Inter-vertebral rotational deformity after endoscopic anterior scoliosis correction may contribute to rib hump recurrence after two years

Introduction. Endoscopic anterior scoliosis correction has been employed recently as a less invasive and level-sparing approach compared with open surgical techniques. We have previously demonstrated that during the two-year post-operative period, there was a mean loss of rib hump correction by 1.4 degrees. The purpose of this study was to determine whether intra- or inter-vertebral rotational deformity during the post-operative period could account for the loss of rib hump correction. Materials and Methods. Ten consecutive patients diagnosed with adolescent idiopathic scoliosis were treated with an endoscopic anterior scoliosis correction. Low-dose computed tomography scans of the instrumented segment were obtained post-operatively at 6 and 24 months following institutional ethical approval and patient consent. Three-dimensional multi-planar reconstruction software (Osirix Imaging Software, Pixmeo, Switzerland) was used to create axial slices of each vertebral level, corrected in both coronal and sagittal planes. Vertebral rotation was measured using Ho’s method for every available superior and inferior endplate at 6 and 24 months. Positive changes in rotation indicate a reduction and improvement in vertebral rotation. Intra-observer variability analysis was performed on a subgroup of images. Results. Mean change in rotation for vertebral endplates between 6 and 24 months post-operatively was -0.26˚ (range -3.5 to 4.9˚) within the fused segment and +1.26˚ (range -7.2 to 15.1˚) for the un-instrumented vertebrae above and below the fusion. Mean change in clinically measured rib hump for the 10 patients was -1.6˚ (range -3 to 0˚). The small change in rotation within the fused segment accounts for only 16.5% of the change in rib hump measured clinically whereas the change in rotation between the un-instrumented vertebrae above and below the construct accounts for 78.8%. There was no clear association between rib hump recurrence and intra- or inter-vertebral rotation in individual patients. Intra-rater variability was ± 3˚. Conclusions. Intra- and inter-vertebral rotation continues post-operatively both within the instrumented and un-instrumented segments of the immature spine. Rotation between the un-instrumented vertebrae above and below the fusion was +1.26˚, suggesting that the un-instrumented vertebrae improved and de-rotated slightly after surgery. This may play a role in rib hump recurrence, however this remains clinically insignificant.

The Music Industry : Music in the Cloud, 1st edition

"The music industry is going through a period of immense change brought about in part by the digital revolution. What is the role of music in the age of computers and the internet? How has the music industry been transformed by the economic and technological upheavals of recent years, and how is it likely to change in the future? This is the first major study of the music industry in the new millennium. Wikström provides an international overview of the music industry and its future prospects in the world of global entertainment. He illuminates the workings of the music industry, and captures the dynamics at work in the production of musical culture between the transnational media conglomerates, the independent music companies and the public." -- back cover Table of Contents Introduction: Music in the Cloud Chapter 1: A Copyright Industry. Chapter 2: Inside the Music Industry Chapter 3: Music and the Media Chapter 4: Making Music - An Industrial or Creative Process Chapter 5: The Social and Creative Music Fan Chapter 6: Future Sounds

Genetic variants of angiotensin converting enzyme and methylenetetrahydrofolate reductase may act in combination to increase migraine susceptibility

Migraine, with and without aura (MA and MO), is a prevalent and complex neurovascular disorder that is likely to be influenced by multiple genes some of which may be capable of causing vascular changes leading to disease onset. This study was conducted to determine whether the ACE I/D gene variant is involved in migraine risk and whether this variant might act in combination with the previously implicated MTHFR C677T genetic variant in 270 migraine cases and 270 matched controls. Statistical analysis of the ACE I/D variant indicated no significant difference in allele or genotype frequencies (P > 0.05). However, grouping of genotypes showed a modest, yet significant, over-representation of the DD/ID genotype in the migraine group (88%) compared to controls (81%) (OR of 1.64, 95% CI: 1.00–2.69, P = 0.048). Multivariate analysis, including genotype data for the MTHFR C677T, provided evidence that the MTHFR (TT) and ACE (ID/DD) genotypes act in combination to increase migraine susceptibility (OR = 2.18, 95% CI: 1.15–4.16, P = 0.018). This effect was greatest for the MA subtype where the genotype combination corresponded to an OR of 2.89 (95% CI:1.47–5.72, P = 0.002). In Caucasians, the ACE D allele confers a weak independent risk to migraine susceptibility and also appears to act in combination with the C677T variant in the MTHFR gene to confer a stronger influence on the disease.

The recovery concept and crisis intervention : time for a revolution in the realm of acute psychiatric care

“Mental illness is a tough illness to survive, it is incurable but manageable. Living with the illness when at its full potency can disrupt your life at any moment.” Intensive care for patients experiencing acute psychiatric distress is an essential yet complex part of mental health services as a whole system. Psychiatric intensive care units remain a source of controversy; despite promising developments to health services incorporating recovery goals and processes outlined by people with a mental illness themselves. In past decades changes in the provision of mental health services have focused on the restoration of a meaningful and empowered life with choice and hope as a defining attribute of recovery. Yet, what does recovery mean and how are recovery principles accomplished in psychiatric intensive care arrangements for someone experiencing acute psychiatric distress?

Ongoing outbreak of dengue serotype 3 in Solomon Islands, January to May 2013

Introduction In January 2013, clinicians in Honiara, Solomon Islands noted several patients presenting with dengue-like illness. Serum from three cases tested positive for dengue by rapid diagnostic test. Subsequent increases in cases were reported, and the outbreak was confirmed as being dengue serotype-3 by further laboratory tests. This report describes the ongoing outbreak investigation, findings and response. Methods Enhanced dengue surveillance was implemented in the capital, Honiara, and in the provinces. This included training health staff on dengue case definitions, data collection and reporting. Vector surveillance was also conducted. Results From 3 January to 15 May 2013, 5254 cases of suspected dengue were reported (101.8 per 10 000 population), including 401 hospitalizations and six deaths. The median age of cases was 20 years (range zero to 90), and 86% were reported from Honiara. Both Aedes aegyti and Aedes albopictus were identified in Honiara. Outbreak response measures included clinical training seminars, vector control activities, implementation of diagnostic and case management protocols and a public communication campaign. Discussion This was the first large dengue outbreak documented in Solomon Islands. Factors that may have contributed to this outbreak include a largely susceptible population, the presence of a highly efficient dengue vector in Honiara, a high-density human population with numerous breeding sites and favourable weather conditions for mosquito proliferation. Although the number of cases has plateaued since 1 April, continued enhanced nationwide surveillance and response activities are necessary.

Familiar drugs may prevent cancer

Despite positive results in large scale chemoprevention trials, many physicians are unaware of the potential cancer preventive properties of drugs in common usage. The antioestrogen tamoxifen and the selective cyclo-oxygenase-2 inhibitor celecoxib have been licensed in the USA for the chemoprevention of breast and colorectal cancers respectively in selected high risk individuals. Similarly, folate and retinol have been shown to decrease the incidence of colorectal cancer and squamous cell carcinoma of the skin respectively in large scale intervention trials. Other retinoids have proved efficacious in the tertiary chemoprevention of cancers of the breast and head/neck. Epidemiological evidence also exists in favour of aspirin, nonsteroidal anti-inflammatory drugs, and angiotensin converting enzyme inhibitors preventing certain cancers. Phytochemicals may represent less toxic alternatives to these agents. Although some of these drugs are available without prescription and most are not yet licensed for use in cancer chemoprevention, physicians and students of medicine should be aware of this accumulating evidence base. Practitioners should be amenable to patient referral to discuss complex issues such as risk estimation or potential benefit from intervention.

Reimagining school libraries : children's perspectives and new opportunities

The Federal Government’s recent Building the Education Revolution program resulted in, among other features, the creation of over 600 new school libraries in Queensland alone. This paper reports on a component of a research project carried out with students in six primary schools and one secondary school that benefitted from the program, investigating the influences of these new physical environments on learning and teaching. In particular, this paper discusses one missing voice from the design process - that of the students who would be key users of the newly-created spaces in those schools. While opportunities for real involvement in design were minimal for most potential users of the new spaces, students’ imagined possibilities for school libraries, as submitted to the research project, suggest that students could have contributed different perspectives to enhance learning engagement through imaginative design elements. The findings of the project have relevance for teachers and teacher librarians in reconsidering the ways in which the new learning spaces are used as well as informing school designers in planning engaging school facilities. The findings may be extrapolated to the design and planning of general classrooms and other learning environments.

The IL-6 response to Chlamydia from primary reproductive epithelial cells is highly variable and may be involved in differential susceptibility to the immunopathological consequences of chlamydial infection

Background Chlamydia trachomatis infection results in reproductive damage in some women. The process and factors involved in this immunopathology are not well understood. This study aimed to investigate the role of primary human cellular responses to chlamydial stress response proteases and chlamydial infection to further identify the immune processes involved in serious disease sequelae. Results Laboratory cell cultures and primary human reproductive epithelial cultures produced IL-6 in response to chlamydial stress response proteases (CtHtrA and CtTsp), UV inactivated Chlamydia, and live Chlamydia. The magnitude of the IL-6 response varied considerably (up to 1000 pg ml-1) across different primary human reproductive cultures. Thus different levels of IL-6 production by reproductive epithelia may be a determinant in disease outcome. Interestingly, co-culture models with either THP-1 cells or autologous primary human PBMC generally resulted in increased levels of IL-6, except in the case of live Chlamydia where the level of IL-6 was decreased compared to the epithelial cell culture only, suggesting this pathway may be able to be modulated by live Chlamydia. PBMC responses to the stress response proteases (CtTsp and CtHtrA) did not significantly vary for the different participant cohorts. Therefore, these proteases may possess conserved innate PAMPs. MAP kinases appeared to be involved in this IL-6 induction from human cells. Finally, we also demonstrated that IL-6 was induced by these proteins and Chlamydia from mouse primary reproductive cell cultures (BALB/C mice) and mouse laboratory cell models. Conclusions We have demonstrated that IL-6 may be a key factor for the chlamydial disease outcome in humans, given that primary human reproductive epithelial cell culture showed considerable variation in IL-6 response to Chlamydia or chlamydial proteins, and that the presence of live Chlamydia (but not UV killed) during co-culture resulted in a reduced IL-6 response suggesting this response may be moderated by the presence of the organism.

The Music Industry : Music in the Cloud, 2nd edition

The music industry is going through a period of immense change brought about in part by the digital revolution. What is the role of music in the age of computers and the Internet? How has the music industry been transformed by the economic and technological upheavals of recent years, and how is it likely to change in the future? This thoroughly revised and updated new edition provides an international overview of the music industry and its future prospects in the world of global entertainment. Patrik Wikström illuminates the workings of the music industry, and captures the dynamics at work in the production of musical culture between the transnational media conglomerates, the independent music companies and the public. New to this second edition are expanded sections on the structure of the music industry, online business models and the links between social media and music. Engaging and comprehensive, The Music Industry will be a must-read for students and scholars of media and communication studies, cultural studies, popular music, sociology and economics.

Evolution or revolution?

Cosmetic tinted soft lenses, which were prescribed in 4-8 per cent of soft lens fits between 1997-2001, have declined in use and since 2003 have accounted for less than 2 per cent of soft lens fits. In general, there has been a slow but steady increase in the rate of prescribing for presbyopia.

Immunity against a Chlamydia infection and disease may be determined by a balance of IL-17 signaling

Most vaccines developed against Chlamydia using animal models provide partial protection against a genital tract infection. However, protection against the oviduct pathology associated with infertility is highly variable and often has no defining immunological correlate. When comparing two adjuvants (CTA1-DD and a combination of Cholera toxin plus CpG- oligodeoxynucleotide–CT/CpG) combined with the chlamydial major outer membrane protein (MOMP) antigen and delivered via the intranasal (IN), sublingual (SL) or transcutaneous (TC) routes, we identified two vaccine groups with contrasting outcomes following infection. SL immunization with MOMP/CTA1-DD induced a 70% reduction in the incidence of oviduct pathology, without significantly altering the course of infection. Conversely, IN immunization with MOMP/CT/CpG prevented an ascending infection, but not the oviduct pathology. This anomaly presented a unique opportunity to study the mechanisms by which vaccines can prevent oviduct pathology, other than by controlling the infection. The IL-17 signaling in the oviducts was found to associate with both the enhancement of immunity to infection and the development of oviduct pathology. This conflicting role of IL-17 may provide some explanation for the discordance in protection between infection and disease and suggests that controlling immunopathology, as opposed to the rapid eradication of the infection, may be essential for an effective human chlamydial vaccine that prevents infertility.

The next publication revolution : open access and the post-2014 Research Excellence Framework

The world is increasingly moving towards more open models of publishing and communication. The UK government has demonstrated a firm commitment to ensuring that academic research outputs are made available to all who might benefit from access to them, and its open access policy attempts to make academic publications freely available to readers, rather than being locked behind pay walls or only available to researchers with access to well-funded university libraries. Open access policies have an important role to play in fostering an open innovation ecosystem and ensuring that maximum value is derived from investments in university-based research. But are we ready to embrace this change?

A pilot randomised trial of Medilixir cream shows some promising results, but control treatment may have been inappropriate

Aim To test the efficacy of Medilixir [cream] against the standard treatment of aqueous cream in the provision of relief from the symptoms of postburn itch. Design RCT with two parallel arms. Setting Professor Stuart Pegg Adult Burns Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia. Participants Fifty-two patients aged between 18 and 80 years, admitted directly to the burns centre between 10 March and 22 July 2008, were able to provide informed consent, and had shown no allergic reaction to a patch test with the study medication, were randomised. Patients admitted from intensive care or high dependency were excluded. Main results Effect estimates and confidence intervals were not reported for any of the outcomes; only group means/proportions and P-values from hypothesis testing were provided. More patients in the intervention group reported itch reduction compared to comparison treatment (91 vs. 82%, P=0.001). Itch recurrence after cream application occurred later in the intervention group compared to the control group (P<0.001). Use of antipruritic medication was significantly greater in the control group (P=0.023). There was no difference in sleep disturbance between groups (not quantified). On average, Medilixir took longer to apply than aqueous cream (157s for Medilixir vs. 139s for aqueous cream; mean difference 17s), but authors noted that the groups did not differ significantly (CI for mean difference and P-values were not reported).

Cryptography in the cloud : advances and challenges

Cloud computing is a currently developing revolution in information technology that is disturbing the way that individuals and corporate entities operate while enabling new distributed services that have not existed before. At the foundation of cloud computing is the broader concept of converged infrastructure and shared services. Security is often said to be a major concern of users considering migration to cloud computing. This article examines some of these security concerns and surveys recent research efforts in cryptography to provide new technical mechanisms suitable for the new scenarios of cloud computing. We consider techniques such as homomorphic encryption, searchable encryption, proofs of storage, and proofs of location. These techniques allow cloud computing users to benefit from cloud server processing capabilities while keeping their data encrypted; and to check independently the integrity and location of their data. Overall we are interested in how users may be able to maintain and verify their own security without having to rely on the trust of the cloud provider.

Processing biases towards gain-framed messages may lead reward sensitive individuals to adopt safer driving behaviours

Using Gray and McNaughton’s revised RST, this study investigated the extent to which the Behavioural Approach System (BAS) and the Fight-Flight-Freeze System (FFFS) influence the processing of gain-framed and loss-framed road safety messages and subsequent message acceptance. It was predicted that stronger BAS sensitivity and FFFS sensitivity would be associated with greater processing and acceptance of the gain-framed messages and loss-framed messages, respectively. Young drivers (N = 80, aged 17–25 years) viewed one of four road safety messages and completed a lexical decision task to assess message processing. Both self-report (e.g., Corr-Cooper RST-PQ) and behavioural measures (i.e., CARROT and Q-Task) were used to assess BAS and FFFS traits. Message acceptance was measured via self-report ratings of message effectiveness, behavioural intentions, attitudes and subsequent driving behaviour. The results are discussed in the context of the effect that differences in reward and punishment sensitivities may have on message processing and message acceptance.