Clinically insignificant association between anterior knee pain and patellofemoral lesions which are found incidentally.

Patellofemoral chondral lesions are frequently identified incidentally during the arthroscopic treatment of other knee pathologies. A role has been described for arthroscopic debridement of such lesions when symptoms are known to originate from pathology of the patellofemoral joint. However, it remains unclear how to manage lesions which are found incidentally whilst tackling other pathologies. The purpose of this study was to establish the strength of association between anterior knee pain and patellofemoral lesions identified incidentally in a typical arthroscopic population. A consecutive series of patients undergoing arthroscopy for a range of standard indications formed the basis of this cross section study. We excluded those with patellofemoral conditions in order to identify patellofemoral lesions which were solely incidental. Pre-operative assessments were performed on 64 patients, where anterior knee pain was sought by three methods: an annotated photographic knee pain map (PKPM), patient indication with one finger and by palpated tenderness. A single surgeon, who was blinded to previous recordings, performed standard arthroscopies and recorded patellofemoral lesions. Statistical correlations were performed to identify the association magnitude. Associations were identified between incidental patellofemoral lesions and tenderness palpated on the medial patella (P=0.007, χ2=0.32) and the quadriceps tendon (P=0.029, χ2=0.26), but these associations were at best fair, which could be interpreted as clinically insignificant. In which case incidental patellofemoral lesions are not necessarily associated with anterior knee pain, we suggest that they could be left alone. This recommendation is only applicable to patellofemoral lesions which are found incidentally whilst addressing other pathology

Validation of an electrogoniometry system as a measure of knee kinematics during activities of daily living

Purpose: The increasing use of electrogoniometry (ELG) in clinical research requires the validation of different instrumentation. The purpose of this investigation was to examine the concurrent validity of an ELG system during activities of daily living. Methods: Ten asymptomatic participants gave informed consent to participate. A Biometrics SG150 electrogoniometer was directly compared to a 12 camera three dimensional motion analysis system during walking, stair ascent, stair descent, sit to stand, and stand to sit activities for the measurement of the right knee angle. Analysis of validity was undertaken by linear regression. Standard error of estimate (SEE), standardised SEE (SSEE), and Pearson’s correlation coefficient r were computed for paired trials between systems for each functional activity. Results: The 95% confidence interval of SEE was reasonable between systems across walking (LCI = 2.43 °; UCI = 2.91 °), stair ascent (LCI = 2.09 °; UCI = 2.42 °), stair descent (LCI = 1.79 °; UCI = 2.10 °), sit to stand (LCI = 1.22 °; UCI = 1.41 °), and stand to sit (LCI = 1.17 °; UCI = 1.34 °). Pearson’s correlation coefficient r across walking (LCI = 0.983; UCI = 0.990), stair ascent (LCI = 0.995; UCI = 0.997), stair descent (LCI = 0.995; UCI = 0.997), sit to stand (LCI = 0.998; UCI = 0.999), and stand to sit (LCI = 0.996; UCI = 0.997) was indicative of a strong linear relationship between systems. Conclusion: ELG is a valid method of measuring the knee angle during activities representative of daily living. The range is within that suggested to be acceptable for the clinical evaluation of patients with musculoskeletal conditions

Assessing Needs and Outcomes of Children and Youth Receiving Intensive Services

This study investigated whether children/youth in Ontario triaged to residential services showed a higher intensity of need than those referred to outpatient services, and whether residential treatment gains were sufficient for transition to community services. Participants included 2053 children/youth assessed at 23 diverse mental health agencies across Ontario using the interRAI™ Child and Youth Mental Health (ChYMH) instrument. Various presenting problems were examined utilizing scales including: Disruptive/Aggressive Behavior, Hyperactive/Distraction, Social Disengagement, Anxiety, and Sleep Difficulties. Analyses were conducted separately for boys and girls. Notable differences were found in the initial assessment, with residential boys scoring higher on all scales than outpatient boys, and residential girls scoring higher on the externalizing scales (Disruptive/Aggressive Behavior, Hyperactive/Distraction) than outpatient girls. Treatment gains at residential discharge included improvements in Anxiety, Social Disengagement, Hyperactive/Distraction and Sleep Difficulties for boys and girls to levels at or below the initial scores of outpatient peers. Disruptive/Aggressive Behavior is still a high need following residential services. The results highlight differences in severity of mental health presentation between children/youth receiving residential and outpatient services, and how multiple agencies in Ontario are providing services that successfully reduce the severity of mental health needs

Dedication Remarks

A selection of speeches given at the dedication of the newly built Law Library

Radiocarbon dates for coastal midden sites at Long Point in the Coorong, South Australia

This paper presents 29 radiocarbon dates from eight surface concentrations of shell and 10 test-pits across four shell middens at Long Point in the Coorong, South Australia. Results indicate that occupation of these sites was confined to the late Holocen

The formyl peptide fMLF primes platelet activation and augments thrombus formation

Formyl peptide receptors (FPRs) play pivotal roles in the regulation of innate immunity and host defence. FPRs include three family members; FPR1, FPR2/ALX and FPR3. The activation of FPR1 by its high affinity ligand, N‐formyl‐methionyl‐leucyl‐phenylalanine (fMLF) (a bacterial chemoattractant peptide), triggers intracellular signalling in immune cells such as neutrophils and exacerbates inflammatory responses to accelerate the clearance of microbial infection. Notably, fMLF has been demonstrated to induce intracellular calcium mobilisation and chemotaxis in platelets that are known to play significant roles in the regulation of innate immunity and inflammatory responses. Despite a plethora of research focused on the roles of FPR1 and its ligands such as fMLF on the modulation of immune responses, their impact on the regulation of haemostasis and thrombosis remains unexplored

Direct radiocarbon dating of fish otoliths from mulloway (Argyrosomus japonicus) and black bream (Acanthopagrus butcheri) from Long Point, Coorong, South Australia

Accelerator Mass Spectrometry (AMS) radiocarbon dates (n=20) determined on fish otoliths from mulloway (Argyrosomus japonicus) and black bream (Acanthopagrus butcheri) are reported from five sites at Long Point, Coorong, South Australia. The dates range from 2938–2529 to 326–1 cal. BP, extending the known period of occupation of Long Point. Previous dating at the sites indicated intensive occupation of the area from 2455–2134 cal. BP. Results provide a detailed local chronology for the region, contributing to a more comprehensive understanding of Aboriginal use of Ngarrindjeri lands and waters. This study validates the use of fish otoliths for radiocarbon dating and reveals how dating different materials can result in different midden chronologies

Eddy-mediated transport of warm Circumpolar Deep Water across the Antarctic Shelf Break

The Antarctic Slope Front (ASF) modulates ventilation of the abyssal ocean via the export of dense Antarctic Bottom Water (AABW) and constrains shoreward transport of warm Circumpolar Deep Water (CDW) toward marine-terminating glaciers. Along certain stretches of the continental shelf, particularly where AABW is exported, density surfaces connect the shelf waters to the middepth Circumpolar Deep Water offshore, offering a pathway for mesoscale eddies to transport CDW directly onto the continental shelf. Using an eddy-resolving process model of the ASF, the authors show that mesoscale eddies can supply a dynamically significant transport of heat and mass across the continental shelf break. The shoreward transport of surface waters is purely wind driven, while the shoreward CDW transport is entirely due to mesoscale eddy transfer. The CDW flux is sensitive to all aspects of the model's surface forcing and geometry, suggesting that shoreward eddy heat transport may be localized to favorable sections of the continental slope