A scoping review comparing two common surgical approaches to the hip for hemiarthroplasty

This is the final version. Available from the publisher via the DOI in this record.Background: Hemiarthroplasty for hip fracture is a common surgical procedure. A number of distinct approaches are used to access the hip joint. The most commonly used are the direct lateral approach (DLA), and the posterior approach (PA). Internationally there is little consensus on which of these approaches to use. Current guidance is based on a limited selection of evidence and choice of approach is frequently based on surgeon preference. Historically, recommendations have been made based on dislocation rates. In light of technical advancements and greater recognition of patient priorities, outcomes such as post-operative function and pain may be considered more important in the modern context. The aim of this scoping review was to summarise the literature pertaining to the comparison of common surgical approaches to the hip for hemiarthroplasty. Methods: A scoping review methodology was used to examine the range and nature of primary research. Using systematic methods we searched for studies that directly compared the DLA and PA. Studies reporting the following outcomes were considered; dislocation, mortality, pain, activities of daily living, functionality, health-related quality of life, length of stay, surgeon assessment of difficulty, and adverse events. MEDLINE, EMBASE and The Cochrane Library were searched. Relevant information was extracted and synthesis of the retrieved data followed a basic content analytical approach. Results: A total of 13 studies were retrieved: 12 observational studies and 1 randomised trial. The majority of studies were based at single sites. Larger observational studies using multi-site and national registry data have emerged in recent years. Reporting of technique and outcomes is inconsistent. A trend for higher rates of dislocation using the PA was observed and eight studies recommended the use of the DLA over the PA. Conclusions: This scoping review demonstrates that the existing evidence is highly heterogeneous in nature and not of a sufficient quality to inform practice recommendations. This issue would be best addressed by additional RCTs, and high quality national-level observational data. Standardisation of the recording of patient risk factors, surgical and post-operative intervention protocols, and outcomes in all study designs would strengthen the potential for valid comparison of future findings.National Institute for Health Research (NIHR

Offenders' motivation to change.

In this thesis, the Personal Concerns Inventory (PCI), a semi-structured interview based upon the Theory of Current Concerns (TCC), is adapted to measure offenders' motivation to change - the Personal Concerns Inventory: Offender Adaptation (PCI:OA). A literature review of treatment non-completion showed that non-completion was associated with increased recidivism and poor motivation is one possible reason for this. Assessment of motivation for treatment is, therefore, important The psychometric properties of the PCI:OA, a potential measure of motivation, are described. After a pilot study of the applicability of PCI:OA with 12 prisoners, 129 adult male prisoners were tested. The construct validity of the PCI:OA was found to be good, replicating the two factors found in the original PCI - adaptive motivation and maladaptive motivation. Test-retest correlations and internal consistency were poor. Concurrent validity was examined by correlating scores on the PCI:OA factors, the University of Rhode Island Change Assessment (a self-report measure of stage of change in therapy), the Treatment Motivation Questionnaire (a measure of the degree of internal and external motivation to enter treatment), and staff ratings of engagement. Only limited concurrent validity was found. The predictive validity of the PCI:OA was examined by survival analysis of factor scores against reconviction at mean 234 days post release. The PCI:OA factors did not predict reconviction. The concerns yielded from the PCI:OA interviews are described in a qualitative study. Finally, because the PCI:OA appeared to motivate offenders to address their problems, the PCI:OA was adapted to suit sex offenders refusing treatment (the PCI:OA (TR)). A pilot study of 18 male sex offenders showed that the treatment group were more likely to express a positive motivational shift than those who had not received the PCI:OA (TR). Overall, the PCI:OA has some potential to assess offenders' motivation to change, but further investigations of the PChOA's ability to predict who engages with treatment, makes gains from programmes, and changes their offending, are required

Γρηγόριος Παλαιολόγος (1793/4-1844): Επιστολική θεωρία και πράξη

Η παρούσα διδακτορική διατριβή πραγματεύεται το Επιστολάριον του Γρηγορίου Παλαιολόγου (1793/4-1844). Πρόκειται για έναν οδηγό συγγραφής επιστολών, που εκδόθηκε το 1843 στην Κωνσταντινούπολη και μέχρι το τέλος του 19ου αιώνα κυκλοφόρησε σε 22 εκδόσεις. Το Επιστολάριον θεωρήθηκε ως «πάρεργο» του συγγραφέα, σε σχέση με το προηγούμενο επιστημονικό και λογοτεχνικό του έργο, υπήρξε όμως τελικά το πιο δημοφιλές και το πιο ανθεκτικό στον χρόνο έργο του. Ο Παλαιολόγος έχοντας πολύ καλή γνώση και αξιοποιώντας την παράδοση των νεοελληνικών εγχειριδίων επιστολογραφίας, από τον Θεόφιλο Κορυδαλέα, τον Σπυρίδωνα Μίλια και τα βενετικά επιστολάρια του 18ου αιώνα μέχρι τα επιστολάρια των ημερών του, κατόρθωσε να εισαγάγει νεωτερικά στοιχεία στο είδος, αντλώντας ιδέες και από ξενόγλωσσα εγχειρίδια επιστολογραφίας της εποχής, κυρίως αγγλικά και γαλλικά. Στη μελέτη εξετάζεται η δομή και το περιεχόμενο του Επιστολαρίου· καταγράφεται η πορεία των εκδόσεών του, η εξέλιξη του κειμένου με την πάροδο των ετών και τις επεμβάσεις των διαφόρων εκδοτών του και επιχειρείται η χαρτογράφηση των σχέσεων εξάρτησης των διαφορετικών εκδόσεων· αναλύεται το κοινό στο οποίο απευθύνθηκε, με βάση τους συνδρομητές της πρώτης έκδοσης και τους ιδεατούς επιστολογράφους, όπως παρουσιάζονται στα υποδείγματα επιστολών που περιέχει. Επιπλέον, εξετάζονται αναλυτικά οι σχέσεις του Επιστολαρίου με την προγενέστερη παραγωγή, τόσο των ελληνικών όσο και πολλών ξενόγλωσσων επιστολαρίων, καθώς και η επίδραση που άσκησε στα μεταγενέστερα νεοελληνικά εγχειρίδια του είδους, επίδραση η οποία εντοπίζεται και σε βενετικές εκδόσεις ελληνικών επιστολαρίων του δεύτερου μισού του 19ου αιώνα, αλλά ακόμη και σε εγχειρίδια των πρώτων δεκαετιών του 20ού αιώνα. Τέλος, γίνεται συσχετισμός του Επιστολαρίου με το υπόλοιπο συγγραφικό έργο και την εν γένει δημόσια δράση του Παλαιολόγου, επιχειρείται ο εντοπισμός κοινών στοιχείων και μοτίβων στο Επιστολάριον και τα δύο μυθιστορήματά του (Ο Πολυπαθής, Ο Ζωγράφος), ενώ εξετάζεται και η δυνατότητα διαφορετικής χρήσης/ανάγνωσης του εγχειριδίου ως κάτι περισσότερο από ένα απλό εγχειρίδιο επιστολογραφίας, μέσω της ανάδειξης λογοτεχνικών χαρακτηριστικών και στοιχείων μυθοπλασίας που περιέχει. Από τα ευρήματα της εργασίας φαίνεται ότι ο Παλαιολόγος, χωρίς να απομακρυνθεί από το λογοτεχνικό του σύμπαν, κατάφερε να μετατρέψει την αλληλογραφία της «κοινωνίας» του Επιστολαρίου σε ένα κείμενο που μπορούσε όχι μόνο να χρησιμοποιηθεί ως οδηγός επιστολογραφίας, αλλά και να αναγνωστεί ως μια σπονδυλωτή επιστολική αφήγηση του βίου και της πολιτείας των ανώνυμων επιστολογράφων του, από την οποία, κατά περίπτωση, οι χρήστες, ταυτιζόμενοι με τους υποτιθέμενους επιστολογράφους, μπορούσαν να αντλήσουν επιστολογραφικές συμβουλές και οι αναγνώστες, αποστασιοποιούμενοι ως παρατηρητές, να έχουν την ευκαιρία να διαβάσουν για τις ζωές κάποιων άλλων. Η διατριβή πλαισιώνεται από εκτενή βιο-εργογραφική μελέτη για τον Παλαιολόγο, καθώς και από αναλυτική βιβλιογραφική καταγραφή των νεοελληνικών εγχειριδίων επιστολογραφίας από το 1625 έως τις αρχές του 20ού αιώνα.This dissertation is about a letter-writing manual, entitled Epistolarion, written by Gregorios Palaiologos (1793/4-1844), a Greek agriculturalist and author of two novels. The manual was published in Constantinople in 1843 and was reprinted at least 22 times until the end of the century, becoming the most popular Greek manual of the kind at the time, quite probably of all times. In examining the structure of the manual, the proposed letters, the instructions on how to write (and how to react) in any given circumstance, the dissertation aims to unfold the epistolary theory suggested by the Epistolarion author, which is, in many aspects, quite modern, introducing new ways and ideas regarding this kind of manuals, but also portraying the evolution of Greek society in the heart of the 19th century. Moreover, the dissertation aims to show the relation between the Epistolarion and the previous Greek letter-writing manuals, but also to discover what Palaiologos owes to such manuals written in other languages, mainly English and French. Furthermore, by tracing the course of the Epistolarion through the years in comparison to other Greek letter-writing manuals published after 1843, this thesis is tracing the big impact that the manual had to the ones that followed. Finally, in comparing the manual to the two novels of Palaiologos (O Polypathes, 1839; O Zografos, 1842) and in pointing out some fiction-like features of the Epistolarion itself, the treatise suggests that the manual, much like many books of the kind in Western European literature, is actually not in contrast to the previous fictive work of the author and could be both used as a letter-writing instruction manual and read as an epistolary fiction short-stories collection depicting a detailed picture of the society of the time. The dissertation includes an extended biography of Gregorios Palaiologos and a thorough bibliography of Greek letter-writing manuals published from 1625 until the beginning of the 20th century

Multi-year chemical composition of the fine-aerosol fraction in Athens, Greece, with emphasis on the contribution of residential heating in wintertime

In an attempt to take effective action towards mitigating pollution episodes in Athens, precise knowledge of PM2.5 composition and its sources is a prerequisite. Thus, a 2-year chemical composition dataset from aerosol samples collected in an urban background site in central Athens from December 2013 to March 2016 has been obtained and a positive matrix factorization (PMF) was applied in order to identify and apportion fine aerosols to their sources. A total of 850 aerosol samples were collected on a 12 to 24&thinsp;h basis and analyzed for major ions, trace elements, and organic and elemental carbon, allowing us to further assess the impact of residential heating as a source of air pollution over Athens.The ionic and carbonaceous components were found to constitute the major fraction of the PM2.5 aerosol mass. The annual contribution of the ion mass (IM), particulate organic mass (POM), dust, elemental carbon (EC), and sea salt (SS) was calculated at 31&thinsp;%, 38&thinsp;%, 18&thinsp;%, 8&thinsp;%, and 3&thinsp;%, respectively, and exhibited considerable seasonal variation. In winter, the share of IM was estimated down to 23&thinsp;%, with POM&thinsp;+ EC being the dominant component accounting for 52&thinsp;% of the PM2.5 mass, while in summer, IM (42&thinsp;%) and carbonaceous aerosols (41&thinsp;%) contributed almost equally.Results from samples collected on a 12&thinsp;h basis (day and night) during the three intensive winter campaigns indicated the impact of heating on the levels of a series of compounds. Indeed, PM2.5, EC, POM, NO3−, C2O42−, non sea salt (nss) K+ and selected trace metals including Cd and Pb were increased by up to a factor of 4 in the night compared to the day, highlighting the importance of heating on air quality in Athens. Furthermore, in order to better characterize wintertime aerosol sources and quantify the impact of biomass burning on PM2.5 levels, source apportionment was performed. The data can be interpreted on the basis of six sources, namely biomass burning (31&thinsp;%), vehicular emissions (19&thinsp;%), heavy oil combustion (7&thinsp;%), regional secondary (21&thinsp;%), marine aerosols (9&thinsp;%), and dust particles (8&thinsp;%). Regarding night-to-day patterns their contributions shifted from 19&thinsp;%, 19&thinsp;%, 8&thinsp;%, 31&thinsp;%, 12&thinsp;%, and 10&thinsp;% of the PM2.5 mass during day to 39&thinsp;%, 19&thinsp;%, 6&thinsp;%, 14&thinsp;%, 7&thinsp;%, and 7&thinsp;% during the night, underlining the significance of biomass burning as the main contributor to fine particle levels during nighttime in winter.</p

Variability in regional background aerosols within the Mediterranean

The main objective of this study is the identification of major factors controlling levels and chemical composition of aerosols in the regional background (RB) along the Mediterranean Basin (MB). To this end, data on PM levels and speciation from Montseny (MSY, NE Spain), Finokalia (FKL, Southern Greece) and Erdemli (ERL, Southern Turkey) for the period 2001 to 2008 are evaluated. Important differences on PM levels and composition are evident when comparing the Western and Eastern MBs. The results manifest W-E and N-S PM(10) and PM(2.5) gradients along the MB, attributed to the higher frequency and intensity of African dust outbreaks in the EMB, while for PM(1) very similar levels are encountered

Variability in regional background aerosols within the Mediterranean

The main objective of this study is the identification of major factors controlling levels and chemical composition of aerosols in the regional background (RB) along the Mediterranean Basin (MB). To this end, data on PM levels and speciation from Montseny (MSY, NE Spain), Finokalia (FKL, Southern Greece) and Erdemli (ERL, Southern Turkey) for the period 2001 to 2008 are evaluated. Important differences on PM levels and composition are evident when comparing the Western and Eastern MBs. The results manifest W-E and N-S PM 10 and PM2.5 gradients along the MB, attributed to the higher frequency and intensity of African dust outbreaks in the EMB, while for PM1 very similar levels are encountered. PM in the EMB is characterized by higher levels of crustal material and sulphate as compared to WMB (and central European sites), however, RB nitrate and OC + EC levels are relatively constant across the Mediterranean and lower than other European sites. Marked seasonal trends are evidenced for PM levels, nitrate (WMB), ammonium and sulphate. Also relatively higher levels of V and Ni (WMB) are measured in the Mediterranean basin, probably as a consequence of high emissions from fuel-oil combustion (power generation, industrial and shipping emissions). Enhanced sulphate levels in EMB compared to WMB were measured. The high levels of sulphate in the EMB may deplete the available gas-phase NH3 so that little ammonium nitrate can form due to the low NH3 levels. This study illustrates the existence of three very important features within the Mediterranean that need to be accounted for when modeling climate effects of aerosols in the area, namely: a) the increasing gradient of dust from WMB to EMB; b) the change of hygroscopic behavior of mineral aerosols (dust) via nitration and sulfation; and c) the abundance of highly hygroscopic aerosols during high insolation (low cloud formation) periods

Variability in regional background aerosols within the Mediterranean

The main objective of this study is the identification of major factors controlling levels and chemical composition of aerosols in the regional background (RB) along the Mediterranean Basin (MB). To this end, data on PM levels and speciation from Montseny (MSY, NE Spain), Finokalia (FKL, Southern Greece) and Erdemli (ERL, Southern Turkey) for the period 2001 to 2008 are evaluated. Important differences on PM levels and composition are evident when comparing the Western and Eastern MBs. The results manifest W-E and N-S PM&lt;sub&gt;10&lt;/sub&gt; and PM&lt;sub&gt;2.5&lt;/sub&gt; gradients along the MB, attributed to the higher frequency and intensity of African dust outbreaks in the EMB, while for PM&lt;sub&gt;1&lt;/sub&gt; very similar levels are encountered. &lt;br&gt;&lt;br&gt; PM in the EMB is characterized by higher levels of crustal material and sulphate as compared to WMB (and central European sites), however, RB nitrate and OC + EC levels are relatively constant across the Mediterranean and lower than other European sites. Marked seasonal trends are evidenced for PM levels, nitrate (WMB), ammonium and sulphate. Also relatively higher levels of V and Ni (WMB) are measured in the Mediterranean basin, probably as a consequence of high emissions from fuel-oil combustion (power generation, industrial and shipping emissions). &lt;br&gt;&lt;br&gt; Enhanced sulphate levels in EMB compared to WMB were measured. The high levels of sulphate in the EMB may deplete the available gas-phase NH&lt;sub&gt;3&lt;/sub&gt; so that little ammonium nitrate can form due to the low NH&lt;sub&gt;3&lt;/sub&gt; levels. &lt;br&gt;&lt;br&gt; This study illustrates the existence of three very important features within the Mediterranean that need to be accounted for when modeling climate effects of aerosols in the area, namely: a) the increasing gradient of dust from WMB to EMB; b) the change of hygroscopic behavior of mineral aerosols (dust) via nitration and sulfation; and c) the abundance of highly hygroscopic aerosols during high insolation (low cloud formation) periods

Monoamine oxidase-A promotes protective autophagy in human SH-SY5Y neuroblastoma cells through Bcl-2 phosphorylation.

Monoamine oxidases (MAOs) are located on the outer mitochondrial membrane and are drug targets for the treatment of neurological disorders. MAOs control the levels of neurotransmitters in the brain via oxidative deamination and contribute to reactive oxygen species (ROS) generation through their catalytic by-product H2O2. Increased ROS levels may modulate mitochondrial function and mitochondrial dysfunction is implicated in a vast array of disorders. However, the downstream effects of MAO-A mediated ROS production in a neuronal model has not been previously investigated. In this study, using MAO-A overexpressing neuroblastoma cells, we demonstrate that higher levels of MAO-A protein/activity results in increased basal ROS levels with associated increase in protein oxidation. Increased MAO-A levels result in increased Lysine-63 linked ubiquitination of mitochondrial proteins and promotes autophagy through Bcl-2 phosphorylation. Furthermore, ROS generated locally on the mitochondrial outer membrane by MAO-A promotes phosphorylation of dynamin-1-like protein, leading to mitochondrial fragmentation and clearance without complete loss of mitochondrial membrane potential. Cellular ATP levels are maintained following MAO-A overexpression and complex IV activity/protein levels increased, revealing a close relationship between MAO-A levels and mitochondrial function. Finally, the downstream effects of increased MAO-A levels are dependent on the availability of amine substrates and in the presence of exogenous substrate, cell viability is dramatically reduced. This study shows for the first time that MAO-A generated ROS is involved in quality control signalling, and increase in MAO-A protein levels leads to a protective cellular response in order to mediate removal of damaged macromolecules/organelles, but substrate availability may ultimately determine cell fate. The latter is particularly important in conditions such as Parkinson's disease, where a dopamine precursor is used to treat disease symptoms and highlights that the fate of MAO-A containing dopaminergic neurons may depend on both MAO-A levels and catecholamine substrate availability