Progress monitoring and feedback delivered in routine psychiatric care: Beneficial but not reaching those thought to need it most.

The study evaluated the use and effectiveness of a progress monitoring system routinely operational in a private mental health care setting. In a nonrandomized trial in which 778 consecutively admitted patients underwent a 2-week cognitive behavioral therapy intervention, the effectiveness of therapists choosing to use progress monitoring feedback to frame therapist-patient discussions about individuals' progress was evaluated. Patients engaged in discussions involving progress monitoring feedback during the intervention achieved a more consistent recovery rate.

Tensioned Wire-Assisted Intramedullary Nail Treatment of Proximal Tibia Shaft Fractures: A Technical Trick.

Proximal tibia shaft fractures are often challenging to manage because of their intrinsic tendency toward valgus and apex anterior deformity. In recent years, intramedullary nailing (IMN) has become more frequently used to treat these injuries, allowing for biologic advantages such as load-sharing, immediate weight-bearing, and avoidance of disruption of periosteal blood supply. Several adjunctive techniques, such as semiextended positioning, blocking screws, and external fixation, have been developed to assist with fracture reduction during IMN.

Statistical learning for speech segmentation: Age-related changes and underlying mechanisms.

Statistical learning (SL) is a powerful learning mechanism that supports word segmentation and language acquisition in infants and young adults. However, little is known about how this ability changes over the life span and interacts with age-related cognitive decline. The aims of this study were to: (a) examine the effect of aging on speech segmentation by SL, and (b) explore core mechanisms underlying SL.

Lexical knowledge boosts statistically-driven speech segmentation.

The hypothesis that known words can serve as anchors for discovering new words in connected speech has computational and empirical support. However, evidence for how the bootstrapping effect of known words interacts with other mechanisms of lexical acquisition, such as statistical learning, is incomplete. In 3 experiments, we investigated the consequences of introducing a known word in an artificial language with no segmentation cues other than cross-syllable transitional probabilities.

A Prospective Randomized Trial to Assess Fixation Strategies for Severe Open Tibia Fractures: Modern Ring External Fixators Versus Internal Fixation (FIXIT Study).

The treatment of high-energy open tibia fractures is challenging in both the military and civilian environments. Treatment with modern ring external fixation may reduce complications common in these patients. However, no study has rigorously compared outcomes of modern ring external fixation with commonly used internal fixation approaches.

Treatment of hypertrophic distal tibia nonunion and early malunion with callus distraction.

Background: Hypertrophic nonunions and early malunions of pilon and distal tibia fractures result in complex, challenging to treat deformities. Callus distraction histiogenesis is an option for their management, allowing for the simultaneous correction of multiplanar deformity and limb length discrepancy.

Methods: A single-surgeon, retrospective case series was performed.

Semantic gradients in picture-word interference tasks: is the size of interference effects affected by the degree of semantic overlap?

We report two experiments attempting to identify the role of semantic relatedness in picture-word interference studies. Previously published data sets have rendered results which directly contradict each other, with one study suggesting that the stronger the relation between picture and distractor, the more semantic interference is obtained, and another study suggesting the opposite pattern. We replicated the two key experiments with only minor procedural modifications, and found semantic interference effects in both.

Lengthening of the femur over an existing intramedullary nail.

Leg length discrepancies can occur despite successful union of femur fractures after intramedullary nailing (IMN). Often, the leg length discrepancy can result in significant disability to the patient, altered gait biomechanics, pelvic obliquity, and pain. Therefore, a successful clinical result for such deformities after IMN involves addressing the leg length inequality.

The treatment of gustilo grade IIIB tibia fractures with application of antibiotic spacer, flap, and sequential distraction osteogenesis.

Gustilo grade III (GIII) B-C open tibia shaft fractures have a wide spectrum of injury to the bone and soft tissues. At the severe end of the spectrum are GIII B tibia fractures that combine segmental bone loss with soft tissue injuries which require flap reconstruction. These complex injuries can be treated combining circular tensioned wire fixation and distraction histiogenesis with flap reconstruction.

Involvement of the thromboxane A2 receptor in the regulation of steroidogenic acute regulatory gene expression in murine Leydig cells.

Recent studies suggested an involvement of thromboxane A2 in cyclooxygenase-2-dependent inhibition of steroidogenic acute regulatory (StAR) gene expression. The present study further investigated the role of thromboxane A2 receptor in StAR gene expression and steroidogenesis in testicular Leydig cells. The thromboxane A2 receptor was detected in several Leydig cell lines.

Salvage of pilon fracture nonunion and infection with circular tensioned wire fixation.

Nonunion, malunion, and infection are complications encountered when treating fractures of the distal tibia extending into the joint surface. There is rank order of severity of those complications extending from a varus collapse of the medial column of the distal tibia with a reduced joint surface to an infected nonunion with destruction of the joint surface, segmental bone loss, and damaged soft tissue envelope. Malunion and malposition of nonunion of the distal tibia have a combination of angular deformity, translation, rotational malalignment, and shortening.

Physiologic interactions between macrophages and Leydig cells.

The purpose of this minireview is to present information concerning the morphologic and functional relationship between testicular macrophages and Leydig cells. Although data concerning the negative influence of macrophage-derived products on testicular Leydig cells exist, this review is focused on the stimulatory influences thought to be involved in the physiologic interactions between these two diverse cell types.

Expression of morphogenic genes in mature ovarian and testicular tissues: potential stem-cell niche markers and patterning factors.

Morphogens are developmental regulators that modulate different tissue patterning, proliferation, differentiation, or remodeling processes in embryonic and adult tissues. Morphogens may also evoke specific regulatory programs in stem cells. Some of the morphogens involved in these processes have been characterized, while others remain unidentified.

Cyclooxygenase-2 regulation of the age-related decline in testosterone biosynthesis.

The age-related decline in testosterone biosynthesis in testicular Leydig cells has been well documented, but the mechanisms involved in the decline are not clear. Recent studies have described a cyclooxygenase-2 (COX2)-dependent tonic inhibition of Leydig cell steroidogenesis and expression of the steroidogenic acute regulatory protein (StAR). The present study was conducted to determine whether COX2 protein increases with age in rat Leydig cells and whether COX2 plays a role in the age-related decline in testosterone biosynthesis.

Paracrine modulation of androgen synthesis in rat leydig cells by nitric oxide.

The free radical nitric oxide (NO), generated through the oxidation of L-arginine to L-citrulline by NO synthases (NOSs), has been shown to inhibit steroidogenic pathways. NOS isoforms are known to be present in rat and human testes. Our study examined the sensitivity of Leydig cells to NO and determined whether NOS activity resides in Leydig cells or in another cell type such as the testicular macrophage.

Effects of bismuth citrate on the viability and function of Leydig cells and testicular macrophages.

Bismuth is present in several popular over-the-counter drugs for nausea and diarrhea and is occasionally abused by patients with chronic gastrointestinal disorders. The most common consequence of bismuth overdose is neurological dysfunction. In experimental animals, bismuth overdose results in lowered serum testosterone levels, suggesting that reproductive dysfunction may be an additional component of bismuth toxicity.

An alternative method of osteosynthesis for distal humeral shaft fractures.

Treatment of extra-articular distal humerus shaft fractures with plating techniques is often difficult, as traditional centrally located posterior plates often encroach on the olecranon fossa, limiting distal osseous fixation. The use of a modified Synthes Lateral Tibial Head Buttress Plate (Synthes, Paoli, PA) allows for a centrally placed posterior plating of the humeral shaft that angles anatomically along the lateral column to treat far distal humeral shaft fractures. Fifteen patients treated in this manner were followed to radiographic and clinical union.

Bismuth uptake in rat testicular macrophages: a follow-up observation suggesting that bismuth alters interactions between testicular macrophages and Leydig cells.

Recent studies suggest that bismuth accumulates in Leydig cells. In addition, a reduced level of serum testosterone and a statistically significant reduction of Leydig cells have been observed. It was therefore hypothesized that Bi has a direct toxic effect on rat Leydig cells.

The use of spring plates in the internal fixation of acetabular fractures.

The spring plate, a modified one third tubular plate, can be a viable and durable option for fixation of periarticular acetabular fractures. The use of the spring plate in acetabular fractures is demonstrated.

Testosterone regulates 25-hydroxycholesterol production in testicular macrophages.

Recently, we found that testicular macrophages produce 25-hydroxycholesterol (25-HC) and express 25-hydroxylase, the enzyme that converts cholesterol to 25-HC. In addition, 25-HC may be an important paracrine factor mediating the known interactions between macrophages and neighboring Leydig cells, because it is efficiently converted to testosterone by Leydig cells. The purpose of the present study was to determine if testosterone can regulate the production of 25-HC in rat testicular macrophages, representing a potential negative-feedback loop from Leydig cells.