"Meniscal" scar as a landmark for the joint line in revision total knee replacement

$\textbf{AIM}$: To determine whether tissue identified at the joint line was actually remnant "meniscal" scar tissue or not. $\textbf{METHODS}$: Nine patients undergoing revision knee surgery following informed consent had meniscal scar tissue sent to the histology department for analyses. All revisions were performed where joint line had been raised or lowered at earlier surgery. Although preoperative radiographic evaluations suggested that the joint line had been altered, intraoperatively there was scar tissue at the level of the recreated joint line. This scar tissue has traditionally been described as meniscal scar, and to identify the origins of this tissue, samples were sent for histological analyses. The tissue samples were stored in formalin, and embedded and sectioned before undergoing histochemical staining. All samples underwent macroscopic and microscopic examination by a histopathologist who was blind to the study aims. The specific features that were examined included tissue organisation, surface and central composition, cellular distribution including histiocytes, nuclear ratio and vasculature. Atypical and malignant features, inflammation and degeneration were specifically looked for. A statistical review of the study was performed by a biomedical statistician. $\textbf{RESULTS}$: The histological findings for the nine patients showing the macroscopic and microscopic findings, and the conclusion are outlined in a Table. The histological analyses were reviewed to determine whether the tissue samples were likely to be meniscal scar tissue. The response was yes (2, 22%), no (6, 67%) and maybe (1, 11%) based on the conclusions. The results were "yes" when on macroscopy, firm cream tissue was identified. In these two "yes" samples, microscopic analyses showed organised fibrous tissue with focal degenerative areas with laminated pattern associated with histiocytes peripherally but no inflammation. The "no" samples were assessed macroscopically and microscopically and were deemed to have appearances representing fibrous synovial tissue and features in keeping with degenerate scar tissue or connective tissue. One sample was indeterminate and microscopically contained fibro-collagenous tissue with synovial hyperplasia. It also contained some degenerate hyalinised tissue that may represent cartilage, but the appearances were not specific. $\textbf{CONCLUSION}$: Based on our pilot study, we recommend reliance on a number of markers to identify the joint line as outlined above, and to exercise caution in using the "meniscal" scar

Pathways to "opportunity and excellence": collaborative curriculum innovation in South Yorkshire

This paper reports on two aspects of a large-scale curriculum project currently taking place in four LEAs in South Yorkshire. The first of these is concerned with the positive and negative influences on effective curriculum innovation and is addressed from the perspective of the LEA project managers who are managing the delivery of the project in the region's schools. The second aspect considers what the pupils (Year 10, age 14-15) think about the new learning opportunities. The project is set in the context of regional regeneration. The paper concludes that the extremely positive responses from the sample of pupils in all three strands of the programme indicate that the greater emphasis on vocational work and work experience in schools is having a strong motivational effect on pupils who are responding with improved attendance, behaviour and achievement.</p

Hydrazine electrolysis for spacecraft propulsion. Analysis and test of a dual-mode gas and liquid system Final report

Dual-mode hydrazine electrolysis for spacecraft propulsion syste

WRF-Chem model predictions of the regional impacts of N2O5 heterogeneous processes on night-time chemistry over north-western Europe

Abstract. Chemical modelling studies have been conducted over north-western Europe in summer conditions, showing that night-time dinitrogen pentoxide (N2O5) heterogeneous reactive uptake is important regionally in modulating particulate nitrate and has a~modest influence on oxidative chemistry. Results from Weather Research and Forecasting model with Chemistry (WRF-Chem) model simulations, run with a detailed volatile organic compound (VOC) gas-phase chemistry scheme and the Model for Simulating Aerosol Interactions and Chemistry (MOSAIC) sectional aerosol scheme, were compared with a series of airborne gas and particulate measurements made over the UK in July 2010. Modelled mixing ratios of key gas-phase species were reasonably accurate (correlations with measurements of 0.7–0.9 for NO2 and O3). However modelled loadings of particulate species were less accurate (correlation with measurements for particulate sulfate and ammonium were between 0.0 and 0.6). Sulfate mass loadings were particularly low (modelled means of 0.5–0.7 μg kg−1air, compared with measurements of 1.0–1.5 μg kg−1air). Two flights from the campaign were used as test cases – one with low relative humidity (RH) (60–70%), the other with high RH (80–90%). N2O5 heterogeneous chemistry was found to not be important in the low-RH test case; but in the high-RH test case it had a strong effect and significantly improved the agreement between modelled and measured NO3 and N2O5. When the model failed to capture atmospheric RH correctly, the modelled NO3 and N2O5 mixing ratios for these flights differed significantly from the measurements. This demonstrates that, for regional modelling which involves heterogeneous processes, it is essential to capture the ambient temperature and water vapour profiles. The night-time NO3 oxidation of VOCs across the whole region was found to be 100–300 times slower than the daytime OH oxidation of these compounds. The difference in contribution was less for alkenes (× 80) and comparable for dimethylsulfide (DMS). However the suppression of NO3 mixing ratios across the domain by N2O5 heterogeneous chemistry has only a very slight, negative, influence on this oxidative capacity. The influence on regional particulate nitrate mass loadings is stronger. Night-time N2O5 heterogeneous chemistry maintains the production of particulate nitrate within polluted regions: when this process is taken into consideration, the daytime peak (for the 95th percentile) of PM10 nitrate mass loadings remains around 5.6 μg kg−1air, but the night-time minimum increases from 3.5 to 4.6 μg kg−1air. The sustaining of higher particulate mass loadings through the night by this process improves model skill at matching measured aerosol nitrate diurnal cycles and will negatively impact on regional air quality, requiring this process to be included in regional models. </jats:p

A wide-spectrum language for verification of programs on weak memory models

Modern processors deploy a variety of weak memory models, which for efficiency reasons may (appear to) execute instructions in an order different to that specified by the program text. The consequences of instruction reordering can be complex and subtle, and can impact on ensuring correctness. Previous work on the semantics of weak memory models has focussed on the behaviour of assembler-level programs. In this paper we utilise that work to extract some general principles underlying instruction reordering, and apply those principles to a wide-spectrum language encompassing abstract data types as well as low-level assembler code. The goal is to support reasoning about implementations of data structures for modern processors with respect to an abstract specification. Specifically, we define an operational semantics, from which we derive some properties of program refinement, and encode the semantics in the rewriting engine Maude as a model-checking tool. The tool is used to validate the semantics against the behaviour of a set of litmus tests (small assembler programs) run on hardware, and also to model check implementations of data structures from the literature against their abstract specifications

Narrative skills in deaf children who use spoken English: Dissociations between macro and microstructural devices

Previous research has highlighted that deaf children acquiring spoken English have difficulties in narrative development relative to their hearing peers both in terms of macro-structure and with micro-structural devices. The majority of previous research focused on narrative tasks designed for hearing children that depend on good receptive language skills. The current study compared narratives of 6 to 11-year-old deaf children who use spoken English (N=59) with matched for age and non-verbal intelligence hearing peers. To examine the role of general language abilities, single word vocabulary was also assessed. Narratives were elicited by the retelling of a story presented non-verbally in video format. Results showed that deaf and hearing children had equivalent macro-structure skills, but the deaf group showed poorer performance on micro-structural components. Furthermore, the deaf group gave less detailed responses to inferencing probe questions indicating poorer understanding of the story's underlying message. For deaf children, micro-level devices most strongly correlated with the vocabulary measure. These findings suggest that deaf children, despite spoken language delays, are able to convey the main elements of content and structure in narrative but have greater difficulty in using grammatical devices more dependent on finer linguistic and pragmatic skills

<i>‘What retention’ means to me</i>: the position of the adult learner in student retention

Studies of student retention and progression overwhelmingly appear adopt definitions that place the institution, rather than the student, at the centre. Retention is most often conceived in terms of linear and continuous progress between institutionally identified start and end points. This paper reports on research that considered data from 38 in-depth interviews conducted with individuals who had characteristics often associated with non-traditional engagement in higher education who between 2006 and 2010 had studied an ‘Introduction to HE’ module at one distance higher education institution, some of whom had progressed to further study at that institution, some of whom had not. The research deployed a life histories approach to seek a finer grained understanding of how individuals conceptualise their own learning journey and experience, in order to reflect on institutional conceptions of student retention. The findings highlight potential anomalies hidden within institutional retention rates – large proportions of the interview participants who were not ‘retained’ by the institution reported successful progression to and in other learning institutions and environments, both formal and informal. Nearly all described positive perspectives on lifelong learning which were either engendered or improved by the learning undertaken. This attests to the complexity of individuals’ lives and provides clear evidence that institution-centric definitions of retention and progression are insufficient to create truly meaningful understanding of successful individual learning journeys and experiences. It is argued that only through careful consideration of the lived experience of students and a re-conception of measures of retention, will we be able to offer real insight into improving student retention

Healthcare resource utilization and related financial costs associated with glucose lowering with either exenatide or basal insulin: a retrospective cohort study

Aims Type 2 diabetes is a major health problem placing increasing demands on healthcare systems. Our objective was to estimate healthcare resource use and related financial costs following treatment with exenatide‐based regimens prescribed as once‐weekly (EQW) or twice‐daily (EBID) formulations, compared with regimens based on basal insulin (BI). Materials and methods This retrospective cohort study used data from the UK Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics (HES). Patients with type 2 diabetes who received exenatide or BI between 2009 and 2014 as their first recorded exposure to injectable therapy were selected. Costs were attributed to primary care contacts, diabetes‐related prescriptions and inpatient admissions using standard UK healthcare costing methods (2014 prices). Frequency and costs were compared between cohorts before and after matching by propensity score using Poisson regression. Results Groups of 8723, 218 and 2180 patients receiving BI, EQW and EBID, respectively, were identified; 188 and 1486 patients receiving EQW and EBID, respectively, were matched 1:1 to patients receiving BI by propensity score. Among unmatched cohorts, total crude mean costs per patient‐year were £2765 for EQW, £2549 for EBID and £4080 for BI. Compared with BI, the adjusted annual cost ratio (aACR) was 0.92 (95% CI, 0.91‐0.92) for EQW and 0.82 (95% CI, 0.82‐0.82) for EBID. Corresponding costs for the propensity‐matched subgroups were £2646 vs £3283 (aACR, 0.80, 0.80‐0.81) for EQW vs BI and £2532 vs £3070 (aACR, 0.84, 0.84‐0.84) for EBID vs BI. Conclusion Overall, exenatide once‐weekly and twice‐daily‐based regimens were associated with reduced healthcare resource use and costs compared with basal‐insulin‐based regimens

The celebrity entrepreneur on television: profile, politics and power

This article examines the rise of the ‘celebrity entrepreneur’ on television through the emergence of the ‘business entertainment format’ and considers the ways in which regular television exposure can be converted into political influence. Within television studies there has been a preoccupation in recent years with how lifestyle and reality formats work to transform ‘ordinary’ people into celebrities. As a result, the contribution of vocationally skilled business professionals to factual entertainment programming has gone almost unnoticed. This article draws on interviews with key media industry professionals and begins by looking at the construction of entrepreneurs as different types of television personalities and how discourses of work, skill and knowledge function in business shows. It then outlines how entrepreneurs can utilize their newly acquired televisual skills to cultivate a wider media profile and secure various forms of political access and influence. Integral to this is the centrality of public relations and media management agencies in shaping media discourses and developing the individual as a ‘brand identity’ that can be used to endorse a range of products or ideas. This has led to policy makers and politicians attempting to mobilize the media profile of celebrity entrepreneurs to reach out and connect with the public on business and enterprise-related issues