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New surgical procedures can expose patients to harm and should be carefully evaluated before widespread use. The InSpace balloon (Stryker, USA) is an innovative surgical device used to treat people with rotator cuff tears that cannot be repaired. We aimed to determine the effectiveness of the InSpace balloon for people with irreparable rotator cuff tears.We conducted a double-blind, group-sequential, adaptive randomised controlled trial in 24 hospitals in the UK, comparing arthroscopic debridement of the subacromial space with biceps tenotomy (debridement only group) with the same procedure but including insertion of the InSpace balloon (debridement with device group). Participants had an irreparable rotator cuff tear, which had not resolved with conservative treatment, and they had symptoms warranting surgery. Eligibility was confirmed intraoperatively before randomly assigning (1:1) participants to a treatment group using a remote computer system. Participants and assessors were masked to group assignment. Masking was achieved by using identical incisions for both procedures, blinding the operation note, and a consistent rehabilitation programme was offered regardless of group allocation. The primary outcome was the Oxford Shoulder Score at 12 months. Pre-trial simulations using data from early and late timepoints informed stopping boundaries for two interim analyses. The primary analysis was on a modified intention-to-treat basis, adjusted for the planned interim analysis. The trial was registered with ISRCTN, ISRCTN17825590.Between June 1, 2018, and July 30, 2020, we assessed 385 people for eligibility, of which 317 were eligible. 249 (79%) people consented for inclusion in the study. 117 participants were randomly allocated to a treatment group, 61 participants to the debridement only group and 56 to the debridement with device group. A predefined stopping boundary was met at the first interim analysis and recruitment stopped with 117 participants randomised. 43% of participants were female, 57% were male. We obtained primary outcome data for 114 (97%) participants. The mean Oxford Shoulder Score at 12 months was 34·3 (SD 11·1) in the debridement only group and 30·3 (10·9) in the debridement with device group (mean difference adjusted for adaptive design -4·2 [95% CI -8·2 to -0·26];p=0·037) favouring control. There was no difference in adverse events between the two groups.In an efficient, adaptive trial design, our results favoured the debridement only group. We do not recommend the InSpace balloon for the treatment of irreparable rotator cuff tears.Efficacy and Mechanism Evaluation Programme, a Medical Research Council and National Institute for Health and Care Research partnership.

Purpose We investigated Nw-hydroxy l -Arginine (NOHA) predictive response in serous ovarian carcinoma based on estrogen-hormone receptor expression status; and assessed the distinctive NOHA response between estrogen-receptor-negative (ER–) tumor subtypes of ovarian and breast cancer. Materials/methods Three-dimensional (3D) spheroids models of ER– and estrogen-receptor-positive (ER+) from breast and ovarian tumor, cultured for 9 weeks, were assayed for cellular levels of inducible nitric oxide synthase (NOS2), nitric oxide (as total nitrite) and l -Arginine, and compared to NOHA in culture medium. Statistical difference was set at p Results Nine-week in vitro studies showed a progressive NOHA reduction in culture medium by at least 0.4–0.8 fold, and 0.65–0.92 fold only in the ER– breast tumor and ER– ovarian tumor 3D spheroids, respectively; with increases in cellular NOS2 and nitric-oxide levels, by at least 1.0–2.45 fold in both ER– tumor subtype 3D spheroids (p l -Arginine to medium NOHA ratio was higher, and by at least 6.5–22.5 fold in ER– breast tumor 3D-spheroids, and at least 10–70 fold in ER– ovarian tumor 3D spheroids, than in ER+ and control conditions; and was ≥48% higher in ER– ovarian cancer than in ER– breast cancer 3D-spheroids. Conclusions The present study shows NOHA as a sensitive and selective indicator differentiating and distinguishing ER– subtypes based on the tumor grade.

We had shown Nw-hydroxy-l-arginine (NOHA) as a promising blood-based biomarker for estrogen-receptor-negative (ER−) breast cancer (BC) that differentiates ER− BC based on grade and molecular phenotype. In this in vitro study, we assessed the metabolic relevance for ER− BC-specific NOHA modulation and correlated them with NOHA regulatory responses. This study aids future NOHA clinical utility in ER− BC diagnosis and therapy management and would prove useful for potential drug discovery and development process.

In our prior study we identified N w-hydroxy-l-arginine (NOHA) as a simple, yet sensitive indicator for estrogen negative (ER−) breast cancer early-prognosis, but not estrogen positive (ER+), and to offer ethnic selectivity for ER− detection. However, the ability of NOHA to assess ER− breast tumor based on disease progression, and tumor severity needs further delineation. Also, the overall NOHA storage stability needs to be validated. To assess the NOHA predictive capability based on disease progression, ER−/ER+ 3D-spheroids (from breast tumor cell lines of human origin) were cultured for 10 weeks. We found only ER− 3D-spheroid cultured for 10 weeks to show a gradual reduction in NOHA (both in culture medium and 3D-spheroid lysates) that correlated with a progressive increase in cellular NOS2 expression and NOS2 activity (measured as total nitrites). We additionally identified the NOHA-NOS2 correlation to be ethnically selective between ER− African American versus ER− Caucasian groups. Interestingly, such NOHA reduction was observed earlier in ER− culture medium (viz., after week 1) than from ER− 3D-spheroids lysates (viz., at the end of 3 weeks). When categorized based on 3D-spheroid grade, we found a ≥ 68% NOHA reduction in ER− spheroids that were ≤ 3 weeks old, that was categorized as “low-grade” (based on tumor size ≤ 250 µm, and with cellular characteristics identical to healthy cells). A substantial reduction in NOHA of ≥ 87% occurred with ER− 3D-spheroids grown for 6 weeks, which were categorized as “intermediate-grade” (with tumor size of ≥ 400 µm, and with less characteristic similarity to control spheroids). These in vitro findings thus suggest a distinct correlation between NOHA reduction and ER− tumor grade. Such distinctive correlation between NOHA and ER− tumor grade was additionally observed in de-identified clinical samples where a onefold higher reduction in NOHA occurred in grade-2 than with grade-1 de-identified patient plasma (when compared with control), and such correlation offered ethnic selectivity between ER− African American and ER− Caucasian groups. Of additional interest, when NOHA overall storage stability was assessed by incubating patient plasma and culture medium spiked with 75 pg/ml NOHA at multiple incubation temperatures and time-points, we found NOHA to maintain its stability for up to 6 weeks in culture medium and for 7 days in plasma at 4 °C and below. These results thus provide the first evidence of NOHA as a stable indicator to monitor ER− disease progression and tumor severity in ethnically distinctive populations.

The National Science Foundation's Large Facilities are major, multi-user research facilities that operate and manage sophisticated and diverse research instruments and platforms (e.g., large telescopes, interferometers, distributed sensor arrays) that serve a variety of scientific disciplines, from astronomy and physics to geology and biology and beyond. Large Facilities are increasingly dependent on advanced cyberinfrastructure (i.e., computing, data, and software systems; networking; and associated human capital) to enable the broad delivery and analysis of facility-generated data. These cyberinfrastructure tools enable scientists and the public to gain new insights into fundamental questions about the structure and history of the universe, the world we live in today, and how our environment may change in the coming decades. This paper describes a pilot project that aims to develop a model for a Cyberinfrastructure Center of Excellence (CI CoE) that facilitates community building and knowledge sharing and that disseminates and applies best practices and innovative solutions for facility CI.

We found a unit error with our LC-MS lower limit of quantitation (LLOQ) measurement in the Amino Acids Journal.

Common approaches to mapping green infrastructure in urbanised landscapes invariably focus on measures of land use or land cover and associated functional or physical traits. However, such one-dimensional perspectives do not accurately capture the character and complexity of the landscapes in which urban inhabitants live. The new approach presented in this paper demonstrates how open-source, high spatial and temporal resolution data with global coverage can be used to measure and represent the landscape qualities of urban environments. Through going beyond simple metrics of quantity, such as percentage green and blue cover, it is now possible to explore the extent to which landscape quality helps to unpick the mixed evidence presented in the literature on the benefits of urban nature to human well-being. Here we present a landscape approach, employing remote sensing, GIS and data reduction techniques to map urban green infrastructure elements in a large U.K. city region. Comparison with existing urban datasets demonstrates considerable improvement in terms of coverage and thematic detail. The characterisation of landscapes, using census tracts as spatial units, and subsequent exploration of associations with social–ecological attributes highlights the further detail that can be uncovered by the approach. For example, eight urban landscape types identified for the case study city exhibited associations with distinct socioeconomic conditions accountable not only to quantities but also qualities of green and blue space. The identification of individual landscape features through simultaneous measures of land use and land cover demonstrated unique and significant associations between the former and indicators of human health and ecological condition. The approach may therefore provide a promising basis for developing further insight into processes and characteristics that affect human health and well-being in urban areas, both in the United Kingdom and beyond.

In our prior study we identified N

In this paper, we estimate separate UK money demand functions for the household and corporate sectors; and calculate estimates of the welfare cost of inflation. We find that the household sector bears most of the welfare burden which is in sharp contrast to previous (US) evidence. Also, we find aggregate welfare cost estimates that are much smaller than previous (largely US) estimates—sufficiently smaller as to challenge the oft-quoted Lucas finding that shoe leather costs are by no means trivial. For the UK, we find welfare costs no greater than one tenth of a per cent of real income.

Enadenotucirev (EnAd) is a chimeric group B adenovirus isolated by bioselection from a library of adenovirus serotypes. It replicates selectively in and kills a diverse range of carcinoma cells, shows effective anticancer activity in preclinical systems, and is currently undergoing phase I/II clinical trials. EnAd kills cells more quickly than type 5 adenovirus, and speed of cytotoxicity is dose dependent. The EnAd death pathway does not involve p53, is predominantly caspase independent, and appears to involve a rapid fall in cellular ATP. Infected cells show early loss of membrane integrity; increased exposure of calreticulin; extracellular release of ATP, HSP70, and HMGB1; and influx of calcium. The virus also causes an obvious single membrane blister reminiscent of ischemic cell death by oncosis. In human tumor biopsies maintained in ex vivo culture, EnAd mediated release of pro-inflammatory mediators such as TNF-α, IL-6, and HMGB1. In accordance with this, EnAd-infected tumor cells showed potent stimulation of dendritic cells and CD4(+) T cells in a mixed tumor-leukocyte reaction in vitro. Whereas many viruses have evolved for efficient propagation with minimal inflammation, bioselection of EnAd for rapid killing has yielded a virus with a short life cycle that combines potent cytotoxicity with a proinflammatory mechanism of cell death.

Background Boxer's fractures of the metacarpals, due to punching, are usually an intentional injury. Almost a third of patients will represent, and the association with psychopathologies has led to the suggestion that all patients presenting with such an injury should have a psychiatric assessment. This study explored the relationship between such injuries and aggression levels in young people aged 11–18 years.

This paper empirically examines the contribution of structural reforms to reducing inflation using a panel data-set of 25 transition economies. Two econometric methodologies are applied. First, the Blundell and Bond (1998) estimator for panel data incorporating lags of the dependent variable. Second, a panel logit estimator is employed to consider the likelihood of achieving low inflation. Results highlight the importance of price and trade liberalization and the reform of credit allocation for reducing inflation, the latter being especially important for bringing inflation below 10%.

This paper examines the influence of trade liberalization on GDP growth during the transition from communism. The level of trade liberalization is found to raise the growth rate, particularly in the early part of the transition and for the countries nearest to the European Union. For the remaining countries and for the later transition period, the positive influence of trade reform on growth requires the negative effect of the interaction between trade reform and privatization to be taken into account. Even with the interaction terms the effect of trade liberalization is not statistically significant in the later transition period.

In this paper, we examine the consequences of sequencing on the progress of reforms in transition economies. The paper uses panel logit models to determine whether or not progress in some reforms enhances the prospects for other reforms. We find that progress on small-scale privatization is associated with advances in several other reforms, perhaps because small-scale privatization creates lobbies for reform. Our estimations suggest that a comprehensive program of small-scale privatization is needed to stimulate large-scale privatization, trade, and banking reform in a country that has undertaken little reform. Moreover, if restructuring is to occur banking reform is necessary. We also find that relaxing the fiscal constraint stimulates large-scale privatization, restructuring, and trade reform. Finally, we find that negotiations about EU accession negotiations advance the transition but only in banking reform and competition policy. Journal of Comparative Economics 33 (4) (2005) 835–850.

The relationship from inflation and the real exchange rate to the rate of depreciation of the exchange rate for Hungary is investigated over 1991m6–2002m2. Evidence is found that prior to the adoption of the pre-announced crawl in 1995 depreciation responded to inflation. After the adoption of the crawl inflation is dominated by a trend that indicates the rate of depreciation to be diminishing over time. This trend is interpreted as being deterministic, as a consequence of the gradual reductions in the rate of official devaluations. In both periods depreciation was found to respond to the real exchange rate in ways that limited real appreciations of the currency.

Hormonal therapy (HT) is one of the most frequently prescribed drug regimens for women after the age of 50 years. HT has been developed progressively since the 1960s to provide estrogen to those women (a) who require relief of symptoms which have resulted from reduced circulating estrogen or (b) to act as an anti-resorptive agent to counteract the effect of the increased bone turnover which occurs with falling menopausal estrogen levels and which results in loss of bone mass leading to postmenopausal osteoporosis. However, a large number of women pass through the menopausal transition without experiencing distress as a result of the natural fall in estrogen hormone levels and since the introduction HT has been thought to be associated with a number of health benefits that have been tested in clinical trials but not substantiated. In women experiencing distressing climacteric symptoms double-blind randomised controlled clinical trials with a variety of HT regimens have shown that HT of any type provides symptom relief with no alternative treatment of similar effect. The dose and regimen of HT need to be individualised and in general the appropriate dose is dependent on the menopausal age. Women experiencing urogenital estrogen deficiency symptoms require long-term treatment which is most easily achieved with local estrogen. With the perspective provided by the most recent epidemiological findings not least from the estrogen only arm of the Women's Health Initiative Study (WHI) EMAS supports research activities generating HT with new compositions including lower doses and a wider range of progestins in order to positively affect the balance of clinical benefit and risk. Currently, however, individualized and appropriate prescription of the available HT products together with life-style management will sustain possibilities for beneficial effects on climacteric symptoms, quality of life and degenerative diseases after the menopause.

This paper combines Hendry’s general to specific procedure and Leamer’s Extreme Bounds analysis to assess the robustness of the relationship between growth in transition countries and a set of variables included in other studies. The results indicate a robust relationship between inflation and growth. A significant long–term effect of liberalization on growth is not found, which throws doubt on previous empirical studies of the relationship between liberalization and growth. However, the long–term benefits from liberalization may be indirect, via macro stability. Robustness tests also throw doubt on the effect of fiscal and exchange rate policies on growth. JEL classification: P24, P41, C23.

The extent to which bank lending policies - and in particular their requirement for firms to post collateral - have imposed constraints on the ability of unincorporated businesses to meet their demand for debt finance has been examined. It was found that for the period from 1982 through to the end of the data sample, variations in the level of bank lending to unincorporated businesses can be explained in terms of a more or less conventional demand function for bank finance - albeit one with a zero interest elasticity - though there is some evidence of the importance of collateral constraints in the shape of a significant positive effect from the growth in the real value of housing wealth. Prior to 1982 there was a sharp increase in the level of bank lending to unincorporated businesses which is much harder to interpret in these terms. Instead, this is seen as having been driven largely by changes in bank lending policies; in particular, by a drive to develop new markets in response to unfavourable conditi...

This article uses co-integration analysis to test purchasing power parity for the Romanian leu against the US dollar. The fact that the purchasing power parity (PPP) hypothesis is not rejected leads to the conclusion that the real appreciation of the leu against the dollar over the transition has not been due to an appreciation of the equilibrium real exchange rate. Rather it is simply the consequence of the leu being devalued beyond the equilibrium level at the start of reform and slowly returning to its constant equilibrium real rate. There is evidence that the adjustment to equilibrium has fallen almost entirely on the price level, so that a major consequence of the excessive undervaluation has been higher inflation.

This research reviews the factors affecting the pricing or rate schedules of home health care agencies. A large number of factors affect costs and thus rate structures. The major factors include reimbursement structures with accompanying discount structures, administrative burdens, and risks. Channel issues include bargaining power, competition, and size. Staffing issues affect pricing and product through the provider level, productivity, and quality outcomes. Physician and patient issues include quality concerns and choices. These factors are discussed in light of overall marketing strategy and the interaction of pricing with other marketing controllables such as product, place/distribution, and promotion. Economic and accounting principles are also reviewed with consideration to understanding direct and indirect costs in order to enable negotiators to effectively price health care services.

Parmar and colleagues ask an important question about research on the health impact of the 2008 financial crisis in Europe and in answering have devised a new assessment tool for observational studies.1 They spend time on seven aspects of bias: among the 41 studies included (from an original 5670), risk of bias was deemed high in 30, moderate in nine, and low in two. These values do not reflect well on …

Introduction Locked knee caused by inferior patellar dislocation is considered rare in elderly patients. It was originally thought that, in the osteoarthritic knee, osteophytes on the pole of the patella become entrapped in the inter-condylar notch, which is managed by performing closed reduction and immobilization in a knee splint for three to four weeks. We present an unusual case of a locked knee with an impaction fracture. To the best of our knowledge, there have been no previous reports of such impaction fractures managed with arthroscopy. Case presentation We present an unusual case of an 88-year-old Caucasian woman with moderate arthritis who had a locked knee caused by an impaction fracture of the patella into the lateral femoral condyle. In this case report, we describe the need for arthroscopic surgery to prevent relocking of the knee in these patients. Conclusions This case report emphasizes the need for careful assessment of locked knees in elderly patients. Impaction fractures should be considered in all rare cases of patellar dislocation, and we advocate arthroscopic assessment of the articular cartilage in these patients. This is an important consideration, as the population demographics change and such impaction fractures may become more common in patients with degeneration in the knees.

Parameters of ciliary beating and water propulsion can be studied in a unique fashion in ctenophores because the beat frequency can be controlled. Pleurobrachia pileus comb plates were driven at frequencies between 2 and 25Hz and at temperatures between 10 and 25°C. As frequency is increased from 5 to 25Hz, the rest period between beats is first shortened and then disappears: the duration of the effective stroke is reduced because the angular velocity (which is directly proportional to the sliding velocity of the microtubules) and the tip speed of each plate increase whilst the amplitude of the beat remains unchanged. The recovery stroke is shortened because the recovery bend is propagated more quickly to the tip of the plate. The phase difference between adjacent plates in the metachronal wave (expressed as a percentage of the cycle) is increased in spite of a sharp decrease in the time delay between adjacent plates, a reduction in the number of plates per wave and an increase in the metachronal wave velocity. The water flow speed becomes more continuous and increases in approximate proportion to the tip speed whilst the estimated power output of a metachronal wave increases exponentially, from 10−10W at a tip speed of about 20 mm s−1 to 10−8 W at a tip speed of about 75 mms−1. When comb plates are driven to beat at 10 Hz and the temperature is raised from 10°C towards 20°C, the duration of the effective stroke is reduced and the comb plates have a somewhat higher angular velocity and tip speed; the duration of the recovery stroke is reduced with a faster propagation of the recovery bend; a rest phase first appears between successive beats and then becomes longer. The phase difference between adjacent plates in a metachronal wave (expressed as a percentage of the cycle time) is decreased, as is the time delay between successive plates in a metachronal wave, so that the number of plates per wave and the wave velocity are increased. The water flow speed and power output are increased by a modest amount (a rise in temperature from 10 to 20°C produces changes equivalent to those produced by a 5Hz increase in frequency at 20°C). The cooperation between adjacent plates in the antiplectic metachronal wave makes a major contribution to the dramatic increase in power output of each metachronal wave that is seen as the beat frequency is increased.

The aim was to evaluate the potential causes of dispensing-label errors at a hospital.The study took place at a 1200-bed NHS Foundation Trust with two main pharmacy dispensaries (one manual and one automated). Face-to-face interviews were conducted with staff involved in label-generation errors to obtain in-depth understanding of dispensing-label errors. Interviews were tape-recorded, transcribed and analysed with the aid of Nvivo into themes.Factors suggested as causing label-generation errors were illegible handwriting, lack of knowledge, hurrying through tasks, distractions, interruptions and the use of past medical records in generating labels. Self-checking every stage of the labelling process was suggested as the key to detecting and preventing errors.The study highlights the vulnerability of the label-generation process to errors, with potential causes linked to organisational, environmental, task, team and individual factors.

Chlamydia trachomatisis a major cause of bacterial sexually transmitted infections worldwide. In 2006, a new variant ofC. trachomatis(nvCT), carrying a 377 bp deletion within the plasmid, was reported in Sweden. This deletion included the targets used by the commercial diagnostic systems from Roche and Abbott. The nvCT is clonal (serovar/genovar E) and it spread rapidly in Sweden, undiagnosed by these systems. The degree of spread may also indicate an increased biological fitness of nvCT. The aims of this study were to describe the genome of nvCT, to compare the nvCT genome to all availableC. trachomatisgenome sequences and to investigate the biological properties of nvCT. An early nvCT isolate (Sweden2) was analysed by genome sequencing, growth kinetics, microscopy, cell tropism assay and antimicrobial susceptibility testing. It was compared with relevantC. trachomatisisolates, including a similar serovar EC. trachomatiswild-type strain that circulated in Sweden prior to the initially undetected expansion of nvCT. The nvCT genome does not contain any major genetic polymorphisms – the genes for central metabolism, development cycle and virulence are conserved – or phenotypic characteristics that indicate any altered biological fitness. This is supported by the observations that the nvCT and wild-typeC. trachomatisinfections are very similar in terms of epidemiological distribution, and that differences in clinical signs are only described, in one study, in women. In conclusion, the nvCT does not appear to have any altered biological fitness. Therefore, the rapid transmission of nvCT in Sweden was due to the strong diagnostic selective advantage and its introduction into a high-frequency transmitting population.

Endometriosis is the presence of endometrial glands or stroma in sites other than the uterine cavity. It is variable in both its surgical appearance and clinical manifestation, often with poor correlation between the two. Surgical treatment of endometriosis aims to remove visible areas of endometriosis and restore anatomy by the division of adhesions.To assess the efficacy of laparoscopic surgery in the treatment of subfertility associated with endometriosis. The review aims to compare outcomes of laparoscopic surgical interventions compared to no treatment or medical treatment with regard to improved fertility.We searched the Cochrane Menstrual Disorders and Subfertility Group Specialised Register of trials (June 2009), Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 2), MEDLINE (1966 to June 2009), EMBASE (1980 to June 2009), and reference lists of articles.Trials were selected if they were randomised and compared the effectiveness of laparoscopic surgery in the treatment of subfertility associated with endometriosis versus other treatment modalities or placebo.Two studies were eligible for inclusion within the review. Both studies compared laparoscopic surgical treatment of minimal and mild endometriosis compared with diagnostic laparoscopy only. The recorded outcomes included live birth, pregnancy, fetal losses, and complications of surgery.When combining live birth rate and ongoing pregnancy after 20 weeks, meta-analysis demonstrated an advantage of laparoscopic surgery when compared to diagnostic laparoscopy only. The odds ratio (OR) was 1.64 (95% confidence interval (Cl) 1.05 to 2.57) in favour of laparoscopic surgery. Meta-analysis also demonstrated an advantage of laparoscopic surgery when compared to diagnostic laparoscopy only in terms of clinical pregnancy rates, with an OR of 1.66 (95% Cl 1.09 to 2.51) favouring laparoscopic surgery. The results still need to be interpreted with caution as Marcoux 1997 reported a large positive effect of surgery whereas Gruppo Italiano reported a small negative effect. When considering fetal losses, meta-analysis did not demonstrate an effect of laparoscopic surgery when compared to diagnostic laparoscopy only. The OR was 1.33 (95% Cl 0.60 to 2.94) favouring diagnostic laparoscopy only.The use of laparoscopic surgery in the treatment of subfertility related to minimal and mild endometriosis may improve future fertility.

We partition post-Soviet Union Transition Economies into two groups: European Union New Member States and countries belonging to the Commonwealth of Independent States or the South Eastern Europe area. Both groups started the 1980s with low levels of inequality, but in the early 2000s the latter group reached a level of inequality seven percentage points higher. We review various factors of inequality and examine whether these had differential effects in the two groups. Foreign Direct Investments and trade flows with the EU had a bigger inequality-enhancing effect in New Member States. We interpret this as evidence of technological catching-up and productivity improvements taking place in this region. Other specific reforms, such as privatisation and price liberalisation, had similarly strong effects in the two groups. We also find some evidence of an inequality-decreasing effect of an indicator of Voice and Accountability in countries outside the EU, and that countries with higher government effectiveness experienced lower levels of inequality. This supports the relevance of institutional capacity in tackling inequality. Finally, we speculate over the effects of the current global crisis on future economic performance. © 2010 Taylor & Francis.

Background: Chlamydia trachomatis is a major human pathogen with a unique obligate intracellular developmental cycle that takes place inside a modified cytoplasmic structure known as an inclusion. Following entry into a cell, the infectious elementary body (EB) differentiates into a non - infectious replicative form known as a reticulate body (RB). RBs divide by binary fission and at the end of the cycle they redifferentiate into EBs. Treatment of C.trachomatis with penicillin prevents maturation of RBs which survive and enlarge to become aberrant RBs within the inclusion in a non - infective persistent state. Persistently infected individuals may be a reservoir for chlamydial infection. The C.trachomatis genome encodes the enzymes for peptidoglycan (PG) biosynthesis but a PG sacculus has never been detected. This coupled to the action of penicillin is known as the chlamydial anomaly. We have applied video microscopy and quantitative DNA assays to the chlamydial developmental cycle to assess the effects of penicillin treatment and establish a framework for investigating penicillin induced chlamydial persistence. Principal Findings: Addition of penicillin at the time of cell infection does not prevent uptake and the establishment of an inclusion. EB to RB transition occurs but bacterial cytokinesis is arrested by the second binary fission. RBs continue to enlarge but not divide in the presence of penicillin. The normal developmental cycle can be recovered by the removal of penicillin although the large, aberrant RBs do not revert to the normal smaller size but remain present to the completion of the developmental cycle. Chromosomal and plasmid DNA replication is unaffected by the addition of penicillin but the arrest of bacterial cytokinesis under these conditions results in RBs accumulating multiple copies of the genome. Conclusions: We have applied video time lapse microscopy to the study of the chlamydial developmental cycle. Linked with accurate measures of genome replication this provides a defined framework to analyse the developmental cycle and to investigate and provide new insights into the effects of antibiotic treatments. Removal of penicillin allows recovery of the normal developmental cycle by 10–20 hrs and the process occurs by budding from aberrant RBs.

Endometriosis is the presence of endometrial glands or stroma in sites other than the uterine cavity. It is variable in both its surgical appearance and clinical manifestation often with poor correlation between the two. Surgical treatment of endometriosis aims to remove visible areas of endometriosis and restore anatomy by division of adhesions and relieve painful symptoms.To assess the efficacy of laparoscopic surgery in the treatment of pelvic pain associated with endometriosis.For the update in July 2009 we searched the Cochrane Menstrual Disorders and Subfertility Group's specialised register of trials (searched July 2009), the Cochrane Controlled Trials Register (The Cochrane Library, Issue 2, 2009), MEDLINE (1966 July 2009), EMBASE (1980 July 2009), and reference lists of articles.Randomised controlled trials were selected comparing the effectiveness of laparoscopic surgery used to treat pelvic pain associated with endometriosis, with other treatment modalities or diagnostic laparoscopy only.Assessment of trial quality and extraction of relevant data was performed independently by two reviewers.Five studies were included in the meta-analysis, including three full papers and two conference reports. All the randomised controlled trials with the exception of Lalchandani 2003 compared different laparoscopic surgical techniques with diagnotic laparoscopy only. Lalchandani 2003 compared laparoscopic coagulation therapy with diagnostic laparoscopy and medical treatment. Three studies (Abbott 2004; Sutton 1994; Tutunaru 2006) reported the pain scores six months post operatively. Meta-analysis demonstrated an advantage of laparoscopic surgery when compared to diagnostic laparoscopy only (OR of 5.72 95%Cl 3.09 to 10.60 ; 171 participants, three trials, Analysis 1.1). A single study (Tutunaru 2006) reported pain scores twelve months after the procedure. Analysis demonstrated an advantage of laparoscopic surgery when compared to diagnostic laparoscopy only (OR of 7.72 95%Cl 2.97 to 20.06 ; 33 participants, one trial, Analysis 1.1).Laparoscopic surgery results in improved pain outcomes when compared to diagnostic laparoscopy alone. There were few women diagnosed with severe endometriosis included in the meta-analysis and therefore any conclusions from this meta-analysis regarding treatment of severe endometriosis should be made with caution. It is not possible to draw conclusions from the meta-analysis which specific laparoscopic surgical intervention is most effective.

We examine factors of within-country income inequality in transition economies of Central and Eastern Europe and the Commonwealth of Independent States after the breakup of the Soviet Union. Internal reforms dominate globalisation factors in accounting for inequality, with price liberalisation showing the strongest effect. Privatisation measures also show robust effects. We find some evidence that the extent of the private sector magnifies the impact of price liberalisation. The only role for globalisation seems to be to moderate the adverse impact of internal reforms on inequality. © 2009 Taylor & Francis.

The authors examine the importance of a disequilibrium real balance effect on non-durable consumers' expenditure in the U.K. Using cointegration techniques and the Johansen procedure they first establish a desired long-run demand function for liquid assets depending on income, wealth and a set of interest rates. Deviations of liquidity from this desired level cause changes in consumption via intertemporal substitution but via its effect on disequilibrium liquidity. Consumption is modeled in an error-correction framework and is also found to depend on income and financial wealth. Both the disequilibrium liquidity and wealth terms may be picking up the effects of financial liberalization (e.g. "mortgage leak") on consumption as funds released will be temporarily held in financial assets. They also find some evidence that changes in the distribution of income have an independent effect on aggregate consumption. Copyright 1991 by MIT Press.

The general-to-specific methodology and cointegration techniques are used to examine the demand for liquid assets by the UK personal sector. The demand for real liquid assets are found to depend positively on the level of transactions, the wealth to income ration and the own rate on liquid assets. In addition a higher rate of return on long-term securities or on bank lending reduces the level of liquid assets in the long run. Evidence in favour of cointegration between these variables is found and a dynamic error correction model with stable parameter estimates is found to hold over the 1970s and 1980s. The stable demand for this broad monetary aggregate however does not imply that it should form the basis for monetary targets since the equation is estimated from a regime that could be broadly characterised as one of interest rate setting. Copyright 1990 by Blackwell Publishers Ltd and The Victoria University of Manchester