Development and Implementation of a Pediatric Nursing Emergency Behavioral Health Assessment Tool.

INTRODUCTION: The national pediatric mental and behavioral health crisis dramatically increased emergency department mental and behavioral health visits and changed emergency nursing practice. Acuity assessment determines patient severity level and supports appropriate resources and interventions. There are no established nursing tools that assess pediatric mental or behavioral health acuity in the emergency department setting. Our goal was to develop and implement the novel pediatric emergency nurse Emergency Behavioral Health Acuity Assessment Tool. METHODS: This quality-improvement project used the plan, do, study, act model to design/refine the Emergency Behavioral Health Acuity Assessment Tool and a non-experimental descriptive design to assess outcomes. The setting was a 47-bed urban level 1 pediatric trauma center with more than 60,000 annual visits. The team designed the tool using published evidence, emergency nurse feedback, and expert opinion. The tool objectively captured patient acuity and suggested acuity-specific nursing interventions. Project outcomes included acuity, length-of-stay, restraint use, and patient/staff injuries. Analyses included descriptive statistics and correlations. RESULTS: With over 3000 annual mental/behavioral-related visits, the emergency department had an average daily census of 23 mental and behavioral health patients. Implementation occurred in August 2021. The Emergency Behavioral Health Acuity Assessment Tool dashboard provided the number of patients, patient location, and acuity. Length-of-stay did not change; however, patient restraint use and patient/staff injuries declined. Number of restraints positively correlated with moderate acuity levels (r = 0.472, P = 0.036). DISCUSSION: For emergency nurses, the Emergency Behavioral Health Acuity Assessment Tool provided an objective measure of patient acuity. Targeted interventions can improve the care of this population.

Decreased Prevalence of New-Onset Adhesive Capsulitis in Patients Prescribed Angiotensin Receptor Blockers.

BACKGROUND: Angiotensin receptor blockers (ARBs) are commonly prescribed antihypertensive agents that have well-known antifibrotic properties. The purpose of this study was to examine the association between ARB use and the rates of new-onset adhesive capsulitis as well as adhesive capsulitis requiring operative treatment. METHODS: Using a large national insurance database, a randomly generated cohort of patients with at least 3 continuous months of ARB use between January 2010 and December of 2019 (n=1,000,000) was compared to a separate randomly generated cohort without ARB use (n=3,000,000) . Rates of newly diagnosed adhesive capsulitis and associated manipulation under anesthesia and/or arthroscopic capsulotomy were calculated over a one- and two-year period following the completion of at least 3 continuous months of ARB therapy. Rates were compared using multivariable logistic regression to control for demographics and comorbidities. Both unadjusted and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated and reported for each comparison. Statistical significance was set at P<0.05. RESULTS: The mean age in the ARBs cohort was 61.8 years (SD = 10.0), while in the control cohort, it was 54.8 years (SD = 12.3) (p < 0.001). The ARBs cohort had significantly lower rates of newly diagnosed adhesive capsulitis compared to the control cohort at both one year (0.15% vs. 0.55%, p < 0.001) and two years (0.3% vs. 0.78%, p < 0.001). Similar findings were observed for the arthroscopic capsular release/MUA cohort associated with adhesive capsulitis. After adjusting for confounding factors, the lower rates of adhesive capsulitis and arthroscopic capsular release/MUA associated with adhesive capsulitis in the ARBs cohort remained statistically significant (p < 0.001). CONCLUSION: Patients prescribed ARBs experienced a decrease rate of newly diagnosed adhesive capsulitis, as well as adhesive capsulitis requiring surgical intervention when compared to a control cohort. These findings suggest a potential protective effect of ARBs against the development of adhesive capsulitis. Further investigations are warranted to elucidate the underlying mechanisms and establish a causal relationship.

Surprise! Draw the scene: Visual recall reveals poor incidental working memory following visual search in natural scenes.

Searching within natural scenes can induce incidental encoding of information about the scene and the target, particularly when the scene is complex or repeated. However, recent evidence from attribute amnesia (AA) suggests that in some situations, searchers can find a target without building a robust incidental memory of it's task relevant features. Through drawing-based visual recall and an AA search task, we investigated whether search in natural scenes necessitates memory encoding. Participants repeatedly searched for and located an easily detected item in novel scenes for numerous trials before being unexpectedly prompted to draw either the entire scene (Experiment 1) or their search target (Experiment 2) directly after viewing the search image. Naïve raters assessed the similarity of the drawings to the original information. We found that surprise-trial drawings of the scene and search target were both poorly recognizable, but the same drawers produced highly recognizable drawings on the next trial when they had an expectation to draw the image. Experiment 3 further showed that the poor surprise trial memory could not merely be attributed to interference from the surprising event. Our findings suggest that even for searches done in natural scenes, it is possible to locate a target without creating a robust memory of either it or the scene it was in, even if attended to just a few seconds prior. This disconnection between attention and memory might reflect a fundamental property of cognitive computations designed to optimize task performance and minimize resource use.

Attention with or without working memory: mnemonic reselection of attended information.

Attention has been regarded as the 'gatekeeper' controlling what information gets selected into working memory. However, a new perspective has emerged with the discovery of attribute amnesia, a phenomenon revealing that people are frequently unable to report information they have just attended to moments ago. This report failure is thought to stem from a lack of consolidating the attended information into working memory, indicating a dissociation between attention and working memory. Building on these findings, a new concept called memory reselection is proposed to describe a secondary round of selection among the attended information. These discoveries challenge the conventional view of how attention and working memory are related and shed new light onto modeling attention and memory as dissociable processes.

Triplet-Triplet Energy Transfer in Bis-Cyclometalated Iridium Complexes with Pyrene-Substituted Isocyanides.

Nonlinear optical (NLO) materials are able to modulate responses of electromagnetic radiation, leading to phenomena critical to modern telecommunications technologies. The last two decades have seen significant advances in the area of molecular nonlinear chromophores, particularly with respect to reverse-saturable absorption (RSA). Here, we introduce a strategy for intense excited-state absorption (ESA) that involves bis-cyclometalated iridium complexes with isocyanide ancillary ligands decorated with pyrene triplet acceptors. Upon excitation, the complexes undergo rapid triplet-triplet energy transfer (TTET) to the acceptor excited states. This report describes five bis-cyclometalated iridium complexes using two different pyrene-substituted isocyanides with the general formula [Ir(C^N)2(CNAr)2]PF6 (C^N = cyclometalating ligand, CNAr = isocyanide ancillary ligand: CNArpyr = 2,6-dimethyl-4-(1-pyrenyl)phenyl isocyanide, CNpyr = 1-pyrenyl isocyanide). The synthesized complexes were thoroughly characterized via 1H and 13C{1H} NMR spectroscopy, Fourier-transform Infrared spectroscopy, and electrospray ionization mass spectrometry. The excited states were evaluated with UV-vis absorption, steady-state and time-resolved photoluminescence, and transient absorption spectroscopy. Phosphorescence is completely quenched at room temperature, but in the solvent glass matrix at 77 K, there is luminescence originating from a π → π* triplet state on the pyrene moiety, abbreviated herein as 3pyrene. All five complexes display intense and long-lived ESA originating from the 3pyrene state. The localization of the ground-state absorption on the cyclometalating ligands and the excited-state absorption on the pyrene moiety allows for independent tuning of ground-state absorption (GSA) and ESA to optimize RSA and other NLO attributes.

Fixation Strategy Does Not Affect Risk of Growth Disturbance After Surgical Treatment of Pediatric Tibial Spine Fracture.

Purpose: To characterize growth abnormalities after surgical treatment of tibial spine fractures and to investigate risk factors for these abnormalities. Methods: A retrospective analysis of children who underwent treatment of tibial spine fractures between January 2000 and January 2019 was performed, drawing from a multicenter cohort among 10 tertiary care children's hospitals. The entire cohort of surgically treated tibial spine fractures was analyzed for incidence and risk factors of growth disturbance. The cohort was stratified into those who were younger than the age of 13 years at the time of treatment in order to evaluate the risk of growth disturbance in those with substantial growth remaining. Patients with growth disturbance in this cohort were further analyzed based on age, sex, surgical repair technique, implant type, and preoperative radiographic measurements with χ2, t-tests, and multivariate logistic regression. Results: Nine patients of 645 (1.4%) were found to have growth disturbance, all of whom were younger than 13 years old. Patients who developed growth disturbance were younger than those without (9.7 years vs 11.9 years, P = .019.) There was no association with demographic factors, fracture characteristics, surgical technique, hardware type, or anatomic placement (i.e., transphyseal vs physeal-sparing fixation) and growth disturbance. Conclusions: In this study, we found an overall low incidence of growth disturbance after surgical treatment of tibial spine fractures. There was no association with surgical technique and risk of growth disturbance. Level of Evidence: Level III, retrospective comparative study.

Cadaveric Analysis of Key Anatomic Structures of Athletic Pubalgia.

PURPOSE: This study proposes to establish in-depth inspection of the anatomic structures involved with the pathology of athletic pubalgia in a cadaver model. METHODS: Eight male fresh frozen cadavers were dissected in a layered fashion. The rectus abdominis (RA) and adductor longus (AL) tendon insertions were isolated to quantify the size of the anatomic footprint and distance from the surrounding anatomy. RESULTS: The RA insertional footprint was 1.65 cm (SD, 0.18) in width by 1.02 cm (SD, 0.26) in length, and the AL insertional footprint on the underside of the pubis was 1.95 cm (SD, 0.28) in length by 1.23 cm (SD, 0.33) in width. The ilioinguinal nerve was 2.49 cm (SD, 0.36) lateral to the center of the RA footprint and 2.01 cm (SD, 0.37) lateral to the center of the AL footprint. The spermatic cord and the genitofemoral nerve were just lateral to the ilioinguinal nerve and were 2.76 cm (SD, 0.44) and 2.66 cm (SD, 0.46) from the rectus and AL footprints, respectively. CONCLUSION: Surgeons should be cognizant of these anatomic relations during both initial dissection and tendon repair to optimize repair and avoid iatrogenic injury to critical structures in the anterior pelvis.

Slipping through the cracks: The peril of unexpected interruption on the contents of working memory.

Working memory allows us to hold specific pieces of information in an active and easily retrieved state, but what happens to that information during an unexpected interruption between study and test? To answer this question, we used a surprise trial paradigm in which an unexpected event precedes a probe of the observer's memory for a search target. In the first set of experiments, participants were tasked to report the identity of the target letter before unexpectedly being asked to read a task-irrelevant passage. We observed that the introduction of this passage interfered with the observer's memory of the target letter, but this interference only occurred after participants had experience completing the task without interruption. However, a remember cue placed just prior to the reading prompt reduced this cost, suggesting that participants can rapidly reinforce information about the target in working memory to resist the interference. We then used this same cuing manipulation to test whether information in an attribute amnesia paradigm, which unexpectedly probes an attribute relevant to target selection but irrelevant to participant's response expectations, could also be protected against unexpected interference. Using this paradigm, we observed that a remember cue did not improve performance following the surprising event, which supports theories that attribute amnesia is not caused solely by interference. These results reveal both the vulnerability and flexibility of working memory and demonstrate the importance of understanding how task experience establishes expectations that impact the underlying cognitive representations formed by the observer. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patient presentations to an after-hours general practice, an urgent care clinic and an emergency department on Sundays: a comparative, observational study.

PURPOSE: The purpose of this paper is to determine which factors are associated with 6,065 patient presentations with non-life-threatening urgent conditions (NLTUCs) to an after-hours general practice, an urgent care clinic (UCC) and an emergency department (ED) on Sundays in Southeast Queensland (Qld). DESIGN/METHODOLOGY/APPROACH: A retrospective, comparative and observational study was conducted involving the auditing of medical records of patients with NLTUCs consulting three medical services between 0,800 and 1,700 h, on Sundays, over a one-year period. The study was limited to 6,065 patients. FINDINGS: There were statistically significant differences in choice of location according to age, number of postcodes from the patient's residence, time of the day, season, patient presentations for infection and injury, non-infectious, non-injurious conditions of the circulatory, gastrointestinal and genitourinary systems, and need for imaging, pathology, plastering/back-slab application, splinting and wound closure. Older adults were more likely to be admitted to the hospital and Ed Short Stay Unit, compared with other age groups. RESEARCH LIMITATIONS/IMPLICATIONS: Based on international models of UCC healthcare systems in United Kingdom (UK), USA and New Zealand (NZ) and the results of this study, it is recommended that UCCs in Australia have extended hours, walk-in availability, access to on-site radiology, ability to treat fractures and wounds and staffing by medical practitioners able to manage these conditions. Recommendations also include setting a national standard for UCC operation (National Urgent Care Centre Accreditation, 2018; NHS, 2020; RNZCUC, 2015) and requirements for vocational registration for medical practitioners (National Urgent Care Centre Accreditation, 2018; RNZCUC, 2015; The Royal College of Surgeons of Edinburgh, 2021a, b). PRACTICAL IMPLICATIONS: This study has highlighted three key areas for future research: first, research involving general practitioners (GPs), emergency physicians, urgent care physicians, nurse practitioners, urgent care pharmacists and paramedics could help to predict the type of patients more accurately, patient presentations and associated comorbidities that might be encouraged to attend or be diverted to Urgent Care Clinics. Second, larger studies of more facilities and more patients could improve the accuracy and generalisability of the findings. Lastly, studies of public health messaging need to be undertaken to determine how best to encourage patients with NLTUCs (especially infections and injuries) to present to UCCs. SOCIAL IMPLICATIONS: The Urgent Care Clinic model has existed in developed countries since 1973. The adoption of this model in Australia close to a patient's home, open extended hours and with onsite radiology could provide a community option, to ED, for NLTUCs (especially patient presentations with infections and injuries). ORIGINALITY/VALUE: This study reviewed three types of medical facilities for the management of NLTUCs. They were an after-hours general practice, an urgent care clinic and an emergency department. This study found that the patient choice of destination depends on the ability of the service to manage their NLTUCs, patient age, type of condition, postcodes lived away from the facility, availability of testing and provision of consumables. This study also provides recommendations for the development of an urgent care healthcare system in Australia based on international models and includes requirements for extended hours, walk-in availability, radiology on-site, national standard and national requirements for vocational registration for medical professionals.

Children and young people's experiences of living with rare diseases: An integrative review.

PROBLEM: Rare diseases are any disease affecting fewer than five people in 10,000. More than 8000 rare diseases and 50-75% of all rare diseases affect children. The purpose of this review was to critically appraise and synthesize existing literature relating to the impact of rare diseases on children's day-to-day lives. ELIGIBILITY CRITERIA: An integrative literature review was conducted using the CINAHL Plus, PsycINFO, and PubMed databases. Studies were included if they were a primary source was published between the years 2005 and 2019 and written in the English language. SAMPLE: Eight primary sources met the inclusion criteria. RESULTS: Seven main themes emerged from the review as follows: (i) the experience of stigmatisations, (ii) self-consciousness, (iii) restrictions in independent living, (iv) developing resilience/coping strategies, (v) psychological and emotional impact, (vi) social impact vs social connectedness and (vii) transition challenges. CONCLUSIONS: The experience of having a rare illness differed across different age groups. Children (typically aged 3-10) with rare diseases generally view themselves and their lives the same way like their healthy peers. They were more likely to report being adaptive and resilient than those aged 12 or older. Young people reported being different compared to young children, and they faced numerous challenges related to their illness. IMPLICATIONS FOR PRACTICE: To provide the best possible level of care for children and families with rare disorders, health services must be informed and equipped to provide the necessary supports specific to the unique needs of children and young people living with rare diseases.

The influence of category representativeness on the low prevalence effect in visual search.

Visual search is greatly affected by the appearance rate of given target types, such that low-prevalence items are harder to detect, which has consequences for real-world search tasks where target frequency cannot be balanced. However, targets that are highly representative of a categorically defined task set are also easier to find. We hypothesized that targets that are highly representative are less vulnerable to low-prevalence effects because an observer's attentional set prioritizes guidance toward them even when they are rare. We assessed this hypothesis by first determining the categorical structure of "prohibited carry-ons" via an exemplar-naming task, and used this structure to assess how category representativeness interacted with prevalence. Specifically, from the exemplar-naming task we selected a commonly named (knives) and rarely named (gas cans) target for a search task in which one of the targets was shown infrequently. As predicted, highly representative targets were found more easily than their less representative counterparts, but they also were less affected by prevalence manipulations. Experiment 1b replicated the results with targets matched for emotional valence (water bottles and fireworks). These findings demonstrate the powerful explanatory power of theories of attentional guidance that incorporate the dynamic influence of recent experience with the knowledge that comes from life experience to better predict behavioral outcomes associated with high-stakes search environments.

Panchromatic Excited-State Absorption in Bis-Cyclometalated Iridium Isocyanide Complexes.

In this work, we introduce a series of cyclometalated iridium complexes and evaluate the suitability of this class of compounds in nonlinear optical (NLO) applications, with an emphasis on long-lived, panchromatic reverse-saturable absorption (RSA). The investigated complexes are represented by the general formula [Ir(C^N)2(CNArdmp)2]+, (C^N = cyclometalating ligand, CNArdmp = 2,6-dimethylphenyl isocyanide). Seven such complexes were synthesized and characterized, including in-depth analysis of their photophysical properties (UV-vis absorption, photoluminescence, and transient absorption). This series of compounds contains seven different cyclometalating ligands (2-phenylbenzothiazole (bt) (Ir1), 5-nitro-2-phenylpyridine (ppyNO2) (Ir2), 5-nitro-2-(9-phenanthryl)pyridine (phenNO2) (Ir3), 2-(benzo[b]thiophen-2-yl)quinoline (btq) (Ir4), 6-(benzo[b]thiophen-2'-yl)phenanthridine (btph) (Ir5), 2,4-diphenylquinoline (dpq) (Ir6), and 6-nitro-2,4-diphenylquinoline (NO2dpq) (Ir7)), which have profound effects on their ground-state and excited-state absorption spectra. To evaluate the effects of the isocyanide ancillary ligands, some heteroleptic bis-cyclometalated iridium(III) acetylacetonate (acac) analogue complexes are included as points of comparison. In the ground state, the bis-isocyanide complexes display UV-vis absorption with the characteristic 1LC (π → π*) band at λ < 350 nm and 1MLCT bands at 350-500 nm. Five of the complexes (Ir1, Ir2, Ir4, Ir5, and Ir6) display broad, intense triplet excited-state absorption with no ground-state bleach (GSB) over the spectral window of 400-900 nm, with excited-state lifetimes spanning three orders of magnitude from ∼32 ns to 12 µs. The photophysical data suggests that the isocyanide ancillary ligand blue-shifts the GSB transient into the UV, which is normally found in the middle of the visible region for cyclometalated iridium complexes. This study demonstrates the applicability of cationic cyclometalated iridium(III) bis-isocyanide complexes as candidate RSA materials.

Manipulating Excited State Properties of Iridium Phenylpyridine Complexes with "Push-Pull" Substituents.

We have prepared a series of complexes of the type [IrIII(ppy)2(L]n+ complexes (1-4), where ppy is a substituted 2-phenylpyridine and L is a chelating phosphine thioether ligand. The parent complex (1) comprises an unsubstituted phenylpyridine ligand, whereas complex 2 contains a nitro substituent on the pyridine ring, complex 3 features a diphenylamine group on the phenyl ring, and 4 has both nitro and diphenylamine groups. Crystallographic, 1H NMR, and elemental analysis data are consistent with each of the chemical formulae. DFT (density functional theory) computational results show a complicated electronic structure with contributions from Ir, ppy, and the PS ligand. Ultrafast pump-probe data show strong contributions from the phenylpyridine moieties as well as strong panchromatic excited state absorption transitions. The data show that nitro and/or diphenylamine substituents dominate the spectroscopy of this series of compounds.

The early attentional pancake: Minimal selection in depth for rapid attentional cueing.

There have been conflicting findings on the degree to which rapidly deployed visual attention is selective for depth, and this issue has important implications for attention models. Previous findings have attempted to find depth-based cueing effects on such attention using reaction time (RT) measures for stimuli presented in stereo goggles with a display screen. Results stemming from such approaches have been mixed, depending on whether target/distractor discrimination was required. To help clarify the existence of such depth effects, we have developed a paradigm that measures accuracy rather than RT in an immersive virtual-reality environment, providing a more appropriate context of depth. Three modified Posner Cueing paradigms were run to test for depth-specific rapid attentional selectivity. Participants fixated a cross while attempting to identify a rapidly masked black letter preceded by a red cue that could be valid in depth, side, or both. In Experiment 1a, a potent cueing effect was found for lateral cueing validity, but a weak effect was found for depth despite an extreme difference in virtual depth (1 vs. 300 m). In Experiment 1b, a near-replication of 1a, the lateral effect replicated while the depth effect did not. Finally, in Experiment 2, to increase the depth cue's effectiveness, the letter matched the cue's color, and the presentation duration was increased; however, again only a minimal depth-based cueing effect - no greater than that of Experiment 1a - was observed. Thus, we conclude that rapidly deployed attention is driven largely by spatiotopic rather than depth-based information.

Vascular Injury in the Zebrafish Tail Modulates Blood Flow and Peak Wall Shear Stress to Restore Embryonic Circular Network.

Mechano-responsive signaling pathways enable blood vessels within a connected network to structurally adapt to partition of blood flow between organ systems. Wall shear stress (WSS) modulates endothelial cell proliferation and arteriovenous specification. Here, we study vascular regeneration in a zebrafish model by using tail amputation to disrupt the embryonic circulatory loop (ECL) at 3 days post fertilization (dpf). We observed a local increase in blood flow and peak WSS in the Segmental Artery (SeA) immediately adjacent to the amputation site. By manipulating blood flow and WSS via changes in blood viscosity and myocardial contractility, we show that the angiogenic Notch-ephrinb2 cascade is hemodynamically activated in the SeA to guide arteriogenesis and network reconnection. Taken together, ECL amputation induces changes in microvascular topology to partition blood flow and increase WSS-mediated Notch-ephrinb2 pathway, promoting new vascular arterial loop formation and restoring microcirculation.

A model of working memory for latent representations.

We propose a mechanistic explanation of how working memories are built and reconstructed from the latent representations of visual knowledge. The proposed model features a variational autoencoder with an architecture that corresponds broadly to the human visual system and an activation-based binding pool of neurons that links latent space activities to tokenized representations. The simulation results revealed that new pictures of familiar types of items can be encoded and retrieved efficiently from higher levels of the visual hierarchy, whereas truly novel patterns are better stored using only early layers. Moreover, a given stimulus in working memory can have multiple codes, which allows representation of visual detail in addition to categorical information. Finally, we validated our model's assumptions by testing a series of predictions against behavioural results obtained from working memory tasks. The model provides a demonstration of how visual knowledge yields compact visual representation for efficient memory encoding.

Computational simulations of the 4D micro-circulatory network in zebrafish tail amputation and regeneration.

Wall shear stress (WSS) contributes to the mechanotransduction underlying microvascular development and regeneration. Using computational fluid dynamics, we elucidated the interplay between WSS and vascular remodelling in a zebrafish model of tail amputation and regeneration. The transgenic Tg (fli1:eGFP; Gata1:ds-red) zebrafish line was used to track the three-dimensional fluorescently labelled vascular endothelium for post-image segmentation and reconstruction of the fluid domain. Particle image velocimetry was used to validate the blood flow. Following amputation to the dorsal aorta and posterior cardinal vein (PCV), vasoconstriction developed in the dorsal longitudinal anastomotic vessel (DLAV) along with increased WSS in the proximal segmental vessels (SVs) from amputation. Angiogenesis ensued at the tips of the amputated DLAV and PCV where WSS was minimal. At 2 days post amputation (dpa), vasodilation occurred in a pair of SVs proximal to amputation, followed by increased blood flow and WSS; however, in the SVs distal to amputation, WSS normalized to the baseline. At 3 dpa, the blood flow increased in the arterial SV proximal to amputation and through anastomosis with DLAV formed a loop with PCV. Thus, our in silico modelling revealed the interplay between WSS and microvascular adaptation to changes in WSS and blood flow to restore microcirculation following tail amputation.

Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures.

BACKGROUND: Several fixation methods have been reported for the operative treatment of tibial eminence fractures. Previous biomechanical studies have demonstrated that suture fixation may be a stronger construct; however, the maturity status of these specimens was not scrutinized. PURPOSE: To examine if suture fixation remains a biomechanically superior fixation method to screw fixation in both skeletally mature and immature specimens. STUDY DESIGN: Controlled laboratory study. METHODS: Sixteen total matched porcine (Yorkshire) knees (8 skeletally immature knees and 8 skeletally mature knees) were procured, and a standardized tibial eminence fracture was created. In each age-matched group of knees, 4 knees underwent randomization to fixation with 2 screws while 4 knees were randomized to fixation using a dual-suture technique. Once fixation was complete, the specimens underwent cyclic loading (200 cycles) in the anteroposterior plane of the tibia and load-to-failure testing, both with the knee positioned at 30° of flexion. Relevant measurements were recorded, and data were analyzed. RESULTS: Among mature specimens, load to failure was 1.9 times higher in the suture fixation group compared with the screw fixation group (1318.84 ± 305.55 vs 711.66 ± 279.95 N, respectively; P = .03). The load to failure was not significantly different between the groups in immature specimens (suture: 470.00 ± 161.91 N vs screw: 348.79 ± 102.46; P = .08). CONCLUSION: These findings suggest that suture fixation may represent a better construct choice for fixation of tibial eminence fractures in the skeletally mature population. However, in the skeletally immature population, fixation with screws or suture may be equivalent. Displacement after cyclic loading did not appear to differ by fixation method, nor did stiffness. CLINICAL RELEVANCE: A stronger fixation construct may be beneficial and allow for earlier range of motion to help potentially decrease postoperative stiffness. Clinical studies are warranted to see if these results may be replicated in humans.

Two-photon absorption characterization and comparison of Au(I) fluorenyl benzothiazole complexes in the visible wavelength regime.

We use the two-photon excited fluorescence method to determine the two-photon absorption (2PA) cross sections of three series of (fluorenyl benzothiazole) gold(I) complexes in the visible wavelength range from 570 to 700 nm. We compare the effect of ancillary ligand substitutions on the 2PA magnitudes and find that the ancillary ligand does not drastically affect either the magnitude or the shape of 2PA. Even so, moderate 2PA cross sections were measured that ranged from 10 to 1000 s of GM (Göppert-Mayer, =10-50cm4s/photon), making these types of complexes nonlinear optical materials for two-photon absorbing applications.