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Man Utd v Reading Odds
Manchester United and Reading hasn't been a regular fixture over the years but Reading will certainly hope to make it one by staying in the Premier League during the coming seasons. They have never beaten the Red Devils in league football and United will start as odds on favourites for this latest fixture.
Brian McDermott's side lost 4-3 in a thrilling meeting at the Madejski Stadium in December. Reading were edged out again as they lost 2-1 at Old Trafford in the fifth round of the FA Cup in February. United justified odds on favouritism to make it three wins from three against Reading as they won 1-0 in their home league game.
Man Utd v Reading Head to Head
|Man Utd Wins
|Reading Wins
|FA Cup:
Last six meetings:
- Premier League - 16th Mar 2013 - Man Utd 1 - 0 Reading
- FA Cup - 18th Feb 2013 - Man Utd 2 - 1 Reading
- Premier League - 1st Dec 2012 - Reading 3 - 4 Man Utd
- Premier League - 19th Jan 2008 - Reading 0 - 2 Man Utd
- Premier League - 12th Aug 2007 - Man Utd 0 - 0 Reading
- FA Cup - 27th Feb 2007 - Reading 2 - 3 Man Utd
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The food was delicious and proportions were large. The service was quick and friendly. The price was very low for the quality of food. Great place to eat!
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Harbhajan Singh and Geeta Basra were blessed with a baby girl on July 28 and the proud mom shared a cute picture of her baby's hand holding her finger tightly. Though the face of the baby is not visible, it is quite adorable. Geeta captioned the picture #Thank you everyone for the love and beaut
Geeta Basra Hot Photo Shoot @ www.hindi-links4u.net
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Yahoo! It's a girl for Geeta Basra and Harbhajan Singh. Geeta Basra delivers a baby girl in a hospital in London on Wednesday. Harbhajan's mother Avtar Kaur shared the good news of the baby birth on Wednesday in London. According to a report, the mother and the baby are doing fine. Highly
Giving birth to a child and becoming a parent is a matter of greatest joy. The news of stork visiting the home bring a lot of happiness and the parents-to-be await the day when they would be able to hold the baby in their arms. Many of our celebrities are also excitedly waiting to welcome their n
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Take the ferry across, on a nice day, views and peaceful walks. Visit the shop beside the old cottage and sports ground. They have keys for the old cottage.
Took the Diamond Harbour launch across with granddaughter, walked up to the shops for a coffee for me and an ice cream for her, Superb views of Lyttelton harbour and port, walked back down to small beach then back on launch to Lyttelton. Great adventure.
We had a wonderful day walking over the Bridle Path to Lyttelton, then down to the docks and over to Diamond Harbour on the ferry. I got Treatme deals of $13 each for return ferry and $10 to spend at Preserved Eatery. Too crowded at the cafe, but still a lovely treat. The ferry was on time and professionally run....
Place perfect to hangout by cloudy or sunny day. Good fishing for Ray or Shark on the left of the park-harbour. People are great and friendly. Sometimes there is a concert on the main place.
Diamond Harbour is a very quiet harbour, and very nice to view. close to Chch but fewer people. It is on the way to Akaroa.
Food took time, but was delicious. Lady was very friendly but the coffe was possibly the nastiest, burnt coffee we've ever tasted.
Twenty years ago we started spending our wedding aniversary weekend getaways at Godley House (built 1880). Alas, all gone owing to the 'quakes, but still a pleasant sculpture garden on its site with heritage signage.
The best way to approach Diamond Harbour is by a launch/ferry ride from Lyttelton ($6.20 each way for adult). It's only 10 minutes and runs...
Lovely afternoon at the domain. went on the coastal walk and found a great spot for afternoon tea with great views out to the heads
Very lucky with weather, beautiful blue skies and warm weather. Found lovely cafe and had yummy breakfast. As small yacht owners, we would love to come back for a sail.
We have recently been for a visit by car, but have also been across on the ferry. The boat trip is awesome, especially on a lovely hot day, although even on a dull day this is a pleasant excursion.


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This review examines the evidence behind commonly debated topics in antibiotic prophylaxis and highlights the uses and advantages of some commonly used antibiotics.
Cite this article: Bone Joint J 2016;98-B:1014–19.]]>
Cite this article: Bone Joint J 2016;98-B:1020–6.]]>
Using a systematic review, we investigated whether there is an increased risk of post-operative infection in patients who have received an intra-articular corticosteroid injection to the hip for osteoarthritis prior to total hip arthroplasty (THA).
Studies dealing with an intra-articular corticosteroid injection to the hip and infection following subsequent THA were identified from databases for the period between 1990 to 2013. Retrieved articles were independently assessed for their methodological quality.
A total of nine studies met the inclusion criteria. Two recommended against a steroid injection prior to THA and seven found no risk with an injection. No prospective controlled trials were identified. Most studies were retrospective. Lack of information about the methodology was a consistent flaw.
The literature in this area is scarce and the evidence is weak. Most studies were retrospective, and confounding factors were poorly defined or not addressed. There is thus currently insufficient evidence to conclude that an intra-articular corticosteroid injection administered prior to THA increases the rate of infection. High quality, multicentre randomised trials are needed to address this issue.
Cite this article: Bone Joint J 2016;98-B:1027–35.
We wished to quantify the extent of soft-tissue damage sustained during minimally invasive total hip arthroplasty through the direct anterior (DA) and direct superior (DS) approaches.
In eight cadavers, the DA approach was performed on one side, and the DS approach on the other, a single brand of uncemented hip prosthesis was implanted by two surgeons, considered expert in their surgical approaches. Subsequent reflection of the gluteus maximus allowed the extent of muscle and tendon damage to be measured and the percentage damage to each anatomical structure to be calculated.
The DA approach caused substantially greater damage to the gluteus minimus muscle and tendon when compared with the DS approach (t-test, p = 0.049 and 0.003, respectively). The tensor fascia lata and rectus femoris muscles were damaged only in the DA approach. There was no difference in the amount of damage to the gluteus medius muscle and tendon, piriformis tendon, obturator internus tendon, obturator externus tendon or quadratus femoris muscle between approaches. The posterior soft-tissue releases of the DA approach damaged the gluteus minimus muscle and tendon, piriformis tendon and obturator internus tendon.
The DS approach caused less soft-tissue damage than the DA approach. However the clinical relevance is unknown. Further clinical outcome studies, radiographic evaluation of component position, gait analyses and serum biomarker levels are necessary to evaluate and corroborate the safety and efficacy of the DS approach.
Cite this article: Bone Joint J 2016;98-B1036–42.
We conducted a randomised controlled trial to assess the accuracy of positioning and alignment of the components in total knee arthroplasty (TKA), comparing those undertaken using standard intramedullary cutting jigs and those with patient-specific instruments (PSI).
There were 64 TKAs in the standard group and 69 in the PSI group.
The post-operative hip-knee-ankle (HKA) angle and positioning was investigated using CT scans. Deviation of > 3° from the planned position was regarded as an outlier. The operating time, Oxford Knee Scores (OKS) and Short Form-12 (SF-12) scores were recorded.
There were 14 HKA-angle outliers (22%) in the standard group and nine (13%) in the PSI group (p = 0.251). The mean HKA-angle was 0.5° varus in the standard group and 0.2° varus in the PSI group (p = 0.492). The accuracy of alignment in the coronal and axial planes and the proportion of outliers was not different in the two groups. The femoral component was more flexed (p = 0.035) and there were significantly more tibial slope outliers (29% versus 13%) in the PSI group (p = 0.032). Operating time and the median three-month OKS were similar (p = 0.218 and p = 0.472, respectively). Physical and mental SF-12 scores were not significantly different at three months (p = 0.418 and p = 0.267, respectively) or at one year post-operatively (p = 0.114 and p = 0.569). The median one-year Oxford knee score was two points higher in the PSI group (p = 0.049).
Compared with standard intramedullary jigs, the use of PSI did not significantly reduce the number of outliers or the mean operating time, nor did it clinically improve the accuracy of alignment or the median Oxford Knee Scores. Our data do not support the routine use of PSI when undertaking TKA.
Cite this article: Bone Joint J 2016;98-B:1043–9.
The Advance Medial-Pivot total knee arthroplasty (TKA) was designed to reflect contemporary data regarding the kinematics of the knee. We wished to examine the long-term results obtained with this prosthesis by extending a previous evaluation.
We retrospectively evaluated prospectively collected data from 225 consecutive patients (41 men and 184 women; mean age at surgery 71 years, 52 to 84) who underwent 284 TKAs with a mean follow-up of 13.4 years (11 to 15). Implant failure, complication rate, clinical (both subjective and objective) and radiological outcome were assessed. Pre- and post-operative clinical and radiographic data were available at regular intervals for all patients. A total of ten patients (4.4%; ten TKAs) were lost to follow-up.
Survival analysis at 15 years showed a cumulative success rate of 97.3% (95% confidence interval (CI) 96.7 to 97.9) for revision for any reason, of 96.4% (95% CI 95.2 to 97.6) for all operations, and 98.8% (95% CI 98.2 to 99.4) for aseptic loosening as an end point. Three TKAs (1.06%) were revised due to aseptic loosening, two (0.7%) due to infection, one (0.35%) due to instability and one (0.35%) due to a traumatic dislocation. All patients showed a statistically significant improvement on the Knee Society Score (p = 0.001), Western Ontario and McMaster University Osteoarthritis Index (p = 0.001), Short Form-12 (p = 0.01), and Oxford Knee Score (p = 0.01). A total of 207 patients (92%) were able to perform age appropriate activities with a mean flexion of the knee of 117° (85° to 135°) at final follow-up.
This study demonstrates satisfactory functional and radiographic long-term results for this implant.
Cite this article: Bone Joint J 2016;98-B:1050–5.
There is uncertainty regarding the optimal means of thromboprophylaxis following total hip and knee arthroplasty (THA, TKA). This systematic review presents the evidence for acetylsalicylic acid (aspirin) as a thromboprophylactic agent in THA and TKA and compares it with other chemoprophylactic agents.
A search of literature published between 2004 and 2014 was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 13 studies were eligible for inclusion.
Evidence from one good quality randomised controlled trial (RCT) showed no difference in rates of venous thrombo-embolism (VTE) in patients given aspirin or low molecular weight heparin (LMWH) following TKA. There was insufficient evidence from trials with moderate to severe risk of bias being present to suggest aspirin is more or less effective than LMWH, warfarin or dabigatran for the prevention of VTE in TKA or THA. Compared with aspirin, rates of asymptomatic deep vein thrombosis (DVT) in TKA may be reduced with rivaroxaban but insufficient evidence exists to demonstrate an effect on incidence of symptomatic DVT. Compared with aspirin there is evidence of more wound complications following THA and TKA with dabigatran and in TKA with rivaroxaban. Some studies highlighted concerns over bleeding complications and efficacy of aspirin.
The results suggest aspirin may be considered a suitable alternative to other thromboprophylactic agents following THA and TKA. Further investigation is required to fully evaluate the safety and efficacy of aspirin.
Cite this article: Bone Joint J 2016;98-B:1056–61.
Tissue responses to debris formed by abrasion of polymethylmethacrylate (PMMA) spacers at two-stage revision arthroplasty for prosthetic joint infection are not well described. We hypothesised that PMMA debris induces immunomodulation in periprosthetic tissues.
Samples of tissue were taken during 35 two-stage revision arthroplasties (nine total hip and 26 total knee arthroplasties) in patients whose mean age was 67 years (44 to 85). Fourier transform infrared microscopy was used to confirm the presence of PMMA particles. Histomorphometry was performed using Sudan Red and Haematoxylin-Eosin staining. CD-68, CD-20, CD-11(c), CD-3 and IL-17 antibodies were used to immunophenotype the inflammatory cells. All slides were scored semi-quantitatively using the modified Willert scoring system.
The mean CD-68 scores did not show any significant change during the six weeks between the stages. Perivascular and diffuse scores showed significant difference in CD-3, CD-20, CD-11(c) and IL-17. At the time of re-implantation, a shift in the pattern of the expression of dendritic cells towards a perivascular arrangement and towards the periphery of PMMA particles was observed. Positive microbiological cultures were found at the time of re-implantation in three patients. Five further revisions were required for other reasons.
Our results represent a biological reaction of the synovial tissues to spacers with a less diffuse expression of dendritic cells and an increased expression of perivascular lymphocytes. The use of spacers in two-stage revision for infection probably induces an immunomodulation of synovial tissues.
Cite this article: Bone Joint J 2016;98-B:1062–8.
The degree of displacement of a fracture of the distal radius is an important factor which can be assessed using simple radiographic measurements. Our aim was to investigate the reliability and reproducibility of these measurements and to determine if they should be used clinically.
A 10% sample was randomly generated from 3670 consecutive adult patients who had presented to University Hospitals of Leicester NHS Trust between 2007 and 2010 with a fracture of the distal radius. Radiographs of the 367 patients were assessed by two independent reviewers. Four measurements of displacement of the fracture were recorded and the inter-observer correlation assessed using the intra-class correlation coefficient.
Inter-observer correlation was high (> 0.8) for three of the four measurements. Repeat measurements of a further randomly generated 10% sample (37) were made four weeks later to assess intra-observer agreement, which was again high (> 0.8) for the same three parameters (radial height, radial inclination and dorsal/palmar tilt). Correlation was poor for articular step and gap.
Radiographic assessment of radial angle, radial inclination and dorsal/palmar tilt is a reliable method of determining the degree of displacement of a fracture of the distal radius.
Cite this article: Bone Joint J 2016;98-B:1069–73.
Our aim was to investigate the outcomes of patients with a displaced fracture of the glenoid fossa who are treated conservatively. There is little information in the literature about the treatment of these rare injuries non-operatively.
We reviewed 24 patients with a mean age of 52 years (19 to 81) at a mean of 5.6 years (11 months to 18 years) after the injury.
At final follow-up, the mean Constant and Murley score was 79 points (18 to 98); the mean Western Ontario Shoulder Instability Index score (WOSI) was 77% (12 to 100) and the mean Rowe score was 93 points (50 to 100). Fractures with little intra-articular displacement (≤ 3 mm) had an uneventful outcome. Those with intra-articular displacement of ≤ 3 mm had a significant better mean Constant and Murley score than those with displacement of ≥ 5 mm and/or a fracture gap of ≥ 5 mm. Poor clinical results such as nonunion and post-traumatic osteoarthritis were associated with displaced or angulated glenoid fragments and significant intra-articular displacement.
Glenoid fossa fractures with displacement of ≥ 5 mm should be treated surgically if the patient's condition allows. Displacement and angulation can lead to nonunion and a poor outcome if the degree of displacement results in a persistent fracture gap in the glenoid fossa or if the angulation of fragments leads to malunion.
Cite this article: Bone Joint J 2016;98-B:1074–9.
Patient-specific glenoid guides (PSGs) claim an improvement in accuracy and reproducibility of the positioning of components in total shoulder arthroplasty (TSA). The results have not yet been confirmed in a prospective clinical trial. Our aim was to assess whether the use of PSGs in patients with osteoarthritis of the shoulder would allow accurate and reliable implantation of the glenoid component.
A total of 17 patients (three men and 14 women) with a mean age of 71 years (53 to 81) awaiting TSA were enrolled in the study. Pre- and post-operative version and inclination of the glenoid were measured on CT scans, using 3D planning automatic software. During surgery, a congruent 3D-printed PSG was applied onto the glenoid surface, thus determining the entry point and orientation of the central guide wire used for reaming the glenoid and the introduction of the component. Manual segmentation was performed on post-operative CT scans to compare the planned and the actual position of the entry point (mm) and orientation of the component (°).
The mean error in the accuracy of the entry point was -0.1 mm (standard deviation (
Pre-operative planning with automatic software and the use of PSGs provides accurate and reproducible positioning and orientation of the glenoid component in anatomical TSA.
Cite this article: Bone Joint J 2016;98-B:1080–5.
Revision total elbow arthroplasty (TEA) is often challenging. The aim of this study was to report on the clinical and radiological results of revision arthroplasty of the elbow with the Latitude TEA.
Between 2006 and 2010 we used the Latitude TEA for revision in 18 consecutive elbows (17 patients); mean age 53 years (28 to 80); 14 women. A Kudo TEA was revised in 15 elbows and a Souter-Strathclyde TEA in three.
Stability, range of movement (ROM), visual analogue score (VAS) for pain and functional scores, Elbow Functional Assessment Scale (EFAS), the Functional Rating Index of Broberg and Morrey (FRIBM) and the Modified Andrews' Elbow Scoring System (MAESS) were assessed pre-operatively and at each post-operative follow-up visit (six, 12 months and biennially thereafter). Radiographs were analysed for loosening, fractures and dislocation. The mean follow-up was 59 months (26 to 89).
The ROM of the elbow did not improve significantly. The mean EFAS and MAESS scores improved significantly six months post-operatively (18.6 points, standard deviation (
Revision surgery using the Latitude TEA results in improvement of functionality, reduced pain and better stability of the elbow. Improvement of ROM of the elbow should not be expected.
Cite this article: Bone Joint J 2016;98-B:1086–92.
The purpose of this study was to investigate the prevalence of sarcopenia and to examine its impact on patients with degenerative lumbar spinal stenosis (DLSS).
This case-control study included two groups: one group consisting of patients with DLSS and a second group of control subjects without low back or neck pain and related leg pain. Five control cases were randomly selected and matched by age and gender (n = 77 cases and n = 385 controls) for each DLSS case. Appendicular muscle mass, hand-grip strength, sit-to-stand test, timed up and go (TUG) test, and clinical outcomes, including the Oswestry Disability Index (ODI) scores and the EuroQol EQ-5D were compared between the two groups.
The prevalence of sarcopenia, as defined by hand-grip strength, was significantly higher in the DLSS group (24%) when compared with the age- and gender-matched control group (12%) (p = 0.004). In the DLSS group, the sarcopenia subgroup demonstrated inferior results for the TUG test and ODI scores when compared with the non-sarcopenia subgroup (p = 0.006 and p = 0.039, respectively) after adjusting for age and gender.
This study demonstrated a higher prevalence of sarcopenia in patients with DLSS and highlighted its negative effect on clinical outcomes.
Cite this article: Bone Joint J 2016;98-B:1093–8.
Loosening of pedicle screws is a major complication of posterior spinal stabilisation, especially in the osteoporotic spine. Our aim was to evaluate the effect of cement augmentation compared with extended dorsal instrumentation on the stability of posterior spinal fixation.
A total of 12 osteoporotic human cadaveric spines (T11-L3) were randomised by bone mineral density into two groups and instrumented with pedicle screws: group I (SHORT) separated T12 or L2 and group II (EXTENDED) specimen consisting of T11/12 to L2/3. Screws were augmented with cement unilaterally in each vertebra. Fatigue testing was performed using a cranial-caudal sinusoidal, cyclic (1.0 Hz) load with stepwise increasing peak force.
Augmentation showed no significant increase in the mean cycles to failure and fatigue force (SHORT p = 0.067; EXTENDED p = 0.239). Extending the instrumentation resulted in a significantly increased number of cycles to failure and a significantly higher fatigue force compared with the SHORT instrumentation (EXTENDED non-augmented + 76%, p < 0.001; EXTENDED augmented + 87%, p < 0.001).
The stabilising effect of cement augmentation of pedicle screws might not be as beneficial as expected from biomechanical pull-out tests. Lengthening the dorsal instrumentation results in a much higher increase of stability during fatigue testing in the osteoporotic spine compared with cement augmentation.
Cite this article: Bone Joint J 2016;98-B:1099–1105.
The aim of this study was to report the outcome following primary fixation or a staged protocol for type C fractures of the tibial plafond.
We studied all patients who sustained a complex intra-articular fracture (AO type C) of the distal tibia over an 11-year period. The primary short-term outcome was infection. The primary long-term outcome was the Foot and Ankle Outcome Score (FAOS).
There were 102 type C pilon fractures in 99 patients, whose mean age was 42 years (16 to 86) and 77 were male. Primary open reduction internal fixation (ORIF) was performed in 73 patients (71.6%), whilst 20 (19.6%) underwent primary external fixation with delayed ORIF. There were 18 wound infections (17.6%). A total of nine (8.8%) were deep and nine were superficial. Infection was associated with comorbidities (p = 0.008), open fractures (p = 0.008) and primary external fixation with delayed ORIF (p = 0.023). At a mean of six years (0.3 to 13; n = 53) after the injury, the mean FAOS was 76.2 (0 to 100) and 72% of patients were satisfied.
This is currently the largest series reporting the outcome following fixation of complex AO type C tibial pilon fractures. Despite the severity of these injuries, we have demonstrated that a satisfactory outcome can be achieved in the appropriate patients using primary ORIF.
Cite this article: Bone Joint J 2016;98-B:1106–11.
We examined risk of developing acute renal failure and the associated mortality among patients aged > 65 years undergoing surgery for a fracture of the hip.
We used medical databases to identify patients who underwent surgical treatment for a fracture of the hip in Northern Denmark between 2005 and 2011. Acute renal failure was classified as stage 1, 2 and 3 according to the Kidney Disease Improving Global Outcome criteria. We computed the risk of developing acute renal failure within five days after surgery with death as a competing risk, and the short-term (six to 30 days post-operatively) and long-term mortality (31 days to 365 days post-operatively). We calculated adjusted hazard ratios (HRs) for death with 95% confidence intervals (CIs).
Among 13 529 patients who sustained a fracture of the hip, 1717 (12.7%) developed acute renal failure post-operatively, including 1218 (9.0%) with stage 1, 364 (2.7%) with stage 2, and 135 (1.0%) with stage 3 renal failure. The short-term mortality was 15.9% and 5.6% for patients with and without acute renal failure, respectively (HR 2.8, 95% CI 2.4 to 3.2). The long-term mortality was 25.0% and 18.3% for those with and without acute renal failure, respectively (HR 1.3, 95% CI 1.2 to 1.5). The mortality was higher in patients with an increased severity of renal failure.
Acute renal failure is a common complication of surgery in elderly patients who sustain a fracture of the hip, and is associated with increased mortality up to one year after surgery despite adjustment for coexisting comorbidity and medication before surgery.
Cite this article: Bone Joint J 2016;98-B:1112–18.
Flail chest from a blunt injury to the thorax is associated with significant morbidity and mortality. Its management globally is predominantly non-operative; however, there are an increasing number of centres which undertake surgical stabilisation. The aim of this meta-analysis was to compare the efficacy of this approach with that of non-operative management.
A systematic search of the literature was carried out to identify randomised controlled trials (RCTs) which compared the clinical outcome of patients with a traumatic flail chest treated by surgical stabilisation of any kind with that of non-operative management.
Of 1273 papers identified, three RCTs reported the results of 123 patients with a flail chest. Surgical stabilisation was associated with a two thirds reduction in the incidence of pneumonia when compared with non-operative management (risk ratio 0.36, 95% confidence interval (CI) 0.15 to 0.85, p = 0.02). The duration of mechanical ventilation (mean difference -6.30 days, 95% CI -12.16 to -0.43, p = 0.04) and length of stay in an intensive care unit (mean difference -6.46 days, 95% CI 9.73 to -3.19, p = 0.0001) were significantly shorter in the operative group, as was the overall length of stay in hospital (mean difference -11.39, 95% CI -12.39 to -10.38, p < 0.0001).
Surgical stabilisation for a traumatic flail chest is associated with significant clinical benefits in this meta-analysis of three relatively small RCTs.
Cite this article: Bone Joint J 2016;98-B:1119–25.
Demineralised bone matrix (DBM) is rarely used for the local delivery of prophylactic antibiotics. Our aim, in this study, was to show that a graft with a bioactive glass and DBM combination, which is currently available for clinical use, can be loaded with tobramycin and release levels of antibiotic greater than the minimum inhibitory concentration for Staphylococcus aureus without interfering with the bone healing properties of the graft, thus protecting the graft and surrounding tissues from infection.
Antibiotic was loaded into a graft and subsequently evaluated for drug elution kinetics and the inhibition of bacterial growth. A rat femoral condylar plug model was used to determine the effect of the graft, loaded with antibiotic, on bone healing.
We found that tobramycin loaded into a graft composed of bioglass and DBM eluted antibiotic above the minimum inhibitory concentration for three days in vitro. It was also found that the antibiotic loaded into the graft produced no adverse effects on the bone healing properties of the DBM at a lower level of antibiotic.
This antibiotic-loaded bone void filler may represent a promising option for the delivery of local antibiotics in orthopaedic surgery.
Cite this article: Bone Joint J 2016;98-B:1126–31.
Compartment syndrome results from increased intra-compartmental pressure (ICP) causing local tissue ischaemia and cell death, but the systemic effects are not well described. We hypothesised that compartment syndrome would have a profound effect not only on the affected limb, but also on remote organs.
Using a rat model of compartment syndrome, its systemic effects on the viability of hepatocytes and on inflammation and circulation were directly visualised using intravital video microscopy.
We found that hepatocellular injury was significantly higher in the compartment syndrome group (192 PI-labelled cells/10-1 mm3, standard error of the mean (
Compartment syndrome can be accompanied by severe systemic inflammation and end organ damage. This study provides evidence of the relationship between compartment syndrome in a limb and systemic inflammation and dysfunction in a remote organ.
Cite this article: Bone Joint J 2016; 98-B:1132–7.
The purpose of this study was to review a large cohort of patients and further assess the correlation between the histological response to chemotherapy in patients with Ewing's sarcoma with the overall (OS) and event-free survival (EFS).
All patients treated for Ewing's sarcoma between 1980 and 2012 were reviewed. Of these, 293 patients without metastases at the time of diagnosis and treated with chemotherapy and surgery were included. Patients were grouped according to the percentage of necrosis after chemotherapy: Group I: 0% to 50%, Group II: 51% to 99% and Group III: 100%.
The mean age at diagnosis was 16 years (1 to 62) and the mean follow-up was 9.1 years (six months to 32.6 years). The OS and EFS for the series were 75% and 65% at five years. There were significant differences in survival between the groups of necrosis: 0% to 50% (OS: 49% and EFS: 45% at five years, respectively) compared with 51% to 99% (OS: 72% and EFS: 59% at five years, respectively) and 100% (OS: 94% and EFS: 81% at five years, respectively) (p < 0.001).
There were no significant differences in survival between patients treated between 1980 and 1989 compared with those treated between 1990 and 1999, and those treated between 2000 and 2012 (p = 0.55).
Only patients with 100% necrosis after chemotherapy should be classified as having a good response to chemotherapy because they have significantly better rates of survival compared with those with any viable tumour in the surgical specimen.
Cite this article: Bone Joint J 2016;98-B:1138–44.
This study compared the long-term results following Salter osteotomy and Pemberton acetabuloplasty in children with developmental dysplasia of the hip (DDH). We assessed if there was a greater increase in pelvic height following the Salter osteotomy, and if this had a continued effect on pelvic tilt, lumbar curvature or functional outcomes.
We reviewed 42 children at more than ten years post-operatively following a unilateral Salter osteotomy or Pemberton acetabuloplasty. We measured the increase in pelvic height and the iliac crest tilt and sacral tilt at the most recent review and at an earlier review point in the first decade of follow-up. We measured the lumbar Cobb angle and the Short Form-36 (SF-36) and Harris hip scores were collected at the most recent review.
During the first decade of follow-up, there was a greater increase in pelvic height in the children who had a Salter osteotomy (Salter, 10.1%; Pemberton, 4.3%, p < 0.001). The difference in the increase in pelvic height was insignificant at the most recent review (Salter, 4.4%; Pemberton, 3.1%, p = 0.249). There was no significant difference between the two groups for the lumbar Cobb angle, (Salter, 3.1°; Pemberton, 3.3°, p = 0.906). A coronal lumbar curve was seen in 41 children (97%), 30 of these had a compensatory curve. Sacral tilt was the radiographic parameter for pelvic imbalance that correlated most with the lumbar Cobb angle (Pearson correlation co-efficient 0.59). The Harris hip score and SF-36 were good and showed no differences between the two groups.
In the long-term, we found no difference in the functional results or pelvic imbalance between Salter osteotomy and Pemberton acetabuloplasty in the management of children with DDH.
Cite this article: Bone Joint J 2016;98-B:1145–50.


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The first book in the Flowers of Eden series introduced readers to Bryony Linwood, an orphan trying desperately to provide for her sisters in the shadow of the Great Depression. In Castles in the Clouds, we meet one of those sisters—Larkspur Linwood, a young woman who has a passion for ... more >
East Sussex, 1914. It is the end of England's brief Edwardian summer, and everyone agrees that the weather has never been so beautiful. Hugh Grange, down from his medical studies, is visiting his Aunt Agatha, who lives with her husband in the small, idyllic coastal town of Rye. Agatha's husband ... more >
When Richard Slater receives a letter of complaint from one of his constituents, a Margaret Hayton, he merely responds with his standard letter of empty promises. Clearly, this woman is insane and must be avoided at all costs. But she will not be dismissed so easily, and when Richard finally ... more >
I have been slowly making my way through the Bronte sisters' oeuvre, having read Jane Eyre twice (in high school and college) and then tackling the frankly batshit Wuthering Heights a few years ago. Since then, I've read Anne's two novels, Agnes Grey and The Tenant of Wildfell Hall, and ... more >


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Ship Management Software
Rolfs Returns As New IT Provider
John Rolfs, a founding director of shipping IT provider Dataworks, has returned to the maritime communications and technology sector after a two-year absence with his new company, Chipcraft. Rolfs left Dataworks in 2001 when it was acquired by Strategic Software. Chipcraft, his first venture back into the maritime sector, is a specialized software provider to the shipping world. Chipcraft is the official U.K. and Northern Europe representative for Danaos Shipping Software of Greece. As well as bringing communications and ship management software to match client needs, the company provides installation and support for its customers through U.K. partner and network specialists, Blue Diamond IT. It was a condition of the sale of Dataworks to Strategic that Rolfs would refrain from competitive business for two years. This clause, which ran to its conclusion at the end of this month, will allow Rolfs to launch his new venture on June 1.
ShipDecision New Module for Vessel Position
Responding to Ship Brokers' need for faster access to accurate information on vessel positions, ShipDecision has released a Broker Module of its ship management software that automates the collection of vessel position data and cargo order information. ShipDecision software eliminates the need for Brokers to search manually through the thousands of incoming daily emails. The Vessel Position feature of the system examines each incoming message and automatically extracts
SIS Secures Contract With Destination Gotland
Star Information Systems (SIS), a provider of integrated fleet management software, has secured a further contract with Destination Gotland for the supply of software systems onboard the company's two Ropax newbuildings. The contract comes shortly after the Swedish shipping company upgraded four of its five vessels with fleet management software from SIS.
SpecTec to Purchase 20% MarineXchange
SpecTec Group, IT supplier to the merchant and cruise shipping markets, has recently acquired a 20% share in MarineXChange Software GmbH. MarineXchange is a provider of enterprise resource management software to the cruise industry. "The two companies have collaborated for several years already, and our software portfolios and philosophies complement each other very well", said Giampiero Soncini, CEO of SpecTec Group
SpecTec Group Opens Newest Office In Rio de Janeiro, Brazil
The SpecTec Group has opened their newest office in Rio de Janeiro: officially, AMOS Brasil Sistemas de Gestão de Recursos e Consultoria de Software Ltda., or SpecTec Brazil, will serve as region headquarters. "With our recently opened office in Buenos Aires, Argentina, and now in Rio de Janeiro, Brazil, SpecTec Latin America is on a strategic course for continued expansion and growth in both the shipping and oil & gas industries", says Giampiero Soncini
DNV Launches Risk Management Software
Structured and analytical risk management have direct effects on a company's ability to build a competitive advantage. To support organizations with one complete solution for managing operational, project and enterprise risk DNV Software has now incorporated the risk management tool EasyRisk Manager with the Synergi Life risk and QHSE-management solution. It provides a real time snapshot of a company's risk picture.
Vector and MPS to Provide Joint Delivery of ISPS Services
Vector Maritime Software and Maritime Protection Systems (MPS) have announced their joint services to clients to implement the forthcoming ISPS requirements using the Vector Management System The services start with practical security consultancy from which MPS develop the company specific ISPS documentation and manuals. The manuals are developed within the Vector ISM Manager software which has been expanded to suit the requirements of ISPS
Eimskip Chooses Star Information Systems
Eimskip, Iceland's oldest shipping company, has chosen Star Information Systems for their fleet management. Under the terms of the agreement, Star Information Systems (SIS) will provide a fully integrated software package, including systems to manage maintenance, purchasing, work planning, guarantee claims, messaging, insurance policies and claims, budget and cost control, project, event, crew and document management
DNV Launches Synergi RBI Software
Managing onshore and offshore assets has previously demanded multiple risk-based inspection (RBI) software tools, increasing operator cost and reducing efficiency. With the new release of DNV Software's Synergi Plant, which has integration with Synergi RBI, operators can use one complete quantitative risk assessment system, moving from subjective to objective decision making and from preventive to predictive maintenance.
Orion Marine Concepts Launches Q-Strata Software
Aiming to provide niche control over managed/owned vessels, Indian maritime based software provider Orion Marine Concepts has released a strategic intelligence software suite approved by DNV GL. Orion Marine along with Chembulk Tankers, USA has taken the lead in developing this quality assurance and fleet performance management suite, named Q-Strata. Q-Strata is a comprehensive web-based tool for efficient management of quality health and safety and environmental aspects of
MN100: MarineCFO
The Company: Founded in 1992, UA Business Solutions was a pioneer in the field of Enterprise Resource Planning (ERP) and an early Microsoft Partner. The ERP evolution into the maritime industry found UA developing industry specific solutions for marine clients
MN100: TPG Marine Enterprises, LLC
The Company: TPG Marine Enterprises, LLC is an operations, logistics and consulting company that specializes in all aspects of cargo movement on the Inland Waterways System. The firm owns and operates eight facilities in the Midwest and has about 200 employees
MobileOps Pursuing Maritime Business
Redmond, Wash. based MobileOps, Inc., a software company specializing in the design and development of maritime software applications (dispatch, safety, compliance, vessel maintenance, timecards and analytics), has recently reformed and is now pursuing further business development within the tug
MN100: Krill Systems, Inc.
The Company: Krill Systems Inc. was founded as a software development company focusing on accurate vessel fuel consumption measurement and efficient data transmission. In 2011, identifying demand from commercial marine markets for accurate, reliable
DNV GL's Synergi Water with four Core Modules
The new release of DNV GL's Synergi Water includes four modules that have previously been separately licensed. The addition of these modules – Unidirectional Flushing, Pipe Design, Calibration and Pump Scheduling – supports Synergi Water's position as a uniquely
First ISDS for DNV GL Classed Ocean Greatwhite
DNV GL has welcomed the world's largest semi-submersible drilling rig into class recently. Ocean Greatwhite is 123 metres long and 78 metres wide and was delivered at Hyundai Heavy Industries in Ulsan, South Korea. Owned by the Houston-based drilling contractor Diamond Offshore
Kongsberg: Blazing a Digital Trail
Earlier this year Kongsberg launched Kongsberg Digital, a new subsidiary to expand its industrial software offering, a "start-up" with about 500 employees. Hege Skryseth, President of Kongsberg Digital and also the Chief Digital Officer of Kongsberg shares with MR her insights on the
Thales to Take Key Role in 'Exercise Unmanned Warrior'
Thales is set to play a key role in a major U.K. Royal Navy exercise later this year to understand how unmanned systems might add real innovative operational capability in a military maritime environment. Exercise Unmanned Warrior will bring together the Royal Navy and 40 organizations
MN100: Horizon Shipbuilding, Inc.
13980 Shell Belt Road Bayou La Batre, Alabama 36509 Telephone: (251) 824-1660 E-mail: email@example.com Website: www.horizonshipbuilding.com CEO/President: Travis Short The Company: Horizon Shipbuilding, Inc. is located on the Southwestern coast of Alabama
Raising the Stakes on Maritime Performance
A Danish software company has set out to help maritime companies facilitate growth in stormy waters. The maritime industry is changing. Emerging technologies, increased regulation and CO2 concerns are pressuring ship owners, operators and technical managers
New Danelec ECDIS Includes UK AIO Service
The United Kingdom Hydrographic Office (UKHO) ADMIRALTY Information Overlay (AIO) is now available on Danelec Marine DM800 G2 Electronic Chart Display and Information Systems (ECDIS). AIO allows subscribers using the ADMIRALTY Vector Chart Service (AVCS) to view the latest temporary and
MN100: FloScan Instruments, Inc.
The Company: FloScan designs and manufactures Fuel Monitoring Systems for use on a wide range of diesel powered commercial vessels on every continent including ocean-going, harbor and inland tugs; oil rig platform, research and fishing vessels. The Case:
MN100: Baker, Lyman & Co., Inc.
The Company: A wheelhouse favorite for generations, Baker, Lyman & Co. is the oldest NOAA & Admiralty Chart Agent in the United States. Baker Lyman has been provisioning vessels with nautical charts, electronic charting systems, publications, safety/educational materials
Hoppe Marine to Present Smart Shipping Solutions
For decades, Hamburg-based Hoppe Marine has produced onboard measuring and control systems. At SMM 2016 the internationally-positioned family-run company will be present itself as a data integrator on vessels as a precondition for Smart Shipping and Big Data.
Grand Bahama Shipyard Adds Four Executives
Grand Bahama Shipyard Limited (GBSL), a Caribbean shipyard providing retrofit, refurbishment and revitalization to cruise and commercial vessels, has added four new positions to its executive team in 2016. Taking up the new executive positions are Ian Edward Ross, Don Keirce


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text:
- Our bakers use frothy egg whites, sugar and matzo meal to make these heavenly coconut confections. They're golden on top with a tender, chewy center inside. While delicate enough to pair with créme brulee and a knockout accompaniment for tropical fruit salads, these sweet cookie classics also go solo with panache. Warning! Our in-house tests have found them to be dangerously addictive.Claims
- No Hydrogenated Oils
- Contains Eggs
- Contains Wheat
- Please note: FreshDirect's kitchen uses eggs, fish, milk, shellfish, soy, peanuts, tree nuts and wheat ingredients.
- Contains Tree Nuts
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You Don't Get Joy Without Risk
A Conversation with Amanda Palmer on "The Art of Asking."
Amanda Palmer is busy, she's juggling a book release, a new musical, the last days of her epic Kickstarter fulfillment, a best friend battling cancer, an upcoming tour, and never quite catching up to herself.
She's a celebrated rockstar, a much maligned internet celebrity, a party thrower, a conversation starter, and a controversy magnet.
When I ask how she's doing she says she's stretched pretty thin, running on fumes.
KB: How long have you felt that way?
AFP: In a certain respect I've been running on fumes since 2001. Though, I feel generally calmer than I did 7 years ago because I'm not as stressed about becoming famous. I've landed on a small island where I like it and I'm gradually reorganizing my life, brain, and time to spend more moments enjoying myself and the people I love instead of wasting time on stupid shit.
KB: What do you do to refuel yourself?
AFP: If there was a single answer to that I would be so happy. But there is no single answer to that because refueling myself on certain days means getting away from everybody and catching up on work and on certain other days it means getting away from work and doing something artistic and on certain days it means making sure I pay attention to my husband, and my friend with cancer. And I have to refuel myself in all of these ways to be able to do any of them.
If there's one consistent thread underlying all of it, it's keeping up my mindfulness practice because when I let that go, everything suffers.
KB: Let's talk about your book, The Art of Asking, which is based on your TED talk. How did the book grow from your talk?
AFP: When I was writing the talk there were a lot of subjects — branches of the tree — that I had to lop off in order to make it the pruned, twelve-minute product that I had to deliver, so my brain had already done the work of making those connections. While I was writing the talk I saw a parallel with every department of my life, whether that was my marriage, or my best friend battling cancer.
Those things didn't all have a place in the talk, it would have taken away from the power of the talk if I'd tried to cram it all in: stripping, and husband, and cancer… And every single thing that is connected to the philosophy of existence.
So I kept the talk structured around music and street performance and human beings seeing each other.
When I started writing the book I gave myself carte blanche, I let myself write about everything. EVERYTHING. I let the garden grow completely wild with weeds and flowers and whatever seeds I wanted to scatter to see what would grow. I figured I would come back in the editing process and manicure it all down to something attractive.
I also give the reader the benefit of the doubt. I assume the reader can make these connections and that I don't have to draw a patronizing line between all the topics.
Crowdfunding is like friendship is like marriage is like the meaning of life.
KB: So this is a book for everybody, not just people who want to crowdfund?
AFP: Absolutely. In fact I wrote about 150,000 words in the original draft and then cut a good 60,000 words. The majority of the cut material was about crowdfunding and internet and how to use Twitter. I figure that's all interesting material but it wasn't for this book. I can always go back and print that as a second book, or put it on the internet. I kept the stuff that I felt was more enduring, that will still be true for everybody in 15 years.
That's the path I gave myself when I was cutting it down, which was really hard because I wrote some really funny, really good stuff about the internet, but I had to let it die to let the book come down to a reasonable length and a more universal point of view.
I openly name and discuss Kickstarter, and Twitter, and Facebook, and all the tools that I use, but it's not a book about using the internet, it's a book about people. The platforms are incredible, but also ephemeral. It's the connection underneath that makes the internet so amazing
KB: The internet is a tool for communicating, we're going to keep communicating with or without it.
AFP: It would be really funny if the internet went away and people just decided not to talk to each other.
KB: We could all become hermits.
AFP: Actually we'd probably talk to each other more. But that's a different book.
KB: Was the book hard for you to write?
AFP: Not because it was hard to write, but because it was hard work, if that makes sense? I never had writer's block, there were never any days spent staring at a blank screen. But I like people and randomness and connections, and I really don't like sitting in a chair for 8 hours a day doing that same thing over and over, and the book necessitated sitting in a chair for 8 hours a day doing the same thing over and over.
KB: You really thrive on the internet — at being part of a conversation, do you think it was hard to write the book because it wasn't the same kind of conversation?
AFP: Well I hope the book starts a greater conversation. But also, having been a blogger for so long it's actually really satisfying to get the chance to really say my piece in the book.
The people who don't like me, don't want to like me, don't want to talk to me, they probably won't read the book, and that sort of makes me happy. It's really easy for an "Amanda Palmer Hater" to respond to a tweet or a short blog post, but the book is so substantial that I think they probably won't read it. But if they do, if someone is a real dedicated hater and they read my book, that in itself is a great feat.
There will undoubtedly be at least one "Hate Ambassador" who tediously combs through the book for things to misquote in their Gawker post about me, but that's a meta part of the book process because it's also a book about criticism and how to take it. It's a book about hate and how to take it.
If the book has one underlying thesis it's that "You don't get joy without risk." It just doesn't work that way, things aren't built that way. So the book, and the reaction to the book, is one more layer in the giant karmic shitcake.
"You don't get joy without risk."
Bring it on.
Though, I've made a vow to not read any reviews. Which will be hard for me, not because I'm a masochist, but because I want to see how the book is hitting people, what resonates, what they discuss.
KB: You do have the benefit of a very vocal audience, so you won't have to read reviews to be part of the conversation about the book.
AFP: Yeah, if I want to avoid criticism altogether the only true route to that is to not get on the internet for a few months and I desperately want to be on the internet when the book comes out so I can promote, and answer questions from real people who want to talk about it.
I've been talking to a lot of musicians friends about reviews lately. The people who don't understand you weigh so much more, psychically, than the people who do understand you. The good doesn't outweigh the bad when it comes to taking on love and hate. Ever.
I also think having an organic, ever-flowing relationship with your critics and your lovers is an important part of the process, it is an important part of being an artist. I learn things from my critics, especially from my fans who criticize me, because they actually know me and I respect them so much more than the troll-y, random haters.
I think closing yourself off to negativity can be just as dangerous. You just start living in a bubble and that's not good.
KB: You'd probably have to stay off the internet for… oh, the rest of your life.
AFP: You could also just dig a hole for yourself and shovel some dirt on top to be protected from all things in the world as well, but that's not necessarily the best option.
KB: So they say.
People tend to see celebrities as perfect, strong, invincible.
AFP: The idea that there is an ideal person standing above you is so tempting. And it's just not true. I've yet to meet a person who's not in pain at some level, who's not vain, and who's not scared and vulnerable at any level. People who act as if they are become less and less believable to me over time.
The strongest people I see are the ones who are willing to be honest about their own vulnerability. It's a different kind of strength. If you're able to embrace your own fear you get a different kind of resilience. You can bounce back much more quickly from the blows of life.
If I seem invincible to people I hope it's because they see that side of me. Not some bullshit side where I am a person who is absolutely not afraid of rejection and not afraid of pain, and not afraid of anyone or anything. Because that's just not true. I am afraid of all these things. But I also believe that we're all afraid, so my main focus is to remember that I'm not alone and to remind other people that they're not alone either.
KB: What's the biggest thing you've learned from asking?
AFP: You can't ask authentically and gracefully without truly being able to accept "No" for an answer. Because if you're not truly willing to accept "No" for an answer, you're not really asking, you're demanding — you're begging. At least, that's how I've come to understand asking.
KB: Final question - What do you want to ask for now?
AFP: I want to ask everybody on the internet to be kind to each other.
I think we as a society, in using the internet to communicate to one another, are really responsible for shaping the etiquette that exists there. And I think we're forgetting how to treat each other in general.
I see a lot of people answering anger with anger, and hitting back at shitty comments with more shitty comments. And I'm banging my head against a wall thinking, "How are we going to get ourselves out of this shitpile?"
Slowly, but surely, I see more people coming up with creative antidotes to the darkness that seems endemic to the internet.
So I'd like to ask the entire world on the internet to take a look at their own etiquette and how they are, or are not, talking to other people because it doesn't take much to create a shift.
I can already see it happening in some places and it's kind of wonderful.
Pre-order "The Art of Asking", US release date is 11/11 — Amanda Palmer is a Hachette author, and since Amazon.com isn't playing nice she needs all the pre-orders she can get through the stores linked to on her website: amandapalmer.net
Amanda is currently excited about the new musical theatre piece she's developing with the talented theatre students at Bard College. Read about it here.
More Amanda Palmer on the web:
This interview was conducted by @kimboekbinder — musician, writer, fox


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V.22 No.23 |
The Daily Word in local drug-treatment for teens, murder and low-impact sources of protein.
By Geoffrey Plant [ Tue Jun 11 2013 10:45 AM ]
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Tricky does Patti Smith.
A "low-impact source of protein."
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Football player gets 30 days for slapping his attorny's ass in court.
On this day in 1983 DEVO's Theme From Doctor Detroit peaked at #59 on the Billboard charts.
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White babies are now officially a minority in the United States
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oh yes so clever of you that one ..yawn ..
your vile , your mother and father would be repulsed bu there forced to bend or be accused of racism ..
but its all good you think by having black babies your gona be saved and protected , hahahahaha they will turn on you in a flash and dont come to us ... iff there is one thing im gona enjoy most its the tramps like you , gona be burned like the witches you are ..
Anonymous Coward 16200132
You make me laugh, lol. Why are you so angry? I love when people that can't even use the correct form of "your/you're" call me stupid. You know nothing. Hate is learned, I am sorry that is what you were taught.
so right Indigo!
But don't feed the trolls LOL
Their racist theories make me laugh really hard HHAHAHAHAHAHAHAHAHAH
lol ... it isnt a theory , just go read the youtube comment and watch the black isrealite videos on youtube ... your fate is clearly writtain out , they dont want you white hoes , they hate you and once the upper hand is granted your seriously in trouble ... we dont want you either we gona make sure you mingers are cast out with the synogog of satan , look what god thought of esau when he mixed with the other tribe non isrealite ... god hated esau for his selling of birhtright and race mixing ... yet you fake jewish people promote it and also you changed gods word now saying the mother carries the seed ... when its the father , dont worry people and above take note its all joted down ...
and im not racist i just see whats going on , to the white bastards who rape kids and worship the devil you are not white you are mongrels ... your vile
Anonymous Coward 16200132
LOLOL NO YOU DON'T see things as they are.
Yes it is a THEORY and a FAILED THEORY because,just to make you see you are so wrong, I will share to you all that I'm white and never had black people in family and never dated with one,except for one uncle who married my aunt from my dad side, and we were very proud they got married on a time when racism was abundant in my country,fascism dictatorship time.
I'm happily married, no kids YET and I'm in favour for LOVE and not hate like you!!!!
As I said in an other thread "Religion is one of causes for big trouble in our world." and YOU ARE LIVING PROOF OF THAT!! You are one religious hatred with a heart of stone!!!!
GROW UP!!!SPECIALLY SPIRITUALLY! Hope you see the bigger picture soon and leave all that nonsense behind.
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