Violet Victoria

Introduction: Liposomal bupivacaine (LB) is a long-acting analgesic that, due to its liposomal formulation, purportedly extends its analgesic effect up to 72 hours. However, the clinical efficacy of LB appears mixed. This systematic review seeks to evaluate the effectiveness of liposomal bupivacaine in improving postoperative outcomes compared to ropivacaine (ROPI), another commonly used long-acting analgesic. Materials and Methods: Prospective and randomized controlled trials (RCTs) evaluating the efficacy of LB compared to ROPI were selected for review. Primary outcomes included hospital length of stay (LOS) and postoperative opioid consumption measured in oral morphine equivalents (OME). Secondary outcomes included analgesic cost. Results: 14 studies met the review criteria. We found that LB and ROPI are equivalent in managing postoperative pain. 8 of the 14 trials reported equal efficacy between LB and ROPI as determined by OME post-procedure and 10 of the 14 trials reported similar LOS after surgery. These findings remained consistent across multiple surgical procedures and multiple drug administrative modalities. Conclusion: Our systematic review found that LB was not superior to ROPI in reducing postoperative OME use and hospital LOS. The only consistent finding was the significantly increased cost of LB compared to that of ROPI. Therefore, the use of LB over ROPI cannot be justified.

US stock markets have created the greatest wealth in human history. This wealth, however, has not been shared or distributed equally. I seek to understand the way in which income disparities work to undermine mechanisms within the market itself. This Thesis addresses a proposed means for making wealth creation more equitable - so-called ‘democratization’ of the stock markets. I argue that one iteration of the approach, exemplified by the retail trading firm Robinhood, does not fulfill this equity ideal. Robinhood makes it cheaper and easier for ‘regular folks’ to get into finance. By way of both its business model and app design and user interface, it has detrimental effects on equity in financial markets. Financial markets can be a force for good, but only as long as they operate to meet their own appropriate goals of efficiently and productively allocating capital resources. Robinhood-style trading, however, creates an environment more similar to a casino than an auction, potentially harming Robinhood traders and distracting finance professionals with the lure of easy new money. Wealth generation in this context comes apart from the allocative purpose of the market. This concern can be mitigated with intelligently designed adjustments to the system that align profitability with ethicality. Such behavioral and structural changes can originate from market participants, technology providers who create the platforms used by participants, or market regulators.