Reply to the letter to the editor: Could the use of bone morphogenetic proteins in fracture healing do more harm than good to our patients?

Surger

Historical Failures in the Use of Proxy Forces and Implications for Future Conflicts

In recent years conflicts in Eastern Europe and the Middle East have thrust the role of proxy forces back into the spotlight. This study examines the past use of proxy forces and the potential for improvement based on examples of failures. This study will revolve around the question: “How can lessons learned from failures in the use of proxy forces translate into modern conflicts.” This study uses two case studies from the Cold War era to highlight factors that led to failures in these specific instances. While there are examples of recent proxy force failures there is more extensive information available on past examples. While much has changed since the Cold War in terms of the geopolitical and technological environment, the fundamentals of proxy warfare remain the same, a larger nation state funding a smaller resistance group with the goal of either overthrowing a target government or achieving another strategic goal. This study discovered that lessons learned from prior failures can be useful today. There are some key factors in past failures which can be used as examples of how to prevent similar issues in the future, while much has changed since the Cold War some things remain the same

The Use of Bone Morphogenetic Protein in the Intervertebral Disk Space in Minimally Invasive Transforaminal Lumbar Interbody Fusion

Study Design: Retrospective Cohort. Objective: The objective of this study was to characterize one surgeon’s experience over a 10-year period using rhBMP-2 in the disk space for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Summary of Background Data: MIS TLIF has been utilized as a technique for decreasing patients’ immediate postoperative pain, decreasing blood loss, and shortened hospital stays. Effectiveness and complications of rhBMP-2’s use in the disk space is limited because of its off-label status. Methods: Retrospective analysis of consecutive MIS TLIFs performed by senior author between 2004 and 2014. rhBMP-2 was used in the disk space in all cases. Patients were stratified based on the dose of rhBMP-2 utilized. Patients had 9 to 12 month computerized tomography scan to evaluate for bony fusion and continued follow-up for 18 months. Results: A total of 688 patients underwent a MIS TLIF. A medium kit of rhBMP-2 was utilized in 97 patients, and small kit was used in 591 patients. Fusion rate was 97.9% and this was not different between the 2 groups with 96/97 patients fusing in the medium kit group and 577/591 patients fusing in the small kit group. Five patients taken back to the operating room for symptomatic pseudoarthrosis, 4 reoperated for bony hyperostosis, and 10 radiographic pseudoarthroses that did not require reoperation. A statistically significant difference in the rate of foraminal hyperostosis was found when using a medium sized kit of rhBMP-2 was 4.12% (4/97 patients), compared with a small kit (0/591 patients, P=0.0004). Conclusions: Utilization of rhBMP-2 in an MIS TLIF leads to high fusion rate (97.9%), with an acceptable complication profile. The development of foraminal hyperostosis is a rare complication that only affected 0.6% of patients, and seems to be a dose related complication, as this complication was eliminated when a lower dose of rhBMP-2 was utilized

Communication, Activism and the News Media: An Agenda for Future Research

This study examines two central questions focusing on the news media and political change: How do we best understand the relationship between the news media and political change? How do we best understand the interaction between the news media and social movements? The analysis initially relates these two questions to three broad issues, exploring the importance of digital activism, stressing the need to examine issues related to power in order to fully grapple with these questions, and highlighting the ahistorical nature of research on digital activism and on disinformation campaigns. Following this discussion, the study defines a detailed agenda for future framing research, pointing to significant shortcomings in this perspective. These limitations include conceptual difficulties in the definition of frames, and the failure of many studies to analyze frame sponsorship and the centrality of resources in the ability to sponsor frames. Subsequently, this discussion focuses on the lack of attention to framing processes in most of the research literature, and the failure to consider emotions as an influence on framing. This study concludes by examining how engaged or activist research can address shortcomings in framing research. By revitalizing framing research, we can better understand the complex relationship between the news media and political change and between the news media and social movements

Communication Activism| Seizing the Social Justice Opportunity: Communication Activism Research at a Politically Critical Juncture

We thank J. Kevin Barge, Robert W. McChesney, and Michelle Rodino-Colocino for their thoughtprovoking responses&mdash;from their respective perspectives of applied communication research (ACR), media studies, and critical-cultural communication research (CCCR)&mdash;to our essay explicating communication activism research (CAR) as a distinct form of engaged communication research. This response acknowledges important connections among our views of engaged communication scholarship, in general, and CAR, in particular, and focuses on some specific points on which we might disagree.</p

A different type of procedure for a different type of pain

No abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55860/1/22260_ftp.pd