The Effect of Perioperative Ketorolac on the Clinical Failure Rate of Meniscal Repair

Background: There has been recent interest in the effect of nonsteroidal anti-inflammatory medications on musculoskeletal healing. No studies have yet addressed the effect of these medications on meniscal healing. Hypothesis The administration of ketorolac in the perioperative period will result in higher rates of meniscal repair clinical failure. Study design Cohort study; Level of evidence, 3. Methods: A total of 110 consecutive patients underwent meniscal repair at our institution between August 1998 and July 2001. Three patients were lost to follow-up, and the remaining 107 (mean age, 15.9 ± 4.4 years) had a minimum 5-year follow-up (mean follow-up, 5.5 years). Thirty-two patients (30%) received ketorolac perioperatively. The primary outcome measure was reoperation for continued symptoms of meniscal pathology. Asymptomatic patients were evaluated by the International Knee Documentation Committee (IKDC) Subjective Knee Form, Short Form–36 (SF-36) Health Survey, and Knee Outcome Osteoarthritis Score (KOOS). Results: Kaplan-Meier survivorship revealed no difference in reoperation rates with and without the administration of perioperative ketorolac (P = .95). There was an overall failure rate of 35% (37/107 patients), with a 34% failure rate in patients receiving ketorolac (11/32 patients). Multivariable Cox regression confirmed that age, duration of symptoms, meniscal tear type, fixation technique, concurrent anterior cruciate ligament repair, and ketorolac usage did not have an impact on the rate of failure (P > .05 for all; ketorolac use, P > .50). Female sex (P = .04) and medial location (P = .01) were predictive of an increased risk for reoperation. Conclusion: Failure of meniscal repair was not altered with the administration of perioperative ketorolac. Further work studying the effects of longer term anti-inflammatory use after meniscal repair is necessary before stating that this class of medications has no effect on meniscal healing. Clinical Relevance Results of this study suggest that nonsteroidal anti-inflammatory ketorolac can be administered perioperatively during a meniscal repair procedure to harness its benefits of decreased narcotic requirement, decreased pain, and shorter length of hospital stay without negatively influencing the long-term outcome of the surgery

A General Business Model for Marine Reserves

Marine reserves are an effective tool for protecting biodiversity locally, with potential economic benefits including enhancement of local fisheries, increased tourism, and maintenance of ecosystem services. However, fishing communities often fear short-term income losses associated with closures, and thus may oppose marine reserves. Here we review empirical data and develop bioeconomic models to show that the value of marine reserves (enhanced adjacent fishing + tourism) may often exceed the pre-reserve value, and that economic benefits can offset the costs in as little as five years. These results suggest the need for a new business model for creating and managing reserves, which could pay for themselves and turn a profit for stakeholder groups. Our model could be expanded to include ecosystem services and other benefits, and it provides a general framework to estimate costs and benefits of reserves and to develop such business models

Diagramming social practice theory:An interdisciplinary experiment exploring practices as networks

Achieving a transition to a low-carbon energy system is now widely recognised as a key challenge facing humanity. To date, the vast majority of research addressing this challenge has been conducted within the disciplines of science, engineering and economics utilising quantitative and modelling techniques. However, there is growing awareness that meeting energy challenges requires fundamentally socio-technical solutions and that the social sciences have an important role to play. This is an interdisciplinary challenge but, to date, there remain very few explorations of, or reflections on, interdisciplinary energy research in practice. This paper seeks to change that by reporting on an interdisciplinary experiment to build new models of energy demand on the basis of cutting-edge social science understandings. The process encouraged the social scientists to communicate their ideas more simply, whilst allowing engineers to think critically about the embedded assumptions in their models in relation to society and social change. To do this, the paper uses a particular set of theoretical approaches to energy use behaviour known collectively as social practice theory (SPT) - and explores the potential of more quantitative forms of network analysis to provide a formal framework by means of which to diagram and visualize practices. The aim of this is to gain insight into the relationships between the elements of a practice, so increasing the ultimate understanding of how practices operate. Graphs of practice networks are populated based on new empirical data drawn from a survey of different types (or variants) of laundry practice. The resulting practice networks are analysed to reveal characteristics of elements and variants of practice, such as which elements could be considered core to the practice, or how elements between variants overlap, or can be shared. This promises insights into energy intensity, flexibility and the rootedness of practices (i.e. how entrenched/ established they are) and so opens up new questions and possibilities for intervention. The novelty of this approach is that it allows practice data to be represented graphically using a quantitative format without being overly reductive. Its usefulness is that it is readily applied to large datasets, provides the capacity to interpret social practices in new ways, and serves to open up potential links with energy modeling. More broadly, a significant dimension of novelty has been the interdisciplinary approach, radically different to that normally seen in energy research. This paper is relevant to a broad audience of social scientists and engineers interested in integrating social practices with energy engineering

Using social media in health literacy research: A promising example involving Facebook with young Aboriginal and Torres Strait Islander males from the top end of the Northern Territory

This brief report describes three key lessons learned during a health literacy research project with young Aboriginal and Torres Strait Islander males from the Top End of the Northern Territory (NT), Australia. More specifically, it is a methodologically focused paper that discusses processes associated with using a combination of yarning sessions and social media content as tools to unpack conceptualisations of health and well‐being among this marginalised population. The lessons discussed include (a) the utility of using social media in providing an authentic window into the lives of a hard‐to‐reach populations; (b) the need to carefully consider ethical implications; and (c) the benefits of using social media content to triangulate data and enhance methodological rigour. To understand the methodological contribution social media can make to equity‐focused health literacy research, it is first useful to understand what is meant by health literacy

Multi-level parallel clocking of CCDs for: improving charge transfer efficiency, clearing persistence, clocked anti-blooming, and generating low-noise backgrounds for pumping

A multi-level clocking scheme has been developed to improve the parallel CTE of four-phase CCDs by suppressing the effects of traps located in the transport channel under barrier phases by inverting one of these phases throughout the transfer sequence. In parallel it was apparent that persistence following optical overload in Euclid VIS detectors would lead to undesirable signal released in subsequent rows and frames and that a suitable scheme for flushing this signal would be required. With care, the negatively biased electrodes during the multi-level transfer sequence can be made to pin the entire surface, row-by-row, and annihilate the problematic charges. This process can also be extended for use during integration to significantly reduce the unusable area of the detector, as per the clocked anti-blooming techniques developed many years ago; however, with the four-phase electrodes architecture of modern CCDs, we can take precautionary measures to avoid the problem of charge pumping and clock induced charge within the science frames. Clock induced charge is not all bad! We also propose the use of on-orbit trap-pumping for Euclid VIS to provide calibration input to ground based correction algorithms and as such a uniform, low noise background is require. Clock induced charge can be manipulated to provide a very suitable, low signal and noise background to the imaging array. Here we describe and present results of multi-level parallel clocking schemes for use in four-phase CCDs that could improve performance of high precision astronomy applications such as Euclid VIS

Community norms for the Eating Disorder Examination Questionnaire (EDE-Q) among transgender men and women

Transgender men and women may be at risk for eating disorders, but prior community norms of the Eating Disorders Examination Questionnaire (EDE-Q) are based on presumed cisgender men and woman and have not intentionally included transgender people. The objective of this study was to develop community norms for eating disorder attitudes and disordered eating behaviors in transgender men and women using the EDE-Q. Participants were 312 transgender men and 172 transgender women participants in The PRIDE Study, an existing cohort study of sexual and gender minority people. We present mean scores, standard deviations, and percentile ranks for the Global score and four subscale scores of the EDE-Q in transgender men and women. Transgender men and women reported any occurrence (≥1/week) of dietary restraint (25.0% and 27.9%), objective binge episodes (11.2% and 12.8%), excessive exercise (8.0% and 8.1%), self-induced vomiting (1.6% and 1.7%), and laxative misuse (.3% and .6%), respectively. Compared to a prior study of presumed cisgender men 18–26 years (Lavender, De Young, & Anderson, 2010), our age-matched subsample of transgender men reported lower rates of objective binge episodes and excessive exercise. Compared to a prior study of presumed cisgender women 18–42 years (Mond, Hay, Rodgers, & Owen, 2006), we found that an age-matched sample of transgender women reported higher rates of dietary restraint but lower rates of excessive exercise. These norms should aid clinicians in applying and researchers in investigating and interpreting the EDE-Q scores of transgender men and women

Sitting Time and Waist Circumference Are Associated With Glycemia in U.K. South Asians: Data from 1,228 adults screened for the PODOSA trial

OBJECTIVE-To investigate the independent contributions of waist circumference, physical activity, and sedentary behavior on glycemia in South Asians living in Scotland. RESEARCH DESIGN AND METHODS-Participants were 1,228 (523 men and 705 women) adults of Indian or Pakistani origin screened for the Prevention of Type 2 Diabetes and Obesity in South Asians (PODOSA) trial. All undertook an oral glucose tolerance test, had physical activity and sitting time assessed by International Physical Activity Questionnaire, and had waist circumference measured. RESULTS-Mean +/- SD age and waist circumference were 49.8 +/- 10.1 years and 99.2 +/- 10.2 cm, respectively. One hundred ninety-one participants had impaired fasting glycemia or impaired glucose tolerance, and 97 had possible type 2 diabetes. In multivariate regression analysis, ay (0.012 mmol.L-1.year [95% CI 0.006-0.017]) and waist circumference (0.018 mmol.L-1.cm(-1) [0.012-0.024]) were significantly independently associated with fasting glucose concentration, and age (0.032 mmol.L-1.year(-1) [0.016-0.049]), waist (0.057 mmolL(-1).cm(-1) [0.040-0.074]), and sitting time (0.097 mmol.L-1.h(-1).day(-1) [0.036-0.158]) were significantly independently associated with 2-h glucose concentration. Vigorous activity time had a borderline significant association with 2-h glucose concentration (-0.819 mmol.L-1.h(-1).day-1 [-1.672 to 0.034]) in the multivariate model. CONCLUSIONS-These data highlight an important relationship between sitting time and 2-h glucose levels in U.K. South Asians, independent of physical activity and waist circumference. Although the data are cross-sectional and thus do not permit firm conclusions about causality to be drawn, the results suggest that further study investigating the effects of sitting time on glycemia and other aspects of metabolic risk in South Asian populations is warrante

Ubiquitous outflows in DEEP2 spectra of star-forming galaxies at z=1.4

Galactic winds are a prime suspect for the metal enrichment of the intergalactic medium and may have a strong influence on the chemical evolution of galaxies and the nature of QSO absorption line systems. We use a sample of 1406 galaxy spectra at z~1.4 from the DEEP2 redshift survey to show that blueshifted Mg II 2796, 2803 A absorption is ubiquitous in starforming galaxies at this epoch. This is the first detection of frequent outflowing galactic winds at z~1. The presence and depth of absorption are independent of AGN spectral signatures or galaxy morphology; major mergers are not a prerequisite for driving a galactic wind from massive galaxies. Outflows are found in coadded spectra of galaxies spanning a range of 30x in stellar mass and 10x in star formation rate (SFR), calibrated from K-band and from MIPS IR fluxes. The outflows have column densities of order N_H ~ 10^20 cm^-2 and characteristic velocities of ~ 300-500 km/sec, with absorption seen out to 1000 km/sec in the most massive, highest SFR galaxies. The velocities suggest that the outflowing gas can escape into the IGM and that massive galaxies can produce cosmologically and chemically significant outflows. Both the Mg II equivalent width and the outflow velocity are larger for galaxies of higher stellar mass and SFR, with V_wind ~ SFR^0.3, similar to the scaling in low redshift IR-luminous galaxies. The high frequency of outflows in the star-forming galaxy population at z~1 indicates that galactic winds occur in the progenitors of massive spirals as well as those of ellipticals. The increase of outflow velocity with mass and SFR constrains theoretical models of galaxy evolution that include feedback from galactic winds, and may favor momentum-driven models for the wind physics.Comment: Accepted by ApJ. 25 pages, 17 figures. Revised to add discussions of intervening absorbers and AGN-driven outflows; conclusions unchange

Chemokine (C-C motif) ligand 2 mediates direct and indirect fibrotic responses in human and murine cultured fibrocytes

<p>Abstract</p> <p>Background</p> <p>Fibrocytes are a population of circulating bone-marrow-derived cells that express surface markers for leukocytes and mesenchymal cells, and are capable of differentiating into myofibroblasts. They have been observed at sites of active fibrosis and increased circulating numbers correlate with mortality in idiopathic pulmonary fibrosis (IPF). Inhibition of chemokine (C-C motif) receptor 2 (CCR2) during experimental models of lung fibrosis reduces lung collagen deposition, as well as reducing lung fibrocyte accumulation. The aim of the present study was to determine whether human and mouse fibrocytes express functional CCR2.</p> <p>Results</p> <p>Following optimized and identical human and murine fibrocyte isolation, both cell sources were shown to be positive for CCR2 by flow cytometry and this expression colocalized with collagen I and CD45. Human blood fibrocytes stimulated with the CCR2 ligand chemokine (C-C motif) ligand 2 (CCL2), demonstrated increased proliferation (<it>P </it>< 0.005) and differentiation into myofibroblasts (<it>P </it>< 0.001), as well as a chemotactic response (<it>P </it>< 0.05). Murine fibrocytes also responded to CCR2 stimulation, with CCL12 being more potent than CCL2.</p> <p>Conclusions</p> <p>This study directly compares the functional responses of human and murine fibrocytes to CCR2 ligands, and following comparable isolation techniques. We have shown comparable biological effects, strengthening the translatability of the murine models to human disease with respect to targeting the CCR2 axis to ameliorate disease in IPF patients.</p

Critical research on populism: Nine rules of engagement

This article formulates precise questions and ‘rules of engagement’ designed to advance our understanding of the role populism can and should play in the present political conjuncture, with potentially significant implications for critical management and organization studies and beyond. Drawing on the work of Ernesto Laclau and others working within the post-Marxist discourse theory tradition, we defend a concept of populism understood as a form of reason that centres around a claim to represent ‘the people’, discursively constructed as an underdog in opposition to an illegitimate ‘elite’. A formal discursive approach to populism brings with it important advantages. For example, it establishes that a populist logic can be invoked to further very different political goals, from radical left to right, or from progressive to regressive. It sharpens too our grasp of important issues that are otherwise conflated and obfuscated. For instance, it helps us separate out the nativist and populist dimensions in the discourses of the United Kingdom Independence Party (UKIP), Trump or the Front National (FN). Our approach to populism, however, also points to the need to engage with the rhetoric about populism, a largely ignored area of critical research. In approaching populism as signifier, not only as a concept, we stress the added need to focus on the uses of the term ‘populism’ itself: how it is invoked, by whom, and to what purpose and effect. This, we argue, requires that we pay more systematic attention to anti-populism and ‘populist hype’, and reflect upon academia’s own relation to populism and anti-populism