Do hip precautions after posterior-approach total hip arthroplasty affect dislocation rates? A systematic review of 7 studies with 6,900 patients

Background and purpose — Hip precautions limiting flexion, adduction, and internal rotation have been prescribed traditionally to minimize dislocation rates following THA. We assessed the prevalence of hip dislocation following posterior approach total hip arthroplasty without postoperative hip precautions. Methods — A systematic review of multiple medical databases was performed using the PRISMA guidelines and checklist. All clinical outcome studies that reported dislocation rates and postoperative instructions following posterior approach, primary surgery, published within the last 6 years, were included. Results — 6,900 patients were included from 7 Level I–IV studies, with 3,517 treated with and 3,383 without precautions. There was no statistically significant difference in the rates of dislocation between groups (2.2% in restricted group vs. 2.0% in unrestricted group). All but 1 study demonstrated no statistically significant differences in patient-reported outcome scores between restricted and unrestricted groups, including those pertaining to return to function, confidence, and pain. Interpretation — The review found no impact on dislocation rates following total hip arthroplasty performed through a posterior approach, regardless of the use of hip precautions. We also found no impact of the prescription of hip precautions on patient-reported outcome scores

A novel role for Hedgehog in T-cell receptor signaling: implications for development and immunity

The Hedgehog (Hh) signaling pathway is a key regulator of both embryonic development and homeostasis of adult tissues, including thymus and blood. In the thymus, Hh signals for differentiation, survival and proliferation in the early stages of T cell development, before TCR gene rearrangement. Our recent data has shown that Hh signaling also modulates T cell receptor (TCR) signal strength in more mature T lineage cells. We showed that constitutive activation of the Hh pathway in thymocytes (by transgenic expression of the transcriptional activator form of Gli2) decreased TCR signal strength with profound consequences for the thymus--allowing self-reactive T cells to escape deletion and altering T cell CD4/CD8 lineage decisions. In contrast, in the Sonic Hh deficient thymus, TCR signaling was increased, again influencing both TCR repertoire selection and CD4/8 lineage commitment. In peripheral T cells, the transcriptional changes induced by activation of the Hh signaling pathway lead to reduced T cell activation. Hh signaling also attenuated ERK phosphorylation and proliferation in mature T cells on TCR ligation. Modulation of TCR signal strength by Hh pathway activation has importance for immunity as the presence or absence of Hh in the environment in which a T cell is activated would shape the immune response

Efficacy of different antifouling treatments for seawater cooling systems

In an industrial seawater cooling system, the effects of three different antifouling treatments, viz. sodium hypochlorite (NaClO), aliphatic amines (Mexel1432) and UV radiation, on the characteristics of the fouling formed were evaluated. For this study a portable pilot plant, as a side-stream monitoring system and seawater cooling system, was employed. The pilot plant simulated a power plant steam condenser, having four titanium tubes under different treatment patterns, where fouling progression could be monitored. The nature of the fouling obtained was chiefly inorganic, showing a clear dependence on the antifouling treatment employed. After 72 days the tubes under treatment showed a reduction in the heat transfer resistance (R) of around 70% for NaClO, 48% for aliphatic amines and 55% for UV, with respect to the untreated tube. The use of a logistic model was very useful for predicting the fouling progression and the maximum asymptotic value of the increment in the heat transfer resistance (DRmax). The apparent thermal conductivity (l) of the fouling layer showed a direct relationship with the percentage of organic matter in the collected fouling. The characteristics and mode of action of the different treatments used led to fouling with diverse physicochemical properties

Sport and the local economy: the role of stadia in regenerating commercial property

The use of sports stadia for economic development and regeneration has gained increasingly credibility in recent years, both academically and in terms of UK urban policy. However, evidence to support the effectiveness of stadia for these purposes is highly variable. This paper uses a comparative case study of the Millennium Stadium and the City of Manchester Stadium to examine the effects of stadia development on the commercial property market, an area of research that has received little attention in the literature. It uses the expert opinion of professionals working in real estate, together with the experience of key stakeholders in Manchester and Cardiff to provide empirical evidence that stadia can create tangible and intangible impacts on the commercial property market, but that these are variable between different sectors. It concludes by arguing the need for further research on the role of stadia in the regeneration process if the impacts of these developments are to be maximised in the future.</p

Prediction of portal and hepatic blood flow from intake level data in cattle

There is growing interest in developing integrated post-absorptive metabolism models for dairy 30 cattle. An integral part of linking a multi-organ post-absorptive model is the prediction of nutrient 31 fluxes between organs, and thus blood flow. It was the purpose of this paper to use a multivariate 32 meta-analysis approach to model portal blood flow (PORBF) and hepatic venous blood flow 33 (HEPBF) simultaneously, with evaluation of hepatic arterial blood flow (ARTBF; ARTBF = 34 HEPBF – PORBF) and PORBF/HEPBF (%) as calculated values. The database used to develop 35 equations consisted of 296 individual animal observations (lactating and dry dairy cows and beef 36 cattle) and 55 treatments from 17 studies, and a separate evaluation database consisted of 34 37 treatment means (lactating dairy cows and beef cattle) from 9 studies obtained from the literature. 38 Both databases had information on DMI, MEI, body weight and a basic description of the diet 39 including crude protein intake and forage proportion of the diet (FP; %). Blood flow (L/h or L/kg 40 BW0.75/h) and either DMI or MEI (g or MJ/d or g or MJ/kg BW0.75/d) with linear and quadratic 41 fits were examined. Equations were developed using cow within experiment and experiment as 42 random effects, and blood flow location as a repeated effect. Upon evaluation with the evaluation 43 database, equations based on DMI typically resulted in lower root mean square prediction errors, 44 expressed as a % of the observed mean (rMSPE%) and higher concordance correlation coefficient 45 (CCC) values than equations based on MEI. Quadratic equation terms were frequently non-46 significant, and the quadratic equations did not out-perform their linear counterparts. The best 47 performing blood flow equations were: PORBF (L/h) = 202 (± 45.6) + 83.6 (± 3.11) × DMI (kg/d) and HEPBF (L/h) = 186 (± 45.4) + 103.8 (± 3.10) × DMI (kg/d), with rMSPE% values of 17.5 and 49 16.6 and CCC values of 0.93 and 0.94, respectively. The residuals (predicted – observed) for 50 PORBF/HEPBF were significantly related to the forage % of the diet, and thus equations for 51 3 PORBF and HEPBF based on forage and concentrate DMI were developed: PORBF (L/h) = 210 52 (± 51.0) + 82.9 (± 6.43) × Forage (kg DM/d) + 82.9 (± 6.04) × Concentrate (kg DM/d), and 53 HEPBF (L/h) = 184 (± 50.6) + 92.6 (± 6.28) × Forage (kg DM/d) + 114.2 (± 5.88) × Concentrate 54 (kg DM/d), where rMSPE% values were 17.5 and 17.6 and CCC values were 0.93 and 0.94, 55 respectively. Division of DMI into forage and concentrate fractions improved the joint Bayesian 56 Information Criterion (BIC) value for PORBF and HEPBF (BIC = 6512 vs. 7303), as well as 57 slightly improved the rMSPE and CCC for ARTBF and PORBF/HEPBF. This was despite 58 minimal changes in PORBF and HEPBF predictions. Developed equations predicted blood flow 59 well, and could easily be used within a post absorptive model of nutrient metabolism. Results also 60 suggest different sensitivity of PORBF and HEPBF to the composition of DMI, and accounting 61 for this difference resulted in improved ARTBF predictions

Not in my back yard! Sports stadia location and the property market

In recent years sports stadia have been built in the UK, not only for their intended sporting purpose but with the twin aim of stimulating economic and physical regeneration. However, proposals to locate stadia in urban areas often prompt a negative reaction from local communities, fearing a decline in property prices. This paper will use a case study of the Millennium Stadium in Cardiff and the City of Manchester Stadium to illustrate that in contrast to this widely held belief, sports stadia can actually enhance the value of residential property. Furthermore, it will argue that stadia also contribute indirectly to property value through the creation of pride, confidence and enhanced image of an area.</p

Sport in the city: measuring economic significance at the local level

In many cities throughout Europe, sport is increasingly being used as a tool for economic revitalisation. While there has been a growth in literature relating to the specific economic impacts of sports-led development, including professional sport facilities, teams, and sport events, limited research has been undertaken on the contribution of the whole sport sector to output and employment. In the United Kingdom (UK), studies have focused on evaluating sport-related economic activity at the national level, yet despite the increasing use of sport for local economic development little research has been undertaken at the city level. To address this situation, this article uses the National Income Accounting framework to measure the economic importance of sport in Sheffield, UK. It shows that the value-added in 1996/97 was 165.61m or 4.11% of Gross Domestic Product (GDP), approximately twice the amount predicted from current national estimates. It is argued that this can primarily be explained by previous studies under-estimating the economic importance of sport, largely due to methodological differences. It goes on to suggest that future research on the significance of sport should be undertaken at the local level to provide policymakers with information at the spatial level where regeneration programmes are being implemented.</p

Malaria Immunity in Man and Mosquito: Insights Into Unsolved Mysteries of a Deadly Infectious Disease

Malaria is a mosquito-borne disease caused by parasites of the obligate intracellular Apicomplexa family, the most deadly of which, Plasmodium falciparum, prevails in Africa. Malaria imposes a huge health burden on the world’s most vulnerable populations, claiming the lives of nearly a million children and pregnant women each year in Africa alone. Although there is keen interest in eradicating malaria, we do not yet have the necessary tools to meet this challenge, including an effective malaria vaccine and adequate vector control strategies. Here we review what is known about the mechanisms at play in immune resistance to malaria in both the human and mosquito hosts at each step in the parasite’s complex life cycle with a view towards developing the tools that will contribute to the prevention of disease and death and ultimately the goal of malaria eradication. In so doing we hope to inspire immunologists to participate in defeating this devastating disease

Repression of hedgehog signal transduction in T-lineage cells increases TCR-induced activation and proliferation

Hedgehog proteins signal for differentiation, survival and proliferation of the earliest thymocyte progenitors, but their functions at later stages of thymocyte development and in peripheral T-cell function are controversial. Here we show that repression of Hedgehog (Hh) pathway activation in T-lineage cells, by expression of a transgenic repressor form of Gli2 (Gli2DeltaC2), increased T-cell differentiation and activationin response to TCR signalling. Expression of the Gli2DeltaC2 transgene increased differentiation from CD4(+)CD8(+) to single positive thymocyte, and increased peripheral T cell populations. Gli2DeltaC2 T-cells were hyper-responsive to activation by ligation of CD3 and CD28: they expressed cell surface activation markers CD69 and CD25 more quickly, and proliferated more than wild-type T-cells. These data show that Hedgehog pathway activation in thymocytes and T-cells negatively regulates TCR-dependent differentiation and proliferation. Thus, as negative regulators of TCR-dependent events, Hh proteins provide an environmental influence on T-cell fate