields of 4.3–5.5% (n = 8, decay-corrected from end of bombardment), with purities ≥98% and specific activities ≥63 GBq/µmol. The synthesis time was 168 min

The Evolution of Management Models: A Neo-Schumpeterian Theory

In the last century and a half, U.S. industry has seen the emergence of several different management models. We propose a theory of this evolution based on three nested and interacting processes. First, we identify several successive waves of technological revolution, each of which prompted a corresponding wave of change in the dominant organizational paradigm. Second, nested within these waves, each of these organizational paradigms emerged through two successive cycles—a primary cycle that generated a new management model making the prior organizational paradigm obsolete, and a secondary cycle that generated another model that mitigated the dysfunctions of the primary cycle’s model. Third, nested within each cycle is a problem-solving process in which each model’s development passed through four main phases: (1) identification of a widespread organizational and management problem, (2) creation of innovative managerial concepts that offer various solutions to this problem, (3) emergence and theorization of a new model from among these concepts, and (4) dissemination and diffusion of this model. By linking new models’ emergence to specific technological revolutions, we can explain changes in their contents. By integrating a dialectical account of the paired cycles with an account of the waves of paradigm change, we can see how apparently competing models are better understood as complementary pairs in a common paradigm. And by unpacking each model’s phases of development, we can identify the roles played by various actors and management concepts in driving change in the models’ contents and see the agency behind these structural changes

Test of time. A case study in the functioning of social systems as a defence against anxiety. Rereading 50 years on

In this paper I revisit Isabel Menzies’s classic ‘nursing paper’ (I.E.P. Menzies [1960]. A case-study in the functioning of social systems as a defence against anxiety: A report on a study of the nursing service of a general hospital. Human Relations, 13, 95—121). I outline the main findings of the paper and connect it to the major theoretical developments made by the Tavistock Institute of Human Relations and consider the current relevance of the paper in the contemporary field of health and social care

The Rise and Fall of Autonomous Group Working in the British Coal Mining Industry

The group organization of work in the British coal mining industry brought to the workers involved significant levels of autonomy; the ability to define the social relations of work; high levels of control over the labor process; and a strong and lasting commitment - to the group. This autonomy was to survive a series of managerial attacks, in the form of changed payment systems and the introduction of new technologies, and was not finally lost until the imposition of full automation that included surveillance systems that made the labor process transparent.Peer reviewe