An experimental study of low-level laser therapy in rat Achilles tendon injury

The aim of this controlled animal study was to investigate the effect of low-level laser therapy (LLLT) administered 30 min after injury to the Achilles tendon. The study animals comprised 16 Sprague Dawley male rats divided in two groups. The right Achilles tendons were injured by blunt trauma using a mini guillotine, and were treated with LLLT or placebo LLLT 30 min later. The injury and LLLT procedures were then repeated 15 hours later on the same tendon. One group received active LLLT (λ = 904 nm, 60 mW mean output power, 0.158 W/cm2 for 50 s, energy 3 J) and the other group received placebo LLLT 23 hours after LLLT. Ultrasonographic images were taken to measure the thickness of the right and left Achilles tendons. Animals were then killed, and all Achilles tendons were tested for ultimate tensile strength (UTS). All analyses were performed by blinded observers. There was a significant increase in tendon thickness in the active LLLT group when compared with the placebo group (p < 0.05) and there were no significant differences between the placebo and uninjured left tendons. There were no significant differences in UTS between laser-treated, placebo-treated and uninjured tendons. Laser irradiation of the Achilles tendon at 0.158 W/cm2 for 50 s (3 J) administered within the first 30 min after blunt trauma, and repeated after 15 h, appears to lead to edema of the tendon measured 23 hours after LLLT. The guillotine blunt trauma model seems suitable for inflicting tendon injury and measuring the effects of treatment on edema by ultrasonography and UTS. More studies are needed to further refine this model

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Intraprenørskap og bærekraft

Intraprenørskap og bærekraft er nøkkelordene for denne oppgaven hvor vi dykker dypere inn i hvordan større, innovative og velkjente selskaper i Norge arbeider med innovasjon og bærekraftig utvikling. Vi ser nærmere på selskapene; Posten Norge, Yara International, Lyse og Jotun, som alle er sterke innen innovasjon og bærekraft, samt selskaper som utøver en form for intraprenørskap. Bedriftene kan omtales som pionéerer innen sine bransjeområder, og er kåret blant Norges mest innovative virksomheter i 2020. I denne forbindelse ser vi nærmere på og besvarer problemstillingen “Hvordan tilrettelegges det for intraprenører i de mest innovative selskapene i Norge og i hvilken grad involveres bærekraft i dette arbeidet?” Innledningsvis presenteres bakgrunn for caset, litt om bedriftene og problemstilling. Deretter går vi videre til teori som introduserer temaet intraprenørskap, med fokus på hvordan det kan tilrettelegges gjennom teoretiske modeller for utøvelse. Sentrale områder som innovasjonskultur, organisasjonsstruktur, strategi, ledelse og ressurser, og faktorer innen disse blir lagt frem med aktiverende og hemmende virkning. Videre går vi inn på hvordan bedriftene forholder seg til bærekraft. Vi har benyttet oss av kvalitativ metode og har intervjuet åtte ansatte i de ulike selskapene. Dette har gjort det mulig å kartlegge arbeidet i selskapene og teste teori med hvordan innovasjon innad i selskapene fungerer i praksis, noe som videre har dannet grunnlaget for utredning i analyse og konklusjon. Problemstillingen blir besvart ved at vi bekrefter faktorer som tilrettelegger for intraprenørskap innen de ulike sentrale områdene. Empirien viser at alle selskapene jobber aktivt med innovasjon, og strukturerer dette arbeidet gjennom ulike systemer. Det foreligger høy grad av autonomi i avdelingene som arbeider med innovasjon, noe som bevisst gjøres for å øke idegenerering og sikre forutsigbarhet.Videre viser ledere engasjement og tillit, noe som åpner opp for risikotaking og eksperimentering. Det er flat struktur som fungerer best i dette arbeidet, hvor kommunikasjon flyter lett på tvers av avdelinger- som skaper bred tilgang på kompetanse og nettverk. Alle bedriftene tar ansvar for bærekraftig utvikling, med variert grad av fokus på økonomi, samfunn og miljø. Dette samtidig som flere av bedriftene har implementert bærekraft i strategien, eller har tydeliggjort arbeidet slik at intraprenører lettere kan jobbe mot bærekraftsmålene. Som en naturlig konsekvens virker det som at skillet mellom intraprenører og sosiale intraprenører begynner å falme, hvor intraprenører så og si utelukket inkluderer bærekraft i sitt arbeid

Allograft tendons are a safe and effective option for revision ACL reconstruction: a clinical review

Revision anterior cruciate ligament reconstruction remains a challenge, especially optimising outcome for patients with a compromised knee where previous autogenous tissue has been used for reconstruction. Allograft tissue has become a recognized choice of graft for revision surgery but questions remain over the risks and benefits of such an option. Allograft tendons are a safe and effective option for revision ACL reconstruction with no higher risk of infection and equivalent failure rates compared to autografts provided that the tissue is not irradiated, or any irradiation is minimal. Best scenarios for use of allografts include revision surgery where further use of autografts could lead to high donor site morbidity, complex instability situations where additional structures may need reconstruction, and in those with clinical and radiologic signs of autologous tendon degeneration. A surgeon needs to be able to select the best option for the challenging knee facing revision ACL reconstruction, and in the light of current data, allograft tissue can be considered a suitable option to this purpose