Patients receiving TKA younger than 55 years old should be informed about the increased risks of dissatisfaction. Offering TKA in KL 1/2 is questionable, with a dissatisfaction rate of 59%. Cite this article: Bone Joint J 2016;98-B:1625-34.

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This article discusses intimate partner violence (IPV) as a major public health issue for women, in particular, African American women. The intersection of IPV and institutional racism doubly victimizes African American women as they try to break out of the cycle of violence. The research shows that IPV in the African American community is more common and violent than in the Caucasian community due to structural, culturalcommunity, and situational contexts, overshadowed by institutional racism, that effect the romantic relationships of African American men and women. Research shows that the anger, hatred, and frustrations of African American men, caused by institutional racism, are being displaced onto their wives and lovers. Suggestions for intervention are presented.

Glycosaminoglycan (GAG)and proteoglycans (PG)were extracted from both relatively uninflamed and severely inflamed human gingiva. The constituent GAG, Hyaluronic acid, dermatan sulphate and chondroitin 4′ sulphate, were present in the same total amount and porportions in both tissues. In contrast the PG underwent substantial breakdown in the serverly inflamed tissue as judged by anion exchange chromatography and cellulose acetate electophoresis. The findings indicate theat whereas the GAG remain apparently unchanged during inflammation, the protein moiety of the PG is catabolised leading to a loss of structural integrity.

Aims The primary aim of this study was to develop a reliable, effective radiological score to assess the healing of humeral shaft fractures, the Radiographic Union Score for HUmeral fractures (RUSHU). The secondary aim was to assess whether the six-week RUSHU was predictive of nonunion at six months after the injury. Patients and Methods Initially, 20 patients with radiographs six weeks following a humeral shaft fracture were selected at random from a trauma database and scored by three observers, based on the Radiographic Union Scale for Tibial fractures system. After refinement of the RUSHU criteria, a second group of 60 patients with radiographs six weeks after injury, 40 with fractures that united and 20 with fractures that developed nonunion, were scored by two blinded observers. Results After refinement, the interobserver intraclass correlation coefficient (ICC) was 0.79 (95% confidence interval (CI) 0.67 to 0.87), indicating substantial agreement. At six weeks after injury, patients whose fractures united had a significantly higher median score than those who developed nonunion (10 vs 7; p < 0.001). A receiver operating characteristic curve determined that a RUSHU cut-off of < 8 was predictive of nonunion (area under the curve = 0.84, 95% CI 0.74 to 0.94). The sensitivity was 75% and specificity 80% with a positive predictive value (PPV) of 65% and a negative predictive value of 86%. Patients with a RUSHU < 8 (n = 23) were more likely to develop nonunion than those with a RUSHU ≥ 8 (n = 37, odds ratio 12.0, 95% CI 3.4 to 42.9). Based on a PPV of 65%, if all patients with a RUSHU < 8 underwent fixation, the number of procedures needed to avoid one nonunion would be 1.5. Conclusion The RUSHU is reliable and effective in identifying patients at risk of nonunion of a humeral shaft fracture at six weeks after injury. This tool requires external validation but could potentially reduce the morbidity associated with delayed treatment of an established nonunion. Cite this article: Bone Joint J 2019;101-B:1300–1306

Effects of stand density and shrub competition on growth and development were compared across a gradient of study sites. Challenge, the most productive site, is located in the foothills of the Sierra Nevada, northern California. Pringle Falls is of intermediate productivity in the rain shadow of the central Oregon Cascades. Trough Springs Ridge is the poorest site with minimally developed soils in California's North Coast Range. Treatments included a minimum of four stand densities, from 150 to 2700 trees·ha–1, in combination with at least no or full shrub removal. Challenge produced almost twice as much tree volume as Pringle Falls, and about three times the volume of Trough Springs Ridge. Regardless of site quality, growth was significantly greater in full shrub removal plots for stand densities <2000 trees·ha–1. After 26–36 years, stand volumes were 25–67 m3·ha–1 (11%–38%) greater at Challenge, 30–33 m3·ha–1 (25%–52%) greater at Pringle Falls, and 27–41 m3·ha–1 (115%–326%) greater at Trough Springs Ridge when shrubs were removed. Periodic volume growth declined substantially during the last 10 years at Challenge and Pringle Falls, regardless of treatment, because of confounding effects of mortality, drought, inter-tree competition, and insect defoliation. Further, the importance of shrub control on growth increment was not evident during the last 10 years at both sites, as tree–shrub competition likely switched to tree–tree competition. On the low quality site, shrub control is critical for stand development.

At Blacks Mountain Experimental Forest in northeastern California, an interdisciplinary team of scientists developed and implemented a research project to study how forest structural complexity affects the health and vigor of interior ponderosa pine (Pinus ponderosa Dougl. ex Laws.) ecosystems, the ecosystem's resilience to natural and human-caused disturbances, and how such ecosystems can be managed for sustained resource values. A randomized, split-plot, factorial design has been developed to test the influences of structural diversity, cattle grazing, and prescribed fire on twelve 250-acre study units. A permanently monumented data reference system on a 100-meter (328-ft) grid will facilitate spatial and temporal analysis as well as integration of information at various scales. Intensive preliminary sampling has established baseline data on small mammal and avian diversity and behavior, forest vegetation structures and floristic diversity, historical fire patterns, bark beetle dynamics, soil properties and processes, and genetic structure of pines and understory species.