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This study examined whether a modern total knee arthroplasty (TKA) protocol without a tourniquet results in less patient-reported pain and in-hospital opioid consumption compared to TKA with a tourniquet.A retrospective study of 203 primary unilateral cemented TKAs consecutively performed with or without tourniquet was performed. Identical perioperative pain and blood loss protocols were used in all cases. In tourniquetless TKAs, the tourniquet was not inflated at any time, and sterile COAfter exclusions for scientific confounds, 184 TKAs (93 with tourniquet; 91 tourniquetless) were analyzed. Controlling for multiple covariates, females with a tourniquet reported significantly more pain (P = .002) and opioid consumption (P.001) the first 24 hours after surgery compared to females without a tourniquet. There were no differences in pain (P = .192) or amount of opioids consumed (P = .203) among males with and without a tourniquet. Tourniquet use resulted in a significant reduction in blood loss for both females (P ≤ .040) and males (P ≤ .020), although the total blood savings of approximately 200 mL is of unknown clinical significance.Avoiding tourniquet use during TKA for females may be a relatively risk-free adjunct to minimize opioid consumption during hospitalization. Further study is warranted to elucidate the factors accounting for different outcomes in females and males.

The purpose of this retrospective study was to assess whether tranexamic acid (TXA) reduces blood loss in cementless total knee arthroplasty (TKA) comparable to levels observed with cemented fixation. After exclusions from 109 consecutive TKAs, 76 cementless knees were matched to 78 cemented knees of identical implant and surgeon. Blood loss with and without TXA was compared. There was no difference between cohorts in sex, age, body mass index, American Society of Anesthesiologists Physical Status classification, or preoperative hemoglobin (p ≥ 0.119). Use of TXA reduced median drain output by only 205 mL in cementless knees compared to 470 mL in cemented knees (p

The skeleton is a high-renewal organ that undergoes ongoing cycles of remodeling. The regenerative bone formation arm ultimately declines in the aging, postmenopausal skeleton, but current therapies do not adequately address this deficit. Bone marrow is the primary source of the skeletal anabolic response and the mesenchymal stem cells (MSCs), which give rise to bone matrix-producing osteoblasts. The identity of these stem cells is emerging, but it now appears that the term 'MSC' has often been misapplied to the bone marrow stromal cell (BMSC), a progeny of the MSC. Nevertheless, the changes in BMSC phenotype associated with age and estrogen depletion likely contribute to the attenuated regenerative competence of the marrow and may reflect alterations in MSC phenotype. Here we summarize current concepts in bone marrow MSC identity, and within this context, review recent observations on changes in bone marrow population dynamics associated with aging and menopause.

Parathyroid hormone (PTH) anabolic osteoporosis therapy is intrinsically limited by unknown mechanisms. We previously showed that disabling the transcription factor Nmp4/CIZ in mice expanded this anabolic window while modestly elevating bone resorption. This enhanced bone formation requires a lag period to materialize. Wild-type (WT) and Nmp4-knockout (KO) mice exhibited equivalent PTH-induced increases in bone at 2 weeks of treatment, but by 7 weeks, the null mice showed more new bone. At 3-week treatment, serum osteocalcin, a bone formation marker, peaked in WT mice, but continued to increase in null mice. To determine if 3 weeks is the time when the addition of new bone diverges and to investigate its cellular basis, we treated 10-week-old null and WT animals with human PTH (1-34) (30 μg/kg/day) or vehicle before analyzing femoral trabecular architecture and bone marrow (BM) and peripheral blood phenotypic cell profiles. PTH-treated Nmp4-KO mice gained over 2-fold more femoral trabecular bone than WT by 3 weeks. There was no difference between genotypes in BM cellularity or profiles of several blood elements. However, the KO mice exhibited a significant elevation in CFU-F cells, CFU-F(Alk)(Phos+) cells (osteoprogenitors), and a higher percentage of CFU-F(Alk)(Phos+) cells/CFU-F cells consistent with an increase in CD45-/CD146+/CD105+/nestin+ mesenchymal stem cell frequency. Null BM exhibited a 2-fold enhancement in CD8+ T cells known to support osteoprogenitor differentiation and a 1.6-fold increase in CFU-GM colonies (osteoclast progenitors). We propose that Nmp4/CIZ limits the PTH anabolic window by restricting the number of BM stem, progenitor, and blood cells that support anabolic bone remodeling.

This study compared lag time characteristics of low impact residential development with traditional residential development. Also compared were runoff volume, peak discharge, hydrograph kurtosis, runoff coefficient, and runoff threshold. Low impact development (LID) had a significantly greater centroid lag-to-peak, centroid lag, lag-to-peak, and peak lag-to-peak times than traditional development. Traditional development had a significantly greater depth of discharge and runoff coefficient than LID. The peak discharge in runoff from the traditional development was 1,100% greater than from the LID. The runoff threshold of the LID (6.0 mm) was 100% greater than the traditional development (3.0 mm). The hydrograph shape for the LID watershed had a negative value of kurtosis indicating a leptokurtic distribution, while traditional development had a positive value of kurtosis indicating a platykurtic distribution. The lag times of the LID were significantly greater than the traditional watershed for small (

Ryan and Frederick’s (1997) measure of vitality, thesubjective feeling of being alive and alert, wasdeveloped in the context of a single factor analysis.The present investigation employed structural equationmodeling (SEM) to assess construct validity andutility of the new measure. A large sample (N = 526) wascollected in two waves, allowing the investigators tofurther develop the model proposed by Ryan andFrederick, and to then validate it on a second dataset. The final model is presented, and the process ofachieving that model is discussed, as are the relativestrengths of SEM in test development.

Chronic degenerative diseases are increasing with the aging U.S. population. One consequence of this phenomenon is the need for long-term osteoporosis therapies. Parathyroid hormone (PTH), the only FDA-approved treatment that adds bone to the aged skeleton, loses its potency within two years of initial treatment but the mechanism regulating its limited "anabolic window" is unknown. We have discovered that disabling the nucleocytoplasmic shuttling transcription factor nuclear matrix protein 4/cas interacting zinc finger protein (Nmp4/CIZ) in mice extends the PTH bone-forming capacity. Nmp4 was discovered during our search for nuclear matrix transcription factors that couple this hormone's impact on osteoblast cytoskeletal and nuclear organization with its anabolic capacity. CIZ was independently discovered as a protein that associates with the focal adhesion-associated mechanosensor p130Cas. The Nmp4/CIZ-knockout (KO) skeletal phenotype exhibits a modestly enhanced bone mineral density but manifests an exaggerated response to both PTH and to BMP2 and is resistant to disuse-induced bone loss. The cellular basis of the global Nmp4/CIZ-KO skeletal phenotype remains to be elucidated but may involve an expansion of the bone marrow osteoprogenitor population along with modestly enhanced osteoblast and osteoclast activities supporting anabolic bone turnover. As a shuttling Cys(2)His(2) zinc finger protein, Nmp4/CIZ acts as a repressive transcription factor perhaps associated with epigenetic remodeling complexes, but the functional significance of its interaction with p130Cas is not known. Despite numerous remaining questions, Nmp4/CIZ provides insights into how the anabolic window is regulated, and itself may provide an adjuvant therapy target for the treatment of osteoporosis by extending PTH anabolic efficacy.

Ferric stearate photoinitiated HDPE films manufactures as supermarket shopping bags were found to rapidly photodegrade after exposure to UV and visible light irradiation. Our studies confirmed manufacturer's claims that the bags would degrate more rapidly tha standard UV stabilised bags. The photodegradable bags had the potential to completely degrade and be resorbed into the biosphere without adverse effect

Under the Air Force sponsored "Reconfigurable Systems for Tailless Fighter Aircraft - RESTORE" program, Boeing Phantom Works developed multiple control allocation algorithms based on linear programming and quadratic programming. According to the comparison analyses performed by the Boeing RESTORE program, the linear programming approach produced the best results in terms of maximum attainable moment space and chatter, but at the expense of increased computational time. The quadratic programming approach, on the other hand, reduced computational time but achieved less in maximum attainable moment space. Based on these observations, a study on control allocation problem was conducted using the Boeing-in-house LI optimization code, which is similar to simplex method of linear programming. The objective of this study is to evaluate the performance of the LI optimization code when applied to control allocation problem, and make assessment toward implementation. The Tailless Advanced Fighter Aircraft (TAFA) model along with its baseline control laws is used as a test bed. The assessment is made by comparisons between the LI optimization and quadratic programming in performance and execution.

Etude des mecanismes qui sous-tendent le «primiting effect» (facilitation de la reponse par presentation precedente d'un item semantiquement lie) dans la reconnaissance semantique d'item, mettant l'accent sur les contributions relatives de deux explications concurrentes a travers quatre experiences, la premiere utilisant un paradigme du temps de reponse (TR) amenage, les trois autres des paradigmes de vitesse-exactitude (SAT) avec interruption