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Background A multitude of chemical agents are currently used intra-articularly to decrease pain after orthopaedic procedures including total knee arthroplasty. However, the possible deleterious effects of these injectable chemicals on chondrocyte viability have not been weighed against their potential benefits. Using a human osteoarthritic chondrocyte model, the purpose of this study was to assess the potential for cartilage damage caused by bupivacaine, Toradol, Duramorph, and acetaminophen from surgical local anesthesia. Methods Human distal femur and proximal tibia cross sections were obtained during total knee arthroplasty and divided into control group and experimental groups treated by bupivacaine, Toradol, Duramorph, and acetaminophen respectively. Chondrocytes obtained from enzymatically digested cartilage were cultured using a 3D alginate bead culture method to ensure lower rates of dedifferentiation. Chondrocyte bead cultures were exposed to the study chemicals. The gene expression and chondrocyte viability were measured by RT-PCR and flow cytometry, respectively. Results Compared with untreated group bupivacaine treatment led to the greatest cellular apoptosis with 30.5 ± 11% dead cells (P = 0.000). Duramorph and acetaminophen did not result in a significant increase in cell death. Bupivacaine treatment led to an increase in Caspase 3 gene expression (P = 0.000) as well as the acetaminophen treatment (P = 0.001) when compared to control. Conclusion Our data demonstrated that Duramorph and Toradol were not cytotoxic to human chondrocytes and may be better alternatives to the frequently used and more cytotoxic bupivacaine. Acetaminophen did not result in increased cell death; however, it did show increased caspase 3 gene expression and caution should be considered.

To compare a femoral physeal sparing anterior cruciate ligament (ACL) reconstruction technique utilizing a posteromedial portal to traditional transphyseal techniques with regards to anatomic tunnel positioning and proximity to important neurovascular structures. Eight cadaveric knees were obtained for the study. Femoral tunnel guide pins were placed utilizing four different techniques: accessory anterior medial portal, posteromedial portal, trans-tibial, and figure-4 methods. The knees were then dissected and the following measurements taken: distance of each pin to the saphenous and peroneal nerve, popliteus tendon, neurovascular bundle, femoral ACL footprint and articular cartilage, and the angle of the guide pin entering the lateral femoral condyle. Fluoroscopic imaging was taken to determine the disruption of the physeal scar. Posteromedial portal guide pin was significantly closer to the neurovascular bundle, popliteal tendon and saphenous nerve when compared to the other 3 techniques, but was further from the peroneal nerve. It also had the smallest distance from the anatomic footprint of the ACL, and the largest angle to the lateral femoral condyle. The posteromedial portal guide pin had similar distance from the articular cartilage as the accessory anterior medial portal and figure-4 guide pin, with the trans-tibial guide pin being the farthest. The posteromedial portal guide pin failed to disrupt the physeal scar in all specimens, while the other three techniques consistently violated the physeal scar. The posteromedial portal technique offers an appropriate method for anatomic ACL reconstruction while protecting the distal femoral physis from injury. Care needs to be taken with this technique as it comes in closer proximity to some of the important neurovascular structures. This study indicates that posteromedial portal technique is a less technically challenging approach for physeal-sparing ACL repair with special attention required for the protection of neurovascular bundle from potential injury.

How do professors connect Shakespeare to “something like social justice and democratic practice” when students see higher education as suspect and “learning as an act of cultural betrayal”? This is the challenge faced by many of those teaching early modern texts to first-generation economically disadvantaged students in rural com- munities who have been raised to doubt that “the arts and humanities have any positive value at all.” This chapter proposes that the first step in engaging such students is helping them see that their disaffection is the result of their having actually been “the objects of an injustice.” Osborne describes a general education seminar in literature and philosophy which gives students space to temporarily “suspend and question their values.” Here, the tragedies of Shakespeare and other authors enable the kind of productive disorientation (aporia) that enables rediscovery and leads to a hunger for justice.

When an astronaut transitions from a low to high gravitational environment, fluid shifts from the head towards the feet resulting in orthostatic intolerance and syncope. Ground based experiments have shown that by stimulating the cardiovascular system via simple mental stressors, syncope can be delayed, potentially enabling astronauts to reach assistance before loss of consciousness. However, the effect of mental stressors on the stimulation of the cardiovascular system in gravitational environments different than that of Earth’s is unknown. As such, this paper investigates the effects that mental stressors under various gravitational environments. To do this, a pilot study was performed in which two participants were flown on two separate parabolic flights that simulated hyper and hypogravity conditions. The plane used was an Aerobatic Single-Engine Cap-10B plane (twin seater), and each participant executed 11 parabolas. The participants were the winners of the Barcelona Zero-G Challenge 2011 organized by UPC Universitat Politecnica de Catalunya-BarcelonaTech and Aeroclub Barcelona-Sabadell. Measurements were made of the participants’ hemodynamic and autonomic response throughout the parabolas, using a Chronocord: high precision HRV monitor. Comparisons of the baseline response without mental stressors, and the response with mental stressors during different gravitational loading conditions were made. It was observed that there is an increase in cardiovascular activity during hypo- and hyper-gravity when performing mental arithmetic. Our results show that the twin seater aerobatic single engine CAP-10B aicraft can provide changing gravitational loading conditions for enough periods to study changes in physiological systems.

Current imaging-based morphometric indicators of osteoarthritis (OA) using whole-compartment mean cartilage thickness (MCT) and volume changes can be insensitive to mild degenerative changes of articular cartilage (AC) due to areas of adjacent thickening and thinning. The purpose of this preliminary study was to evaluate cartilage thickness-based surface roughness as a morphometric indicator of OA. 3D magnetic resonance imaging (MRI) datasets were collected from osteoarthritis initiative (OAI) subjects with Kellgren-Lawrence (KL) OA grades of 0, 2, and 4 (n = 10/group). Femoral and tibial AC volumes were converted to two-dimensional thickness maps, and MCT, arithmetic surface roughness (S

Background Psychogenic non-epileptic seizures (PNES) pose a substantial burden to patients and the health care system, due to long diagnostic and treatment delays. Methods This study used medical chart notes from 103 patients to shed light on the diagnostic process. Electronic medical records and cost data from a US health system were also used to investigate costs and utilization for the 12-months before and after PNES diagnosis. Results The results show that accurate diagnosis was typically achieved via the use of multiple medical tests, including vEEG, magnetic resonance imaging (MRI), and computed tomography (CT) scans, as well as historical diagnostic and clinical information. In the year following PNES diagnosis, a decline in average visits (−1.45) and costs (−$1784) were observed. The largest cost savings were seen in neurology care and inpatient stays. Conclusions This study has implications for timely and accurate diagnosis of PNES, which may decrease the overall health care burden for individuals and the health care system.

The recent past has seen robots develop into autonomous artificial agents capable of executing complex tasks. In the near future, robots will likely develop the ability to adapt and learn from their surroundings. Robots have reliance, accuracy, and can operate in hostile environments - all attributes well suited for space exploration. Robots also reduce mission costs, increase design flexibility, and maximize data production. On the other hand, when faced with new scenarios and unexpected events, robots pale in comparison with intuitive and creative human counterparts. The future of space exploration will require that mission designers balance intelligently the flexibility and ingenuity of humans with robust and sophisticated robotic systems.The Cooperation of Humans And Robots for Mars (CHARM) team at the 2011 Space Studies Program of the International Space University integrates international, intercultural, and interdisciplinary perspectives to investigate Mars exploration objectives, robotic capabilities, and the interaction between humans and robots. Based on the goals of various space agencies, this report selects an exploration objective for the time frame between 2015 and 2035, and drafts different scenarios to accomplish this objective. Each scenario uses different degrees of human-robot interaction. A theoretical model is then developed based on discrete requirements to help create an effective combination of human and robots. The CHARM model uses an interdisciplinary approach, including technical, societal, political, legal, financial, scientific and mission risk perspectives. The results of the CHARM model are then further analyzed using these interdisciplinary aspects, with considerations to the future studies of human-robot cooperation.The CHARM team believes that this decision-making model can be used to select missions more efficiently and rationally, thus bringing down both mission costs and risks, and making space exploration more feasible.

Self-sustaining communities throughout Africa rely on local agriculture rather than external sources. Meanwhile, desertification is a widespread problem caused by a combination of human and natural factors. While desertification has consequences that directly affect agriculture, health, urban planning, and water scarcity, it is known that increasing populations, food demands, and short-term economic interests lead to the overexploitation of resources and unsustainable agricultural practices which drive soil degradation and the destruction of ecosystems. In both of these areas, developing and developed African states can greatly benefit from space-based earth observation applications. Can these earth observation applications assist countries with little or no space infrastructure? As an outcome of the Space and Africa Team Project at International Space University's 2012 Masters Program in Strasbourg, France, this paper will present two innovative applications based on earth observation, and geared towards implementation throughout Africa. The Identifying and Developing Effective Applications of Space for Africa (IDEAS for Africa) team investigated two possible earth observation applications, and using three different African countries as examples, determined how these can be used to promote development across the continent. South Africa, Morocco, and Liberia were selected not only based on their respective levels of space development, but also because they differ geographically, socially, economically, and politically. Consequently, a broad comparative analysis can be performed. Due to the dissimilarity of these three states, analogies can be drawn to other African states at comparable levels of development. The paper will shows how space and the innovations of the space industry can benefit Africa by aiding development across the continent and improving the lives and opportunities of those who live there.

This report presents the conclusions of the Space and Africa Team Project at the International Space University‟s (ISU) 2011-2012 Masters Program, held at Strasbourg, France. The Identifying and Developing Effective Applications of Space for Africa (IDEAS for Africa) team has assessed how space can contribute to sustained social and economic development in Africa. Space can provide many benefits - from spinoff technologies, satellite applications, and even establishing self-sustained commercial industries. But how is space relevant for Africa? How can space be used to save and improve lives, protect the environment, mitigate severe weather conditions, and build industries and economies? In ISU's first African-focused team project, this report begins by selecting three dissimilar countries to serve as examples for the entire continent. Liberia, Morocco, and South Africa are selected not only based on their respective levels of space development, but also because they differ geographically, socially, economically, and politically. In learning about these target countries, the report maintains a focus on six socio-political focus areas (agriculture, education, energy, environment, health, and STEM education – Science, Technology, Engineering and Mathematics).Next, the report discusses three spinoffs especially relevant to improving these conditions. The team selected three for further investigation: Organically Derived Colloidals, Solid Oxide Fuel Cells, and docosahexaenoic acid (DHA) supplements. Born from space industry research, these spinoffs can be repurposed to improve lives across Africa. The report then finds and analyses four satellite applications especially relevant to African concerns. FarmaBooths (a way of bringing satellite imagery to rural African farmers), Telemedicine Vans, a Desert Movement Predictor, and an Anti-poaching program, are all applications of space technology that can be implemented in Africa. Two potential space businesses are then analyzed. An African Space Education Center can be used to build domestic capacity in high technology fields, prevent “brain drain”, and foster a domestic space industry. The revival of South Africa's Overberg Test Range is then offered as a potential commercial venture. A discussion of the strengths, weaknesses, opportunities, and threats is included in the discussion of each space spinoff, satellite application, and space business proposal, along with any ethical implications. Finally, the creation of two organizations to bring space to Africa is discussed. An African Space Agency and a Space for Africa Non-Governmental Organization are two ways to implement our ideas for Africa.

This paper will present a model for collaborative space exploration through effective and efficient cooperation of humans and robots — an extension to the Cooperation of Humans and Robots Model (CHARM) developed by the Human-Robotic Cooperation (HRC) team at the International Space University’s 2011 Space Studies Program held in Graz, Austria. The HRC team integrated international, intercultural, and interdisciplinary perspectives to develop a decision-making model (the CHARM model) capable of selecting a mission scenario which best utilizes humans and robotics in order to accomplish a given objective. Human and robotic capabilities differ, with each offering their own benefits and drawbacks. Robots are reliable and accurate, and can operate in hostile environments — all attributes well-suited for space exploration. However, when faced with new scenarios and unexpected events, robots pale in comparison with the intuition and creativity of humans. Future space exploration will have to intelligently balance the flexibility and ingenuity of humans with robust and sophisticated robotic systems. Based on various space agency goals and the 2011 International Space Exploration Coordination Group (ISECG) Roadmap, this paper selects an exploration objective for the timeframe between 2015 and 2030, and drafts different scenarios to accomplish this objective. Each scenario uses different degrees of human-robot interaction. CHARM is applied to select an optimal mix of human and robotics in order to accomplish the selected objective. CHARM uses an interdisciplinary approach, scoring attributes including technical, scientific, life sciences, political, social, financial, and legal perspectives. In this iteration of CHARM, an Analytical Hierarchy Process is used to assign weighting values to each attribute and the respective categories. The weights are complemented with those collected by survey of a panel of international experts in space exploration mission planning. The results demonstrate that CHARM can be used to select missions efficiently and rationally, thereby reducing both mission costs and risks, making space exploration more feasible and long-term space exploration sustainable. To quantify output confidence in the CHARM scenario selection, a Monte Carlo probabilistic simulation is used to analyze the uncertainty in attribute weighting, introduced by the inclusion of numerous weight value input sources.

This paper will present the conclusions of International Space University's 2012 Masters program Team Project on Space and Africa. Remote sensing applications, spin-off technologies, and even self-sustaining commercial industries can bring benefits to many countries. In addition to those countries with an already well-established space industry, there exists a need to demonstrate how space can be used in assisting in the sustained socio-economic development of underdeveloped or developing nations, and answering the question of how these applications or technologies can assist countries with little or no space development. The Identifying and Developing Effective Applications of Space for Africa (IDEAS for Africa) team from the 2011-2012 Masters program at the International Space University in Strasbourg, France, has assessed how space can contribute to improve the sustained social and economic development in Africa. Using three dissimilar African countries as examples, the IDEAS team proposes space spin-off technologies, satellite applications, and space business potentials applicable in fostering development. Each area: spin-off technologies, satellite applications, and space business potentials - was analyzed for each of the three example African nations. South Africa, Morocco, and Liberia were selected not only based on their respective levels of space development, but also because they differ geographically, socially, economically, and politically. Consequently, a broad comparative analysis can be performed by investigating the effects of space activities for these three selected countries. Additionally, due to the dissimilarity of the three countries, parallels can be drawn to other nations which are at comparable levels of development, to show how space can be used to drive development across the African continent.