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Background: Hospital length of stay is a major driver of cost in the total hip arthroplasty (THA) episode of care, and as a result, significant efforts are being made to minimize it. This study aims to assess the utility of the Outpatient Arthroplasty Risk Assessment (OARA) screening tool in accurately identifying patients for safe and early discharge after THA., Methods: A retrospective review was conducted on 332 consecutive patients who underwent primary THA at a single tertiary academic center. Patients were evaluated using the OARA score, a tool that has been proposed to identify patients who can safely undergo early discharge after THA. The validity of these claims was assessed by analyzing the OARA score's positive and negative predictive values for high vs low OARA scores between patients enrolled in our (1) same-day discharge (SDD) and 2) next-day discharge (NDD) pathways., Results: When comparing the utility of the OARA score in accurately predicting length of stay, the OARA score demonstrated a (1) higher, but constant, positive predictive value for discharge on postoperative day (POD) 0 for SDD (86.1%) than POD1 for NDD (35.5%) and (2) lower negative predictive value for discharge on POD0 (23.1%) for SDD than POD1 for NDD (86.1%)., Conclusion: The OARA score was developed to risk-stratify patients who can safely undergo SDD or NDD after THA. In this study, the OARA score was a highly predictive tool in identifying NDD patients at risk for failure of discharge by POD1., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The resurgent component of voltage-gated Na + (Nav) currents, I NaR , has been suggested to provide the depolarizing drive for high-frequency firing and to be generated by voltage-dependent Nav channel block (at depolarized potentials) and unblock (at hyperpolarized potentials) by the accessory Navβ4 subunit. To test these hypotheses, we examined the effects of the targeted deletion of Scn4b (Navβ4) on I NaR and on repetitive firing in cerebellar Purkinje neurons. We show here that Scn4b -/- animals have deficits in motor coordination and balance and that firing rates in Scn4b -/- Purkinje neurons are markedly attenuated. Acute, in vivo short hairpin RNA (shRNA)-mediated "knockdown" of Navβ4 in adult Purkinje neurons also reduced spontaneous and evoked firing rates. Dynamic clamp-mediated addition of I NaR partially rescued firing in Scn4b -/- Purkinje neurons. Voltage-clamp experiments revealed that I NaR was reduced (by ∼50%), but not eliminated, in Scn4b -/- Purkinje neurons, revealing that additional mechanisms contribute to generation of I NaR ., (Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.)

We examined among college students the interactive effects of drinking to cope (DTC) motivation, anxiety and depression symptoms, and drinking level in predicting drinking-related problems (DRPs). Using an Internet-based survey, participants (N = 844, 53% women) first reported on their drinking motives and monthly for up to three months, they reported on their drinking level, anxiety, depression, and DRPs. We found a three-way interaction between DTC motivation and average levels of drinking and anxiety (but not depression) in predicting DRPs. Specifically, among individuals with stronger DTC motives, higher mean levels of anxiety were associated with a stronger positive association between mean drinking levels and DRPs. We did not find three-way interactions in the models examining monthly changes in anxiety, depression, and drinking in predicting monthly DRPs. However, individuals high in DTC motivation showed a stronger positive association between changes in drinking level and DRPs. The results are discussed in terms of mechanisms related to attention-allocation and self-control resource depletion.

Aims: Intermittent presentations of the ethanol sipper have been reported to induce more ethanol drinking in rats than when the ethanol sipper was continuously available during the session. This intermittent sipper effect was observed in a social drinking situation, in which subjects experienced intermittent opportunities to interact briefly with a conspecific rat. The objective of this study was to evaluate the effects of the intermittent sipper procedure in situations providing for intermittent presentations of food, and, in addition, in situations that do not provide for intermittent presentations of another rewarding event., Methods: Four groups of male Long-Evans hooded rats, arranged in a 2 x 2 factorial design with two levels of Sipper Procedure (Intermittent vs Continuous) and two levels of Food procedure (Food vs No Food), were trained in drinking chambers. During each daily session, Intermittent Sipper groups received access to the ethanol sipper during each of 25 trials of 10 s each, while Continuous Sipper groups had access to the ethanol sipper during the entire session (approximately 30 min). During each session, Food groups received 25 presentations of food pellets while No Food groups received no food pellets. Ethanol concentrations in the sipper [3, 4, 6, 8, and 10% (vol./vol.)] increased across sessions., Results: More rapid escalation of ethanol intake was observed in the Intermittent Sipper groups than in the Continuous Sipper groups, and this effect was observed in both the Food and No Food conditions (P's < 0.05), which did not differ from one another., Conclusions: Intermittent Sipper procedures provide less access to the ethanol sipper, yet induced more ethanol drinking than Continuous Sipper procedures. The intermittent sipper effect is not dependent on presentations of food. Implications for schedule-induced polydipsia and Pavlovian autoshaping are discussed.

We evaluated the effects of social interaction opportunity (SIO) and intermittent presentations of the ethanol sipper tube (IS) on autoshaping of ethanol drinking in nondeprived rats. Rats were assigned to one of seven groups. Two groups experienced brief IS, either paired with or randomly related to the response-independent raising of a guillotine door (D) revealing the presence of a conspecific male rat in a holding cage (SIO). Two control groups received similar training, respectively, except that the D revealed an empty cage, whereas a third control group received IS but neither D nor SIO. For two additional control groups, the ethanol sipper tube was continuously available during the session, with and without SIO, with both groups receiving intermittent D. In IS conditions, procedures with SIO induced more ethanol intake than did non-SIO procedures, indicating that SIO contributed to ethanol intake, but D procedures did not differ from non-D procedures, indicating that ethanol drinking was not related to the operation of the door. Groups that received training procedures providing for both SIO and IS showed more rapid initiation of ethanol intake and more rapid escalation of ethanol intake as the concentration of ethanol in the sipper tube conditioned stimulus was increased across sessions. Theoretical accounts, which are based on cue at response manipulandum/autoshaping, schedule-induced polydipsia, incentive sensitization, and intermittency-induced arousal, are considered.