Short-term fear of movement improves less after anterior cruciate ligament reconstruction with concomitant meniscus repair.

BACKGROUND: Psychological response is important in return-to-sport decisions for athletes recovering from anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare psychological response after ACLR with a concomitant meniscus repair compared to isolated ACLR. METHODS: Thirty-five individuals completed the Tampa Scale of Kinesiophobia (TSK) and Anterior Cruciate Ligament Return-to-Sport after Injury (ACL-RSI) scale before ACLR and 2, 4, and 6 months after ACLR. Participants were dichotomized based on presence of concomitant meniscus repair (Yes/No). Separate group X time repeated measures analyses of variance were conducted for both scales. RESULTS: Participants were 65.7% female, 19.1 ± 4.7 years old with BMI of 24.9 ± 4.4 kg/m2. Sixteen individuals had an isolated ACLR with 19 individuals having an ACLR with concomitant meniscus repair. For the TSK, there was a group × time interaction effect(p = 0.028), with improvement in TSK scores for the isolated ACLR group (ACLR:2 months = 24.8 ± 3.7; 4 months = 22.0 ± 5.7; 6 months: 19.9 ± 5.9; Meniscus Repair:2 months = 25.5 ± 4.7; 4 months = 24.1 ± 5.0; 6 months: 23.8 ± 4.7). Six months after ACLR, TSK scores were worse in the meniscus repair group(p = 0.036). For the ACL-RSI, there was no interaction(p = 0.07). CONCLUSION: Concomitant meniscus repair with ACLR results in less post-operative improvement in kinesiophobia through 6 months after ACLR compared to isolated ACLR.

Validation of two case definitions to identify pressure ulcers using hospital administrative data.

OBJECTIVE: Pressure ulcer development is a quality of care indicator, as pressure ulcers are potentially preventable. Yet pressure ulcer is a leading cause of morbidity, discomfort and additional healthcare costs for inpatients. Methods are lacking for accurate surveillance of pressure ulcer in hospitals to track occurrences and evaluate care improvement strategies. The main study aim was to validate hospital discharge abstract database (DAD) in recording pressure ulcers against nursing consult reports, and to calculate prevalence of pressure ulcers in Alberta, Canada in DAD. We hypothesised that a more inclusive case definition for pressure ulcers would enhance validity of cases identified in administrative data for research and quality improvement purposes. SETTING: A cohort of patients with pressure ulcers were identified from enterostomal (ET) nursing consult documents at a large university hospital in 2011. PARTICIPANTS: There were 1217 patients with pressure ulcers in ET nursing documentation that were linked to a corresponding record in DAD to validate DAD for correct and accurate identification of pressure ulcer occurrence, using two case definitions for pressure ulcer. RESULTS: Using pressure ulcer definition 1 (7 codes), prevalence was 1.4%, and using definition 2 (29 codes), prevalence was 4.2% after adjusting for misclassifications. The results were lower than expected. Definition 1 sensitivity was 27.7% and specificity was 98.8%, while definition 2 sensitivity was 32.8% and specificity was 95.9%. Pressure ulcer in both DAD and ET consultation increased with age, number of comorbidities and length of stay. CONCLUSION: DAD underestimate pressure ulcer prevalence. Since various codes are used to record pressure ulcers in DAD, the case definition with more codes captures more pressure ulcer cases, and may be useful for monitoring facility trends. However, low sensitivity suggests that this data source may not be accurate for determining overall prevalence, and should be cautiously compared with other prevalence studies.

Uranyl-peroxide interactions favor nanocluster self-assembly.

Uranyl peroxide polyhedra are known to self-assemble into complex closed clusters with fullerene and other topologies containing as many as 60 polyhedra. Here clusters containing 20 uranyl pentagonal triperoxides have been isolated and characterized that assume the smallest possible fullerene topology consisting only of 12 pentagons. Oxalate has been used to crystallize fragments of larger uranyl peroxide clusters, and these fragments and other known structures indicate that the U-O(2)-U dihedral angle is inherently bent. Such bending is thought to be essential in directing the self-assembly of uranyl peroxide polyhedra into closed clusters.

Crown and bowl-shaped clusters of uranyl polyhedra.

Bowl (U(16)) and crown-shaped clusters (U(20R) and U(24R)) containing 16, 20, and 24 uranyl peroxide polyhedra self-assemble in alkaline aqueous solution under ambient conditions. Structural analyses of crystallized clusters provided details of their topologies. Each contains uranyl hexagonal bipyramids in which two cis edges are peroxide, with a third edge defined by two OH groups, as well as hexagonal bipyramids in which three edges are peroxide. These are the first open uranyl peroxide clusters reported, and they join a growing family of complex cluster topologies based on uranium that hold promise for nanoscale control of chemistry in nuclear energy cycles.

Symmetry versus minimal pentagonal adjacencies in uranium-based polyoxometalate fullerene topologies.

C U soon: Clusters containing 60, 44, and 36 uranyl peroxide hydroxide polyhedra (see picture) adopt fullerene topologies of maximum symmetry. The largest of these, denoted U60, is topologically identical to C(60) with no pentagonal adjacencies and the highest possible symmetry. U44 adopts the topology with maximum symmetry rather than that with the lowest number of pentagonal adjacencies.