Acetabular components in total hip arthroplasty: is there evidence that cementless fixation is better?

BACKGROUND: The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade. Most total hip arthroplasties being performed in North America currently use cementless acetabular components. The objective of this systematic review and meta-analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty. METHODS: A primary literature search in PubMed identified 3488 articles, of which 3407 did not meet the inclusion criteria and were excluded. Only English-language articles on either the survivorship or revision rate of primary total hip arthroplasty at a minimum of ten years of follow-up were included. The present study analyzed forty-five articles reporting the long-term outcome of cementless acetabular components, twenty-nine reporting the outcome of cemented acetabular components, and seven comparing cemented and cementless acetabular components. Meta-analysis (with a random-effects model) was performed on the data from the seven comparative studies, and study-level logistic regression analysis (with a quasibinomial model) was performed on the pooled data on the eighty-one included articles to determine a consensus. The studies were weighted according to the number of total hip arthroplasties performed. RESULTS: The meta-analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate. The regression analysis revealed the estimated odds ratio for survivorship of a cemented acetabular component to be 1.60 (95% confidence interval, 1.32 to 2.40; p = 0.002) when adjustments for factors including age, sex, and mean duration of follow-up were made. CONCLUSIONS: The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence. Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components, the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade

The relationship between the perception of distributed leadership in secondary schools and teachers' and teacher leaders' job satisfaction and organizational commitment

This study investigates the relation between distributed leadership, the cohesion of the leadership team, participative decision-making, context variables, and the organizational commitment and job satisfaction of teachers and teacher leaders. A questionnaire was administered to teachers and teacher leaders (n=1770) from 46 large secondary schools. Multiple regression analyses and path analyses revealed that the study variables explained significant variance in organizational commitment. The degree of explained variance for job satisfaction was considerably lower compared to organizational commitment. Most striking was that the cohesion of the leadership team and the amount of leadership support was strongly related to organizational commitment, and indirectly to job satisfaction. Decentralization of leadership functions was weakly related to organizational commitment and job satisfaction

Advanced Techniques for Search-Based Program Repair

Debugging and repairing software defects costs the global economy hundreds of billions of dollars annually, and accounts for as much as 50% of programmers' time. To tackle the burgeoning expense of repair, researchers have proposed the use of novel techniques to automatically localise and repair such defects. Collectively, these techniques are referred to as automated program repair. Despite promising, early results, recent studies have demonstrated that existing automated program repair techniques are considerably less effective than previously believed. Current approaches are limited either in terms of the number and kinds of bugs they can fix, the size of patches they can produce, or the programs to which they can be applied. To become economically viable, automated program repair needs to overcome all of these limitations. Search-based repair is the only approach to program repair which may be applied to any bug or program, without assuming the existence of formal specifications. Despite its generality, current search-based techniques are restricted; they are either efficient, or capable of fixing multiple-line bugs---no existing technique is both. Furthermore, most techniques rely on the assumption that the material necessary to craft a repair already exists within the faulty program. By using existing code to craft repairs, the size of the search space is vastly reduced, compared to generating code from scratch. However, recent results, which show that almost all repairs generated by a number of search-based techniques can be explained as deletion, lead us to question whether this assumption is valid. In this thesis, we identify the challenges facing search-based program repair, and demonstrate ways of tackling them. We explore if and how the knowledge of candidate patch evaluations can be used to locate the source of bugs. We use software repository mining techniques to discover the form of a better repair model capable of addressing a greater number of bugs. We conduct a theoretical and empirical analysis of existing search algorithms for repair, before demonstrating a more effective alternative, inspired by greedy algorithms. To ensure reproducibility, we propose and use a methodology for conducting high-quality automated program research. Finally, we assess our progress towards solving the challenges of search-based program repair, and reflect on the future of the field

Gender politics in 21st century literacy reform

From 2001 to 2004 Education Queensland undertook significant literacy reform in schools through the Literate Futures Project. Research into the impact of this reform has revealed that significant demands were placed on women at all levels, from those producing resources to those leading change within schools. Although the reform was a government response to globalisation, many women were driven by a commitment to a collaborative approach to professional learning that addressed equity and improving educational outcomes for all students. But what was the cost of this commitment to the project? Failure to acknowledge the emotion work demanded by educational reform effectively silences women and the significant contribution they make. This paper examining a 21st century literacy reform draws on the work of Fraser and Boler to argue for gender justice and acknowledgement of emotion work

Teacher quality in the twenty first century: new lives, old truths

This chapter is based upon a keynote address to the first global teacher education summit, organised by Beijing Normal University in 2011, in which research across the world about influences which affect teachers' sense of professional identity, capacity for compassion, commitment, resilience and effectiveness long after they have graduated from their pre-service education and training programmes in universities and colleges were shared. The findings suggest that teaching pre-service students about how the conditions in which they work may enhance or diminish their capacity to teach to their best and how they might act to mediate these is a key part of the work of all teacher educators and an important focus for the work of educational researchers

How do ecological perspectives help understand schools as sites for teacher learning?

Schools are sites of teachers’ professional learning for both new entrants and experienced practitioners. In this paper, schools are conceptualised as complex, multidimensional ecologies that are constituted by the relations that exist between school leaders, teachers, mentors and all members of the school community. As relational environments, the conditions affecting professional learning – both formal and informal – are constantly dynamic, with multiple and simultaneous interactions taking place between these stakeholders. Interactions are also multi-layered – between the school system, individuals, classrooms, the community and the policy environment. School leaders are a major influence on these dynamics and affect how schools act as sites of professional formation, mediating external policy as well as affecting micro-dynamics within individual school systems. The challenge of realising professional learning within these relational contexts can be viewed as a ‘wicked problem’, a feature of complex systems that resists simplified solutions. In conceptualising a complex ecology at work, we illuminate the relational dynamics with a focus, for all stakeholders within schools, including leaders, on the need to recognise and value the importance of ‘emergence’ in professional learning. This means embracing inevitable uncertainty as a feature of schools as complex systems

α-conotoxin GI triazole-peptidomimetics: potent and stable blockers of a human acetylcholine receptor

The potency and selectivity of conotoxin peptides for neuropathic receptors has made them attractive lead compounds in the development of new therapeutics. Specifically, α-conotoxin GI has been shown to be an unparalleled antagonist of the nicotinic acetylcholine receptor (nAChR). However, as with other peptidic leads, poor protease resistance and the redox instability of the conotoxin scaffold limit bioactivity. To counter this, we have employed the underutilised 1,5-disubstituted 1,2,3-triazole to act as a structural surrogate of the native disulfide bonds. Using an efficient, on-resin ruthenium azide-alkyne cycloaddition (RuAAC), each disulfide bond was replaced in turn and the biological activities quantified. One of the mimetic isomers exhibited a comparable activity to the native toxin, while the other showed no biological effect. The active mimetic isomer 11 was an order of magnitude more stable in plasma than the native GI. The NMR solution structure of the mimetic overlays extremely well with the structure for the native GI demonstrating that the triazole bridge is an exceptional surrogate for the disulfide bridge. Development of this potent and stable mimetic of GI leads us to believe that this strategy will yield many other new conotoxin-inspired probes and therapeutics

Exploring the role of curriculum materials in teacher professional development

Curriculum materials (schemes of work, lesson plans, etc.) play a complex and pivotal role in school and teacher practices. The adaptation and development of curriculum materials often constitute part of teacher professional development (PD) activities. However, compared with research examining the relationship between PD and teacher professional change, the role of curriculum materials in professional learning remains under-researched and under-theorised. We address this gap by applying a multi-perspectival approach to data from a PD programme in which teachers were supported to develop curriculum materials. We use an interconnected model to analyse the role of curriculum materials in catalysing change in individual teachers’ practice. Our use of Boundary Theory proposes that curriculum material adoption is mediated by the solidity of boundaries between school practice and research findings, and Actor-Network Theory perspectives examine the assemblage of networked relations within and beyond schools that are entangled in curriculum materials. We highlight how combining linear and non-linear perspectives may contribute to improved understanding of the complexity of supporting teachers’ learning and use our analyses to outline implications of using curriculum materials in teacher professional development