How good is the orthopaedic literature?

Randomized trials constitute approximately 3% of the orthopaedic literature Concerns regarding quality of the orthopaedic literature stem from a widespread notion that the overall quality of the surgical literature is in need of improvement. Limitations in surgical research arises primarily from two pervasive issues: 1) A reliance on low levels of evidence to advance surgical knowledge, and 2) Poor reporting quality among the high level surgical evidence that is available. The scarcity of randomized trials may be largely attributable to several unique challenges which make them difficult to conduct. We present characteristics of the orthopaedic literature and address the challenges of conducting randomized trials in surgery

Automated Repair of Layout Cross Browser Issues Using Search-Based Techniques

A consistent cross-browser user experience is crucial for the success of a website. Layout Cross Browser Issues (XBIs) can severely undermine a website’s success by causing web pages to render incorrectly in certain browsers, thereby negatively impacting users’ impression of the quality and services that the web page delivers. Existing Cross Browser Testing (XBT) techniques can only detect XBIs in websites. Repairing them is, hitherto, a manual task that is labor intensive and requires significant expertise. Addressing this concern, our paper proposes a technique for automatically repairing layout XBIs in websites using guided search-based techniques. Our empirical evaluation showed that our approach was able to successfully fix 86% of layout XBIs reported for 15 different web pages studied, thereby improving their cross-browser consistency

Political geographies of the object

This paper examines the role of objects in the constitution and exercise of state power, drawing on a close reading of the acclaimed HBO television series The Wire, an unconventional crime drama set and shot in Baltimore, Maryland. While political geography increasingly recognizes the prosaic and intimate practices of stateness, we argue that objects themselves are central to the production, organization, and performance of state power. Specifically, we analyze how three prominent objects on The Wire—wiretaps, cameras, and standardized tests—arrange and produce the conditions we understand as ‘stateness’. Drawing on object-oriented philosophy, we offer a methodology of power that suggests it is generalized force relations rather than specifically social relations that police a population—without, of course, ever being able to fully capture it. We conclude by suggesting The Wire itself is an object of force, and explore the implications of an object-oriented approach for understanding the nature of power, and for political geography more broadly

Pre-conceptual Design Assessment of DEMO Remote Maintenance

EDFA, as part of the Power Plant Physics and Technology programme, has been working on the pre-conceptual design of a Demonstration Power Plant (DEMO). As part of this programme, a review of the remote maintenance strategy considered maintenance solutions compatible with expected environmental conditions, whilst showing potential for meeting the plant availability targets. A key finding was that, for practical purposes, the expected radiation levels prohibit the use of complex remote handling operations to replace the first wall. In 2012/13, these remote maintenance activities were further extended, providing an insight into the requirements, constraints and challenges. In particular, the assessment of blanket and divertor maintenance, in light of the expected radiation conditions and availability, has elaborated the need for a very different approach from that of ITER. This activity has produced some very informative virtual reality simulations of the blanket segments and pipe removal that are exceptionally valuable in communicating the complexity and scale of the required operations. Through these simulations, estimates of the maintenance task durations have been possible demonstrating that a full replacement of the blankets within 6 months could be achieved. The design of the first wall, including the need to use sacrificial limiters must still be investigated. In support of the maintenance operations, a first indication of the requirements of an Active Maintenance Facility (AMF) has been elaborated.Comment: 6 pages, 5 figure

The interplay between extrinsic and intrinsic factors in determining migration decisions in brown trout (Salmo trutta): An experimental study

Many species are capable of facultative migration, but the relative roles of extrinsic versus intrinsic factors in generating diverse migratory tactics remain unclear. Here we explore the proximate drivers of facultative migration in brown trout in an experimental laboratory setting. The effects of reduced food, as a putative environmental cue, were examined in two populations: one that exhibits high rates of anadromy (sea-migration) in nature, and one that does not exhibit anadromy in nature. Juveniles derived from wild-caught parents were reared for two years under four environmental treatments: low food in years 1 and 2 (Low-Low); high food in years 1 and 2 (High-High), low food in year 1 and high in year 2 (Low-High), and vice versa (High-Low). Food restriction had a significant effect on migratory tactics, with the frequency of smolts (juveniles choosing migration) highest in the Low-Low treatment in both populations. No individuals became smolts in the High-High treatment, and intermediate smolting rates were observed in the Low-High and High-Low treatments. Higher overall smolting rates in the naturally anadromous population suggested an inherited component to anadromy/migration decisions, but both populations showed variability in migratory tactics. Importantly, some fish from the naturally non-anadromous population became smolts in the experiment, implying the capacity for migration was lying ‘dormant’, but they exhibited lower hypo-osmoregulatory function than smolts from the naturally anadromous population. Tactic frequencies in the naturally anadromous population were more affected by food in the 2nd year, while food in the 1st year appeared more important for the naturally non-anadromous population. Migratory tactics were also related to sex, but underpinned in both sexes by growth in key periods, size and energetic state. Collectively these results reveal how migration decisions are shaped by a complex interplay between extrinsic and intrinsic factors, informing our ability to predict how facultatively migratory populations will respond to environmental change

Metabolic traits in brown trout (Salmo trutta) vary in response to food restriction and intrinsic factors

Metabolic rates vary hugely within and between populations, yet we know relatively little about factors causing intraspecific variation. Since metabolic rate determines the energetic cost of life, uncovering these sources of variation is important to understand and forecast responses to environmental change. Moreover, few studies have examined factors causing intraspecific variation in metabolic flexibility. We explore how extrinsic environmental conditions and intrinsic factors contribute to variation in metabolic traits in brown trout, an iconic and polymorphic species that is threatened across much of its native range. We measured metabolic traits in offspring from two wild populations that naturally show life-history variation in migratory tactics (one anadromous, i.e. sea-migratory, one non-anadromous) that we reared under either optimal food or experimental conditions of long-term food restriction (lasting between 7 and 17 months). Both populations showed decreased standard metabolic rates (SMR—baseline energy requirements) under low food conditions. The anadromous population had higher maximum metabolic rate (MMR) than the non-anadromous population, and marginally higher SMR. The MMR difference was greater than SMR and consequently aerobic scope (AS) was higher in the anadromous population. MMR and AS were both higher in males than females. The anadromous population also had higher AS under low food compared to optimal food conditions, consistent with population-specific effects of food restriction on AS. Our results suggest different components of metabolic rate can vary in their response to environmental conditions, and according to intrinsic (population-background/sex) effects. Populations might further differ in their flexibility of metabolic traits, potentially due to intrinsic factors related to life history (e.g. migratory tactics). More comparisons of populations/individuals with divergent life histories will help to reveal this. Overall, our study suggests that incorporating an understanding of metabolic trait variation and flexibility and linking this to life history and demography will improve our ability to conserve populations experiencing global change

Cytogerontology since 1881: A reappraisal of August Weismann and a review of modern progress

Cytogerontology, the science of cellular ageing, originated in 1881 with the prediction by August Weismann that the somatic cells of higher animals have limited division potential. Weismann's prediction was derived by considering the role of natural selection in regulating the duration of an organism's life. For various reasons, Weismann's ideas on ageing fell into neglect following his death in 1914, and cytogerontology has only reappeared as a major research area following the demonstration by Hayflick and Moorhead in the early 1960s that diploid human fibroblasts are restricted to a finite number of divisions in vitro. In this review we give a detailed account of Weismann's theory, and we reveal that his ideas were both more extensive in their scope and more pertinent to current research than is generally recognised. We also appraise the progress which has been made over the past hundred years in investigating the causes of ageing, with particular emphasis being given to (i) the evolution of ageing, and (ii) ageing at the cellular level. We critically assess the current state of knowledge in these areas and recommend a series of points as primary targets for future research

Piecewise-Linear Models of Genetic Regulatory Networks: Theory and Example

International audienceThe experimental study of genetic regulatory networks has made tremendous progress in recent years resulting in a huge amount of data on the molecular interactions in model organisms. It is therefore not possible anymore to intuitively understand how the genes and interactions together influence the behavior of the system. In order to answer such questions, a rigorous modeling and analysis approach is necessary. In this chapter, we present a family of such models and analysis methods enabling us to better understand the dynam-ics of genetic regulatory networks. We apply such methods to the network that underlies the nutritional stress response of the bacterium E. coli. The functioning and development of living organisms is controlled by large and complex networks of genes, proteins, small molecules, and their interactions, so-called genetic regulatory networks. The study of these networks has recently taken a qualitative leap through the use of modern genomic techniques that allow for the simultaneous measurement of the expression levels of all genes of an organism. This has resulted in an ever growing description of the interactions in the studied genetic regulatory networks. However, it is necessary to go beyond the simple description of the interactions in order to understand the behavior of these networks and their relation with the actual functioning of the organism. Since the networks under study are usually very large, an intuitive approach for their understanding is out of ques-tion. In order to support this work, mathematical and computer tools are necessary: the unambiguous description of the phenomena that mathematical models provide allows for a detailed analysis of the behaviors at play, though they might not exactly represent the exact behavior of the networks. In this chapter, we will be mostly interested in the modeling of the genetic reg-ulatory networks by means of differential equations. This classical approach allows precise numerical predictions of deterministic dynamic properties of genetic regu-latory networks to be made. However, for most networks of biological interest the application of differential equations is far from straightforward. First, the biochemi-cal reaction mechanisms underlying the interactions are usually not or incompletel

Food and temperature stressors have opposing effects in determining flexible migration decisions in brown trout (Salmo trutta)

With rapid global change, organisms in natural systems are exposed to a multitude of stressors that likely co‐occur, with uncertain impacts. We explored individual and cumulative effects of co‐occurring environmental stressors on the striking, yet poorly understood, phenomenon of facultative migration. We reared offspring of a brown trout population that naturally demonstrates facultative anadromy (sea migration), under different environmental stressor treatments and measured life history responses in terms of migratory tactics and freshwater maturation rates. Juvenile fish were exposed to reduced food availability, temperatures elevated to 1.8°C above natural conditions or both treatments in combination over 18 months of experimental tank rearing. When considered in isolation, reduced food had negative effects on the size, mass and condition of fish across the experiment. We detected variable effects of warm temperatures (negative effects on size and mass, but positive effect on lipids). When combined with food restriction, temperature effects on these traits were less pronounced, implying antagonistic stressor effects on morphological traits. Stressors combined additively, but had opposing effects on life history tactics: migration increased and maturation rates decreased under low food conditions, whereas the opposite occurred in the warm temperature treatment. Not all fish had expressed maturation or migration tactics by the end of the study, and the frequency of these ‘unassigned’ fish was higher in food deprivation treatments, but lower in warm treatments. Fish showing migration tactics were smaller and in poorer condition than fish showing maturation tactics, but were similar in size to unassigned fish. We further detected effects of food restriction on hypo‐osmoregulatory function of migrants that may influence the fitness benefits of the migratory tactic at sea. We also highlight that responses to multiple stressors may vary depending on the response considered. Collectively, our results indicate contrasting effects of environmental stressors on life history trajectories in a facultatively migratory species

Comparison of microbiological diagnosis of urinary tract infection in young children by routine health service laboratories and a research laboratory: Diagnostic cohort study

OBJECTIVES: To compare the validity of diagnosis of urinary tract infection (UTI) through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory. POPULATION AND METHODS: We conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard), was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC) for UTI predicted by pre-specified symptoms, signs and dipstick test results (the "index test"), separately according to whether samples were obtained by clean catch or nappy (diaper) pads. RESULTS: 251 (5.2%) and 88 (1.8%) children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43), and better for clean catch (0.54; 0.45, 0.63) than nappy pad samples (0.20; 0.12, 0.28). In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80) than the research laboratory (0.86; 0.79, 0.92). Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively) than clean catch samples. CONCLUSIONS: The agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples) could be due to contamination. Health service laboratories should consider adopting procedures used in the research laboratory for paediatric urine samples. Primary care clinicians should try to obtain clean catch samples, even in very young children