Are Platelet-Rich Plasma Injections Effective at Reducing Pain in Adults With Knee Osteoarthritis?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “platelet-rich plasma injections are effective at reducing pain in adults with knee osteoarthritis?” STUDY DESIGN: A systematic review of two double-blind, randomized controlled trials (RCTs) and one single-blind randomized controlled trial published after 2015. All studies were published in English. DATA SOURCES: The two double-blind randomized controlled trials and one single-blind randomized controlled trial were found via PubMed. All sources were published in peer-reviewed journals and were chosen based on their relevance to the clinical question. OUTCOMES MEASURED: Pain reduction was the outcome measured in all three studies using the WOMAC pain scale. In this systematic review, the level of pain was evaluated at baseline and 24 weeks (6 months). RESULTS: In the double-blind RCT conducted by Cole et.al (Am J Sports Med. 2017;45(2):339-346. doi: 10.1177/0363546516665809), there was reduction in pain with platelet-rich plasma injections with a mean change from baseline of 2.89. However, no statistical significance was noted in this study. In the single-blind RCT by Lisi et al. (Clin Rehabil. 2018;32(3):330-339. doi: 10.1177/0269215517724193), reduction of pain was noted with a median change from baseline of 4, but no statistical effect was noted. Lastly, in the double-blind RCT by in Rahimzadeh et al. (Clin Interv Aging. 2018;13:73-79. doi:10.2147/CIA.S147757), there was reduction in pain with a mean change from baseline of 8.6, as well as statistical significance with a p-value of \u3c0.001. CONCLUSION: While clinical reduction was demonstrated by all three studies based on the decrease in mean change from baseline, statistical significance was not noted in the studies conducted by Cole et al. (Am J Sports Med. 2017;45(2):339-346. doi: 10.1177/0363546516665809) and Lisi et al. (Clin Rehabil. 2018;32(3):330-339. doi: 10.1177/0269215517724193). Thus, the results of this review are inconclusive. Future studies need to be designed in order to showcase statistical significance with the use of platelet-rich plasma injections in reducing pain in those with knee OA

Perceptions and Motivations to the Utilization of Preventive Care by Labor Union Members

The underutilization of preventive exams by labor union members in the transportation and manufacturing industries, coupled with workplace barriers including long hours, unhealthy diets, and lack of physical activity, put this population at high risk for chronic disease development. Highmark insures over 17 million unionized workers and their families; taking a proactive approach to healthcare is of utmost importance to employers in order to retain a productive workforce with less turnover and decrease healthcare costs. The purpose of this inquiry project was to conduct a needs assessment to understand the perceptions of and motivators to preventive care utilization by labor union members. The participants are n=24 labor union members’ ages 18 and older from manufacturing and transportation labor unions in western and northeastern Pennsylvania. A survey was promoted via email, word of mouth at a labor union trustee meeting, and a mailed communication. The survey link was posted to a labor union Fund’s website. Descriptive statistics (frequencies) were calculated to summarize participant demographics, health status, and preventive care utilization data for the total group. Results from the adapted MAPP Care Utilization Survey were calculated as frequencies for each individual item. Analyses were run via pivot tables in Excel. Results indicated that preventive care utilization differed by demographics including gender, age, occupation, and education level. The majority of participants received at least one preventive exam within the last 12 months; however, descriptively, male laborers used preventive care less frequently than those in other occupations. The health status of v participants was poor and over half reported having a chronic disease. Participants had a positive attitude toward health care and their general practitioner. The top barriers to accessing preventive care were time (95.7%, n=22) and knowledge of health benefits (39.1%; n=9). The top facilitators to accessing preventive care were support from family/spouse (95.5%; n=21) and possessing health insurance (95.5%; n=21). There were varying levels of workplace support and accommodations to access preventive care within labor unions. Implications for practice include changes to workplace policies in labor unions to promote job flexibility, increased support and modeling from Fund managers and trustees, incentivize employees to participate in wellness and chronic disease management programs, and offering employer-sponsored health plans to employees

A comprehensive analysis of the importance of translation initiation factors for Haloferax volcanii applying deletion and conditional depletion mutants

Translation is an important step in gene expression. The initiation of translation is phylogenetically diverse, since currently five different initiation mechanisms are known. For bacteria the three initiation factors IF1 – IF3 are described in contrast to archaea and eukaryotes, which contain a considerably higher number of initiation factor genes. As eukaryotes and archaea use a non-overlapping set of initiation mechanisms, orthologous proteins of both domains do not necessarily fulfill the same function. The genome of Haloferax volcanii contains 14 annotated genes that encode (subunits of) initiation factors. To gain a comprehensive overview of the importance of these genes, it was attempted to construct single gene deletion mutants of all genes. In 9 cases single deletion mutants were successfully constructed, showing that the respective genes are not essential. In contrast, the genes encoding initiation factors aIF1, aIF2γ, aIF5A, aIF5B, and aIF6 were found to be essential. Factors aIF1A and aIF2β are encoded by two orthologous genes in H. volcanii. Attempts to generate double mutants failed in both cases, indicating that also these factors are essential. A translatome analysis of one of the single aIF2β deletion mutants revealed that the translational efficiency of the second ortholog was enhanced tenfold and thus the two proteins can replace one another. The phenotypes of the single deletion mutants also revealed that the two aIF1As and aIF2βs have redundant but not identical functions. Remarkably, the gene encoding aIF2α, a subunit of aIF2 involved in initiator tRNA binding, could be deleted. However, the mutant had a severe growth defect under all tested conditions. Conditional depletion mutants were generated for the five essential genes. The phenotypes of deletion mutants and conditional depletion mutants were compared to that of the wild-type under various conditions, and growth characteristics are discussed

Human-Robot Dichotomy

This paper belongs to the area of roboethics and responsible robotics. It discusses the conceptual and practical separation of humans and robots in designing and implementing robots into real-world environments. We argue here that humans are often seen as a component that is only optional in design thinking, and in some cases even an obstacle to the successful robot performance. Such an approach may vary from viewing humans as a factor that does not belong to the robotics domain, through attempts to ‘adjust’ humans to robot requirements, to the overall replacement of humans with robots. Such separation or exclusion of humans poses serious ethical challenges, including the very exclusion of ethics from our thinking about robots

Optical Absorption Measurements on Crystalline Silicon at 1550nm

Crystalline silicon is currently being discussed as test-mass material for future generations of gravitational wave detectors that will operate at cryogenic temperatures. We present optical absorption measurements on a large-dimension sample of crystalline silicon at a wavelength of 1550nm at room temperature. The absorption was measured in a monolithic cavity setup using the photo-thermal self-phase modulation technique. The result for the absorption coefficient of this float-zone sample with a specific resistivity of 11kOhm cm was measured to be \alpha_A=(264 +/- 39)ppm/cm.Comment: 11 pages, 6 figures, 1 tabl

PERANCANGAN SENSE OF PLACE PROYEK RUMAH KULINER TRADISIONAL MODERN KHAS PONOROGO

Dengan adanya riset analisa lingkungan bisnis yang mencakup Industry Forces, Market Forces, Key Trends, serta Macro Economic Forces, maka terdapatlah peluang dan permasalahan yang dihadapi dalam mendirikan usaha. Didirikannya usaha Rumah Kuliner Ponorogo dengan pendekatan sense of place merupakan bentuk dari jawaban permasalahan akan efisiensi dan kelayakan untuk mendapat produk serta fasilitas kuliner khas Ponorogo yang memadai. Hal ini juga tidak lepas dari bentuk solusi akan adanya pandemi yang berlangsung secara global. Tidak hanya menyediakan fasilitas untuk mendapatkan produk kuliner, usaha ini juga dilengkapi dengan penyediaan toko oleh-oleh yang menjual produk kerajinan lokal warga setempat untuk membantu UMKM warga. Proyek Rumah Kuliner Ponorogo merupakan sebuah proyek perancangan fasilitas kuliner yang menawarkan sebuah tempat dengan suasana tradisional yang dikombinasikan dengan suasana modern yang mengikuti tren, namun tetap memiliki ciri khas Ponorogo. Mengingat semakin berkembangnya usaha kuliner dengan suasana café yang modern, harapannya fasilitas kuliner ini dapat tetap mengikuti tren dengan menunjukkan suasana Ponorogo tersendiri yang melekat bagi pengunjungnya. Penerapan konsep dalam Rumah Kuliner Ponorogo terlihat pada tatanan masa bangunan yang diadaptasi dari rumah tradisional Jawa. Ciri khas Ponorogo sendiri terlihat pada ruang interior restoran, seperti adanya dinding mural dengan tokoh-tokoh dalam cerita tari reog, ornament dan dekorasi burung merak yang merupakan bagian dari ikon reog, serta penerapan material mentah seperti kayu, batu bata merah, dan acian pada pelingkup bangunan interior

Sr-isotope analysis of speleothems by LA-MC-ICP-MS: High temporal resolution and fast data acquisition

Speleothems are well established climate archives. A wide array of geochemical proxies, including stable isotopes and trace elements are present within speleothems to reconstruct past climate variability. However, each proxy is influenced by multiple factors, often hampering robust interpretation. Sr isotope ratios (87Sr/86Sr) can provide useful information about water residence time and water mixing in the host rock, as they are not fractionated during calcite precipitation. Laser ablation multi-collector-inductively coupled plasma mass spectrometry (LA-MC-ICP-MS) has rarely been used for determination of Sr isotope signatures in speleothems, as speleothems often do not possess appropriately high concentrations of Sr to facilitate this analysis. Yet the advantages of this approach include rapid data acquisition, higher spatial resolution, larger sample throughput and the absence of chemical treatment prior to analysis. We present LA-MC-ICP-MS Sr isotope data from two speleothems from Morocco (Grotte de Piste) and India (Mawmluh Cave), and we compare linescan and spot analysis ablation techniques along speleothem growth axes. The analytical uncertainty of our LA-MC-ICP-MS Sr data is comparable to studies conducted on other carbonate materials. The results of both ablation techniques are reproducible within analytical error, implying that this technique yields robust results when applied to speleothems. In addition, several comparative measurements of different carbonate reference materials (i.e. MACS-3, JCt-1, JCp-1), including tests with standard bracketing and comparison of the 87Sr/86Sr ratios with a nanosecond laser ablation system and a state-of-the-art femtosecond laser ablation system, highlight the robustness of the method

ADM mass in warp drive spacetimes

What happens when a warp bubble has mass? This seemingly innocent question forces one to carefully formalize exactly what one means by a warp bubble, exactly what one means by having the warp bubble "move" with respect to the fixed stars, and forces one to more carefully examine the notion of mass in warp-drive spacetimes. This is the goal of the present article. In this process, we will see that often-made throw-away comments regarding "payloads" are even simpler than commonly assumed, while there are two further, distinct yet subtle ways in which a mass can appear in connection with a warp drive space-time: One, that the warp bubble (not its payload) has the mass; two, that the mass is a background feature in front of which the warp drive moves. For simplicity, we consider generic Nat\'ario warp drives with zero-vorticity flow field. The resulting spacetimes are sufficiently simple to allow an exact and fully explicit computation of all of the stress-energy components, and verify that (as expected) the null energy condition (NEC) is violated. Likewise the weak, strong, and dominant energy conditions (WEC, SEC, DEC) are violated. Indeed, this confirms the community's folk wisdom, and recent (fully general, but implicit) results of the present authors which closed previous gaps in the argument. However, folk wisdom should be carefully and critically examined before being believed, and the present examples for general results will greatly aid physical intuition.Comment: V1:19 pages; V2: 22 pages. Authors re-ordered, abstract rewritten; 4 references added; improved presentation and discussion; calculations unaltered; physics conclusions unaltere