Early weight-bearing following distal femur fracture fixation - a systematic review and meta-analysis.

Introduction: The global standard of care for hip fracture surgery is early weight-bearing, but this has not extended to other lower extremity fractures in the elderly. Patients undergoing fixation of distal femur fractures are often prescribed weight-bearing restrictions, which may lead to deconditioning and other complications. The purpose of this study was to compare the outcomes and complication rates between patients permitted early versus restricted weight-bearing following distal femur fracture fixation.

PRACTICE makes progress, a self-care course for mental health professionals in the child trauma field: A preliminary investigation.

Objective: Mental health professionals who work with clients exposed to trauma commonly experience secondary traumatic stress (STS) and burnout, which have a well-documented negative impact on clinicians as well as clients. As self-care has been identified as a protective factor against STS and burnout, the current study aimed to examine the effects of a self-care course for mental health professionals working with trauma-exposed clients.

Method: This pretest-posttest pilot study examined the impact of a six-session virtual self-care course on the well-being of 43 mental health professionals previously trained in Trauma-focused Cognitive Behavioral Therapy(TF-CBT), a well-established, evidence-based treatment for childhood trauma.

Unrecognised entrapment of a herniated bladder at the pubic symphysis following reduction and external fixation of an unstable pelvic fracture.

Bladder injury is frequently associated with complex pelvic fractures with men being the predominant population to sustain such injuries. Entrapment of the bladder through the site of pelvic fracture is a rare clinical entity. We report a case of an entrapped bladder post closed reduction and external fixation of an unstable anteroposterior compression type 3 (APC-3) fracture.

Bisphenol-A and phthalate metabolism in children with neurodevelopmental disorders.

Background: The etiology of autism spectrum (ASD) and Attention Deficit/Hyperactivity (ADHD) disorders are multifactorial. Epidemiological studies have shown associations with environmental pollutants, such as plasticizers. This study focused on two of these compounds, the Bisphenol-A (BPA) and Diethylhexyl Phthalate (DEHP).

Prospects for useful fission from singlet states higher than S in aggregated organic chromophores.

The few known reports and the likely prospects of finding new efficient routes to exciton fission from higher excited singlet states, S ( > 1), are reviewed. Aggregates of molecules that have large S-S electronic energy spacings and/or emit measurable "contra-Kasha" emission may offer further opportunities. Among these, electronically excited molecular systems that exhibit known efficient (T + T) triplet-triplet annihilation producing S could exhibit efficient singlet fission in aggregates when appropriately substituted to meet the necessary energy requirements.

TF-CBT Training Augmented with a Self-Care Focus: Understanding Facilitators and Barriers to Treatment Implementation.

Clinicians working with youth exposed to trauma may be at increased risk for experiencing elevated levels of stress and symptoms of secondary traumatic stress, which can negatively impact clinician wellbeing and ultimately contribute to reduced access to quality care for clients. An innovative Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training incorporating self-care practices (i.e.

Maintaining Joint Line Obliquity Optimizes Outcomes of Functional Alignment in Total Knee Arthroplasty in Patients With Constitutionally Varus Knees.

Background: Functional alignment (FA) strives to balance the knee soft-tissue envelope during total knee arthroplasty (TKA) using implant alignment adjustments rather than soft-tissue releases. There is a debate on how best to achieve FA. We compared minimum two-year outcomes between FA with a mechanical alignment plan [FA(m)] and FA with a kinematic alignment plan [FA(k)].

Functional alignment achieves a more balanced total knee arthroplasty than either mechanical alignment or kinematic alignment prior to soft tissue releases.

Purpose: Total knee arthroplasty with functional alignment uses pre-resection balancing to determine component position within the soft tissue envelope to achieve balance and restoration of native joint obliquity. The purpose of this study was to assess the balance achievable with a mechanical axis alignment and kinematic axis alignment plan, and the subsequent balance achievable after adjustment of the component position to functional alignment.

Methods: A prospective cohort of 300 knees undergoing cruciate retaining total knee arthroplasty were included in this study.

Decreased Adiponectin Levels in Early Pregnancy Are Associated with High Risk of Prematurity for African American Women.

The relationship of low maternal serum adiponectin levels with preterm delivery among a multi-ethnic group has not been extensively investigated. We examined ethnic differences in cytokine/adipokine profiles and whether they contribute to several adverse pregnancy outcomes, particularly preterm delivery. Data and samples were from a large prospective observational cohort (n = 1776) of young, generally healthy pregnant women (African American 36.

Caregiver Satisfaction and Perceptions of Trauma-Focused Cognitive Behavioral Therapy.

Although caregivers have been found to be critical to children's healing, little has been documented about caregivers' experiences in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). The current study describes caregivers' satisfaction with and perceptions of TF-CBT. Caregivers ( = 431) of children/adolescents ( = 496) who completed TF-CBT filled out pre-treatment questionnaires on demographics and perceived aloneness in facing their child's trauma, and posttreatment questionnaires on treatment satisfaction and perceptions of TF-CBT.

Short-Term Benefits of Robotic Assisted Total Knee Arthroplasty Over Computer Navigated Total Knee Arthroplasty Are Not Sustained With No Difference in Postoperative Patient-Reported Outcome Measures.

Background: The purpose of this study was to compare early clinical and patient-reported outcomes between robotic assisted (RA) and computer navigation (CN) total knee arthroplasty (TKA).

Methods: One hundred and fifty patients were enrolled in this prospective, single-surgeon, cohort study, with 75 patients each receiving CN-TKA or RA-TKA in a consecutive series. There were no differences in patient age ( = .

Latent TGFβ complexes are transglutaminase cross-linked to fibrillin to facilitate TGFβ activation.

TGFβ superfamily members are potent growth factors in the extracellular matrix with essential roles in all aspects of cellular behaviour. Latent TGFβ binding proteins (LTBPs) are co-expressed with TGFβ, essential for correct folding and secretion of the growth factor, to form large latent complexes. These large latent complexes bind extracellular proteins such as fibrillin for sequestration of TGFβ in the matrix, essential for normal tissue function, and dysregulated TGFβ signalling is a hallmark of many fibrillinopathies.

A prospective randomised control trial comparing functional with mechanical axis alignment in total knee arthroplasty: study protocol for an investigator initiated trial.

Background: A drive to improve functional outcomes for patients undergoing total knee arthroplasty (TKA) has led to alternative alignment being used. Functional alignment (FA) uses intraoperative soft tissue tension to determine the optimal position of the prosthesis within the patient's soft tissue envelope. Angular limits for bone resections are followed to prevent long-term prosthesis failure.

Spectroscopic and Dynamic Properties of Electronically Excited Pendant Porphyrin Polymers with Backbones of Differing Flexibility.

A zinc porphyrin-pendant norbornene polymer with a rigid backbone characterized by a 2:1 / isomeric structure ratio has been synthesized, and its spectroscopic and photophysical properties are examined. Zinc tetraphenylporphyrin, the porphyrin-substituted norbornene monomer, and a previously reported zinc porphyrin-pendant polymer with a flexible polymethylene backbone have been used as comparators. Unlike its flexible counterpart, the rigid norbornene polymer exhibits clear exciton splitting of its Soret band, much more rapid relaxation rates of its excited singlet states, and a very small yield of an unusually short-lived triplet state.

Disseminating Trauma-Focused Cognitive Behavioral Therapy with a Systematic Self-care Approach to Addressing Secondary Traumatic Stress: PRACTICE What You Preach.

This pilot study evaluated the effectiveness of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training programs augmented with a systematic "PRACTICE What You Preach" (PWYP) self-care focus, which has trainees personally utilize the coping skills they teach their clients. Participants were 115 clinicians/supervisors who completed a PWYP TF-CBT training program. Pre- to post-training analyses documented significant increases in participants' competency and fidelity in implementing TF-CBT (ps < .

The use of anterior subcutaneous internal fixation (INFIX) for treatment of pelvic ring injuries in major trauma patients, complications and outcomes.

Purpose: Pelvic anterior internal fixators (INFIX) are a relatively new alternative in the treatment of unstable pelvic fractures. The authors wanted to review the use of complications and outcomes of this method of pelvic fixation at our institution.

Method: Patients over the age of 18 who had an INFIX used in treatment of their pelvic ring injury were identified.

Individual free fatty acids have unique associations with inflammatory biomarkers, insulin resistance and insulin secretion in healthy and gestational diabetic pregnant women.

Objective: We investigated the relationships of maternal circulating individual free fatty acids (FFA) with insulin resistance, insulin secretion and inflammatory biomarkers during mid-pregnancy.

Research Design And Methods: The data were drawn from a prospective cohort of generally healthy pregnant women (n=1368, African-American 36%, Hispanic 48%, Caucasian 16%) in Camden, NJ. We quantitatively determined 11 FFAs, seven cytokine/adipokine, homeostatic model assessment of insulin resistance (HOMA-IR) and C-peptide levels from the fasting blood samples that were collected at 16 weeks of gestation.

Exciton Dynamics of Photoexcited Pendant Porphyrin Polymers in Solution and in Thin Films.

Several new polymers with rotatable zinc porphyrin pendants have been synthesized and their optical spectroscopic and photophysical properties, including upconversion efficiencies, determined in both fluid solution and thin films. Comparisons made with the β-substituted zinc tetraphenylporphyrin monomers and ZnTPP itself reveal that the yield of triplets resulting from either Q-band or Soret-band excitation of the polymers is surprisingly small. A detailed kinetic analysis of the fluorescence decays and transient triplet absorptions of the substituted monomers and their corresponding polymers reveals that this phenomenon is due to two parallel internal singlet quenching processes assigned to transient intrachain excimer formation.

A Gut Feeling: A Hypothesis of the Role of the Microbiome in Attention-Deficit/Hyperactivity Disorders.

Attention-deficit/hyperactivity disorder (ADHD) is a neurologic disorder characterized by hyperactivity/impulsivity and/or inattentiveness, with genetic and environmental factors contributing to the disorder. With the growing recognition of the microbiome's role in many neurological disorders, the authors propose that it may also be implicated in ADHD. Here, we describe several evolving areas of research to support this hypothesis.

Comment on "Metal-organic green dye: chemical and physical insight into a modified Zn-benzoporphyrin for dye-sensitized solar cells" by G. Zanotti, N. Angelini, G. Mattioli, A. M. Paoletti, G. Pennesi, G. Rossi, D. Caschera, L. de Marcoc and G. Giglide, , 2016, , 5123.

The emission spectroscopy and photophysics reported in the title paper are shown to be untenable in light of previously reported experimental results and widely accepted theories of electronic excited state relaxation. The published results strongly suggest that the newly synthesized dye is contaminated with one of more highly fluorescent impurities.

Overall severities of gastrointestinal symptoms in pediatric outpatients with and without autism spectrum disorder.

In order to determine the effectiveness of a Gastrointestinal Severity Index to screen for gastrointestinal disorders, the Gastrointestinal Severity Index was administered to 135 children with autism spectrum disorders and 146 comparisons with and without gastrointestinal disorders. The mean Gastrointestinal Severity Index scores of the groups were 3.53 ± 1.

Prospects for efficient solar energy upconversion using metalloporphyrins as dual absorber-upconverters.

The novel potential use of selected metalloporphyrins as dual absorber-upconverters in solar photovoltaics is discussed. Additional efficiencies are available if use can be made of the porphyrin's short-lived S2 state, which is formed directly by excitation in the strong Soret transition in the blue-violet and also by absorption in the Q bands followed by rapid intersystem crossing and upconversion by triplet-triplet annihilation. The main challenge in realizing a working photovoltaic based on such a protocol is that energy must be extracted from the S2 state of the porphyrin within its picosecond lifetime.

Photophysics of Zinc Porphyrin Aggregates in Dilute Water-Ethanol Solutions.

Dimeric and multimeric aggregates of a model metalloporphyrin, zinc tetraphenylporphyrin (ZnTPP), have been produced in a controlled manner by incrementally increasing the water content of dilute aqueous ethanol solutions. Steady state absorption, fluorescence emission, and fluorescence excitation spectra have been measured to identify the aggregates present as a function of solvent composition. The dynamics of the excited states of the aggregates produced initially by excitation in the Soret region have been measured by ultrafast fluorescence upconversion techniques.

Determinants of the efficiency of photon upconversion by triplet-triplet annihilation in the solid state: zinc porphyrin derivatives in PVA.

Spectroscopic, photophysical and computational studies designed to expose and explain the differences in the efficiencies of non-coherent photon upconversion (NCPU) by triplet-triplet annihilation (TTA) have been carried out for a new series of alkyl-substituted diphenyl and tetraphenyl zinc porphyrins, both in fluid solution and in solid films. Systematic variations in the alkyl-substitution of the phenyl groups in both the di- and tetraphenyl porphyrins introduces small, but well-understood changes in their spectroscopic and photophysical properties and in their TTA efficiencies. In degassed toluene solution TTA occurs for all derivatives and produces the fluorescent S product states in all cases.

Improvements in personal resiliency among youth who have completed trauma-focused cognitive behavioral therapy: A preliminary examination.

This preliminary investigation assessed whether different aspects of personal resiliency improved for youth (7-17 years old) impacted by child sexual abuse (CSA) after completing trauma-focused cognitive behavioral therapy (TF-CBT). The Resiliency Scales for Children and Adolescents (RSCA; Prince-Embury, 2007) were administered to 157 youth before and after participating in TF-CBT with their nonoffending caregivers. Hierarchal regression analyses were performed to ascertain whether pretest RSCA resiliency scores moderated decreases in the posttraumatic stress and self-reported depressive symptoms at posttreatment.