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Background Anterior cruciate ligament (ACL) and meniscus tears are common knee injuries. Despite the high rate of post-traumatic osteoarthritis (PTOA) following these injuries, the contributing factors remain unclear. In this study, we characterized the immune cell profiles of normal and injured joints at the time of ACL and meniscal surgeries. Methods Twenty-nine patients (14 meniscus-injured and 15 ACL-injured) undergoing ACL and/or meniscus surgery but with a normal contralateral knee were recruited. During surgery, synovial fluid was aspirated from both normal and injured knees. Synovial fluid cells were pelleted, washed, and stained with an antibody cocktail consisting of fluorescent antibodies for cell surface proteins. Analysis of immune cells in the synovial fluid was performed by polychromatic flow cytometry. A broad spectrum immune cell panel was used in the first 10 subjects. Based on these results, a T cell-specific panel was used in the subsequent 19 subjects. Results Using the broad spectrum immune cell panel, we detected significantly more total viable cells and CD3 T cells in the injured compared to the paired normal knees. In addition, there were significantly more injured knees with T cells above a 500-cell threshold. Within the injured knees, CD4 and CD8 T cells were able to be differentiated into subsets. The frequency of total CD4 T cells was significantly different among injury types, but no statistical differences were detected among CD4 and CD8 T cell subsets by injury type. Conclusions Our findings provide foundational data showing that ACL and meniscus injuries induce an immune cell-rich microenvironment that consists primarily of T cells with multiple T helper phenotypes. Future studies investigating the relationship between immune cells and joint degeneration may provide an enhanced understanding of the pathophysiology of PTOA following joint injury.

Background Lumbar spinal stenosis (LSS) is a common degenerative condition that contributes to back and back-related leg pain in older adults. Most patients with symptomatic LSS initially receive non-operative care before surgical consultation. However, there is a scarcity of data regarding prognosis for patients seeking non-surgical care. The overall goal of this project is to develop and evaluate a clinically useful model to predict long-term physical function of patients initiating non-surgical care for symptomatic LSS. Methods This is a protocol for an inception cohort study of adults 50 years and older who are initiating non-surgical care for symptomatic LSS in a secondary care setting. We plan to recruit up to 625 patients at two study sites. We exclude patients with prior lumbar spine surgeries or those who are planning on lumbar spine surgery. We also exclude patients with serious medical conditions that have back pain as a symptom or limit walking. We are using weekly, automated data pulls from the electronic health records to identify potential participants. We then contact patients by email and telephone within 21 days of a new visit to determine eligibility, obtain consent, and enroll participants. We collect data using telephone interviews, web-based surveys, and queries of electronic health records. Participants are followed for 12 months, with surveys completed at baseline, 3, 6, and 12 months. The primary outcome measure is the 8-item PROMIS Physical Function (PF) Short Form. We will identify distinct phenotypes using PROMIS PF scores at baseline and 3, 6, and 12 months using group-based trajectory modeling. We will develop and evaluate the performance of a multivariable prognostic model to predict 12-month physical function using the least absolute shrinkage and selection operator and will compare performance to other machine learning methods. Internal validation will be conducted using k-folds cross-validation. Discussion This study will be one of the largest cohorts of individuals with symptomatic LSS initiating new episodes of non-surgical care. The successful completion of this project will produce a cross-validated prognostic model for LSS that can be used to tailor treatment approaches for patient care and clinical trials.

High body mass index (BMI) and obesity have been implicated as risk factors for lumbar degenerative disc disease and low back pain. Despite this, there is limited in vivo data to quantify how obesity influences the mechanical function of intervertebral discs (IVD) in response to activities of daily living. Recently, our lab has developed methodologies to non-invasively measure in vivo IVD deformation resulting from activities of daily living using magnetic resonance (MR) imaging and solid modeling techniques. This pilot study expands on these methodologies to assess how BMI influences IVD deformation following treadmill walking in eight asymptomatic individuals. Ordinary least squares regression analyses revealed a statistically significant relationship between BMI and compressive deformation (strain (%)) in the L5-S1 IVD (R2 = 0.61, p < 0.05). This relationship was weaker in the L3-L4 (R2 = 0.28, p > 0.05) and L4-L5 IVDs (R2 = 0.28, p > 0.05). Importantly, no relationship between pre-exercise disc height and BMI was identified (p > 0.05). Therefore, the results of this study suggest that BMI may alter the mechanical response of lumbar spine IVDs, particularly at the L5-S1 level. Furthermore, the observed relationship between increased BMI and IVD compressive deformation, in the absence of a detected relationship between pre-exercise disc height and BMI, suggests that changes in IVD mechanical function may be more sensitive to alterations in disc health than static clinical imaging alone. This finding highlights the importance of quantifying disc mechanical function when examining the relationship between BMI and IVD degeneration.

Acute low back pain (LBP) is a common experience; however, the associated pain severity, pain frequency, and characteristics of individuals with acute LBP in community settings have yet to be well understood. In this manuscript, two acute-LBP severity categorization definitions were developed: 1) pain impact frequency (impact-based) and 2) pain intensity (intensity-based) severity categories. The purpose of this manuscript is to describe and then compare these acute-LBP severity groups in the following characteristics: 1) sociodemographic, 2) general and physical health, and 3) psychological using a feasibility cohort study. This cross-sectional study used baseline data from 131 community-based participants with acute LBP (<4 weeks duration before screening and ≥30 pain-free days before acute LBP onset). Descriptive associations were calculated as prevalence ratios of categorical variables and Hedges' for continuous variables. Our analyses identified several large associations for impact-based and intensity-based categories with global mental health, global physical health, STarT Back Screening Tool risk category, and general health. Larger associations were found with social constructs (racially and ethnically minoritized, performance of social roles, and isolation) when using the intensity-based versus impact-based categorization. This study adds to the literature by providing standard ways to characterize community-based individuals experiencing acute-LBP. The robust differences observed between these categorization approaches suggest that how we define acute-LBP severity is consequential; these different approaches may be used to improve the early identification of factors potentially contributing to the development of chronic-LBP.

Biochemical biomarkers may provide insight into musculoskeletal pain reported at individual or multiple body sites. The purpose of this study was to determine if biomarkers or pressure-pain threshold (PPT) were associated with individual or multiple sites of pain. This cross-sectional analysis included 689 community-based participants. Self-reported symptoms (ie, pain, aching, or stiffness) were ascertained about the neck, upper back/thoracic, low back, shoulders, elbows, wrist, hands, hips, knees, ankles, and feet. Measured analytes included CXCL-6, RANTES, HA, IL-6, BDNF, OPG and NPY. A standard dolorimeter measured PPT. Logistic regression was used determine the association between biomarkers and PPT with individual and summed sites of pain. Increased IL-6 and HA were associated with knee pain (OR=1.30, 95% CI 1.03, 1.64) and (OR=1.32, 95% CI 1.01, 1.73) respectively; HA was also associated with elbow/wrist/hand pain (OR=1.60, 95% CI 1.22, 2.09). Those with increased NPY levels were less likely to have shoulder pain (OR=0.56, 95% CI 0.33, 0.93). Biomarkers HA (OR=1.50, 95% CI 1.07, 2.10), OPG (OR=1.74, 95% CI 1.00, 3.03), CXCL-6 (OR=1.75, 95% CI 1.02, 3.01) and decreased PPT (OR=3.97, 95% CI 2.22, 7.12) were associated with multiple compared to no sites of pain. Biomarker HA (OR=1.57, 95% CI 1.06, 2.32) and decreased PPT (OR=3.53, 95% CI 1.81, 6.88) were associated with multiple compared to a single site of pain. Biomarkers of inflammation (HA, OPG, IL-6 and CXCL-6), pain (NPY) and PPT may help to understand the etiology of single and multiple pain sites.

Introduction The late Senator Melvin Littlecrow spoke often about members of the Whitecap Dakota First Nation performing at Pion-Era in the 1950s and 1960s.1 A summer heritage exhibition of agriculture, produced annually by the Western Development Museum (WDM) in Saskatoon since 1955, Pion-Era was designed to bring settlers together to be simultaneously nostalgic for the past and optimistic about a progressive prairie future. Community members lived in the camp for the week, sharing their culture with visitors from first thing in the morning until well into the night.6 The tipi camp at Pion-Era was more than a static installation of traditional Indigenous housing-it was the site of complex community relations and activities. According to Senator Littlecrow, they also brought about a dozen of their own horses and stabled them at Pion-Era. Only community members who understand the spiritual significance can apply the paint, which represents the sacred bond between the horse and rider.

A comprehensive guide to service-learning for social justice written by an international panel of experts The Wiley International Handbook of Service-Learning for Social Justice offers a review of recent trends in social justice that have been, until recently, marginalized in the field of service-learning. The authors offer a guide for establishing and nurturing social justice in a variety of service-learning programs, and show that incorporating the principles of social justice in service-learning can empower communities to resist and disrupt oppressive power structures, and work for solidarity with host and partner communities. With contributions from an international panel of experts, the Handbook contains a critique of the field's roots in charity; a review of the problematization of Whitenormativity, paired with the bolstering of diverse voices and perspectives; and information on the embrace of emotional elements including tension, ambiguity, and discomfort. This important resource: * Considers the role of the community in service-learning and other community?engaged models of education and practice * Explores the necessity of disruption and dissonance in service-learning * Discusses a number of targeted issues that often arise in service-learning contexts * Offers a practical guide to establishing and nurturing social justice at the heart of an international service-learning program Written for advanced undergraduate students, graduate students, scholars, and educators, The Wiley International Handbook of Service-Learning for Social Justice highlights social justice as a conflict?ridden struggle against inequality, xenophobia, and oppression, and offers practical suggestions for incorporating service-learning programs in various arenas.

“Canada’s Aboriginal peoples were in every sense key to the victory that firmly established Canada as a distinct country in North America. Now, of course, much has changed in 200 years. The war, contrary to a lot of expectations of the time, ushered in a long peace between Canada and the United States. The Americans are now our great friends and allies. Canada The bicentennial of the War of 1812 provided the Canadian government with a welcome opportunity to recognize the role of First Nations in the founding of Canada. A War of 1812 National Recognition Ceremony acknowledging descendants of

[...]in an interview from the time of Halfbreed's publication, Campbell insists that division between \"halfbreeds\" and other groups are largely a product of the \"system\": \"It is this whole thing about non-status, Treaty, halfbreeds, White and Black, that's how our whole system lays it on us. According to Cairnie, such negotiation is the \"project\" for writers of what she calls \"composite\" origins: \"to identify the negative and positive aspects of their hybridity, to portray it as a painful division and to celebrate it as a rich cultural heritage\" (96). [...]Monika Kaup is so attached to the hybrid ideal, which she calls \"the plural poetics of métissage\" (1 97), that she views Campbell's identification with the Riel rebellion, a \"Native-like resistance movement\" (198), as a sign of her failure to fulfill the \"promise\" of hybridity (1 97). [...]we contacted a group of scholars by way of e-mail8 to inquire how and why they teach Halfbreed in their classrooms.9 In the responses that we received,10 we found that Campbell's Halfbreed is still widely taught, primarily in introductory or survey courses on the canon of Aboriginal/Indigenous literatures (Episkenew, Ruffo, and Renate Eigenbrod) but also in courses in Métis history (Brenda MacDougall), Indigenous Women's Stories (Eigenbrod), as well as in Women's Studies and Native Studies courses (Deanna Reder).