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Developed more than 2 decades ago, the MEZURE (Assessment Technologies, 1995-2020; https://www.mezure.com/) has received increased attention as a result of the COVID-19 pandemic. It is the first individualized test of cognitive ability created to use an online (local or remote) assessment modality. The MEZURE claims to be aligned both with the extended Gf-Gc theory and the Cattell-Horn-Carroll model of abilities. Whereas the test publisher claims it used exploratory factor analysis to investigate the instrument's factor structure, only the subtest factor loadings on the Gf-Gc factors were furnished. No other structural validity information was provided, suggesting that users of the instrument should interpret the scores produced by the MEZURE with caution. Accordingly, the present study used exploratory and confirmatory factor analysis to more fully investigate the structural validity of the MEZURE. The results revealed that the MEZURE contains a combined perceptual reasoning (i.e., [Gf/Gv]/working memory [Gwm]) group factor, a verbal ability group factor, and a relatively weak general factor that is dominated by perceptual reasoning. The finding of a paltry general factor that is weakly loaded by verbal subtests is inconsistent with the broader research on traditional cognitive ability assessment and could be related to the online administration format of the test. Future research is required to better understand this finding. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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Measurement of adaptive skills is important in the diagnosis, intervention planning, and progress monitoring of children with intellectual and developmental disabilities (IDD). Thus, ensuring accurate measurement, including measurement invariance, across children with and without IDD is critical. In this study, we evaluate the measurement invariance using multigroup confirmatory factor analysis (MG-CFA) of the Vineland-3 Comprehensive Interview (CIF) across children ages 6-21 years with and without IDD (N = 1,192) using archival data. Results showed that the Vineland-3 CIF exhibits configural invariance but may show some metric non-invariance in children with and without IDD. Suggestions for using the Vineland-3 CIF in this population are provided and future research and measure development needs are discussed.

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Decision-makers in school psychology are presently engaged in the process of determining how to, if possible, move forward with conducting mandated psychoeducational evaluations of students in schools during the pandemic. Whereas prominent organizations within the profession (e.g., American Psychological Association, National Association of School Psychologists) have issued guidance and encouraged practitioners to delay testing, it is not clear whether that is a viable option in every jurisdiction. Accordingly, professionals are now considering the potential use of telehealth platforms to conduct assessments, in some form, as we move forward and deal with this crisis. The goal of this brief commentary is to raise some provisional limitations associated with the use of telehealth to conduct psychological assessments that we believe will have to be considered as use of these platforms is debated. Recommendations for professional practice are also provided.

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As the Vineland Scales are among the most relevant, well-developed, and popular measures of adaptive behavior available for use, this study evaluated the factor structure and dimensionality of the Vineland-3 Comprehensive Interview Form. Drawing data from 2,560 participants in the norming sample, exploratory and confirmatory factor analyses were completed across two independent samples from four age-groups ranging from preschool-age children to adults. Results from exploratory factor analysis revealed evidence for a unidimensional model across age-groups, but results from confirmatory factor analysis indicated that multidimensional models were better fitting than unidimensional models for each age-group. Discussion focuses on whether the Vineland-3 Comprehensive Interview Form is truly a unidimensional or multidimensional measure.

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The electrochemistry of aryl diazonium salts is usually dominated by one-electron reduction, loss of dinitrogen, and the grafting of aryl radicals onto the electrode. In contrast, p-nitro- and p-cyanobenzene diazonium salts dissolved in mixed aqueous-acetonitrile solvents showed diffusion-limited, quasi-reversible, two-electron cyclic voltammetry. Voltammetric pH-dependence and spectrophotometric kinetic studies suggest that the basicity and low polarity of the aqueous solvent mixture has revealed the biologically-significant interconversion of diazohydroxide and diazene.

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In symptomatic patients, undercorrection of a flatfoot deformity can lead to the need for revision surgery to restore functional mechanics and prevent progression of deformity. The underlying cause of undercorrection is failure to fully recognize or understand the extent of the deformity. This article discusses the typical deformities in adult flatfoot and indications for surgical intervention. Also presented are the surgical procedures for the correction of the typical deformity patterns with available outcome statistics and a stepwise algorithm for patient evaluation to assist in treatment and mitigate the risk of undercorrection of deformity.

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BACKGROUND: Optimization of the electronic medical record (EMR) is essential to support the clinician and to improve the quality and efficiency of patient care. The present report describes the development and implementation of a standardized template that is embedded in the EMR and is focused on a comprehensive physical examination during the evaluation of pediatric supracondylar humeral fractures. We compared the completeness of physical examinations as well as the timing of detection and documentation of neurovascular injuries before and after implementation of the template. We hypothesized that the use of a template would increase the completeness of examinations and would lead to earlier documentation of neurovascular injuries. METHODS: A multidisciplinary quality-improvement task force was created to address neurovascular documentation practices for patients who underwent operative treatment of supracondylar humeral fractures. Following a series of formative and process evaluations, a standardized EMR template was implemented. Neurovascular examination documentation practices that were in use before (pre-template group, n = 224) and after (template group, n = 300) the implementation of the template were compared. Logistic regression analyses of the 2 groups were used to compare the likelihood of a complete neurovascular examination and the timing of neurovascular injury identification. RESULTS: There was significant improvement in the documentation of the vascular (odds ratio [OR], 70.7; 95% confidence interval [CI], 39.5 to 126.6; p < 0.0001), motor (OR, 17.6; 95% CI, 9.5 to 32.7; p < 0.0001), and sensory (OR, 23.9; 95% CI, 12.9 to 44.4; p < 0.0001) examinations in the template group. Neurological injuries were more likely to be identified preoperatively in the template group compared with the pre-template group (OR, 6.8; 95% CI, 1.7 to 27.1; p = 0.0067). CONCLUSIONS: The incorporation of a standardized template in the EMR improved the completeness and timing of documentation of neurological injury. Standardized EMR templates developed by a clinically driven multidisciplinary task force have the potential to improve the quality of clinical documentation and to ease communication among providers. LEVEL OF EVIDENCE: Level III. See Instructions for Authors for a complete description of levels of evidence.

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Patient-controlled analgesia (PCA) is regularly used to manage pain following major surgery. The fentanyl hydrochloride iontophoretic transdermal system (ITS) was developed to overcome some of the limitations of intravenous (IV) PCA. The small, self-adhesive, needle-free disposable system is applied to the skin on the upper arm or chest and is controlled by patients clicking a button on the device. The authors identified patients who were underwent spinal surgery from 2 prior multicenter, randomized studies and analyzed their data. Of the 1296 patients in the original trials, 170 underwent spine surgery procedures: 90 were randomized to the fentanyl ITS (40 mcg/activation) and 80 to IV PCA morphine (1 mg/dose). More patients treated with the fentanyl ITS rated their method of pain control as "excellent" across all time points, but differences did not reach statistical significance. However, investigators' ratings of "excellent" satisfaction with study treatment were significantly higher for the fentanyl ITS. Discontinuation rates and overall adverse event rates were similar between groups. The only significant difference was that patients treated with the fentanyl ITS had a higher rate of application site reactions than infusion site reactions in the IV PCA morphine group; the reactions were typically mild-to-moderate erythema that resolved shortly after removal of the fentanyl ITS device and did not require further treatment. Ratings of satisfaction with pain control method were consistently higher for the fentanyl ITS than the IV PCA morphine. The 2 groups had a similar safety profile. These results suggest that the fentanyl ITS appears to be a safe, efficacious alternative to IV PCA in spine surgery patients.

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In many organisms there is a balance between carbon and nitrogen metabolism. These observations extend to the nitrogen-fixing, nonsulfur purple bacteria, which have the classic family of P(II) regulators that coordinate signals of carbon and nitrogen status to regulate nitrogen metabolism. Curiously, these organisms also possess a reverse mechanism to regulate carbon metabolism based on cellular nitrogen status. In this work, studies in Rhodobacter sphaeroides firmly established that the activity of the enzyme that catalyses nitrogen fixation, nitrogenase, induces a signal that leads to repression of genes encoding enzymes of the Calvin-Benson-Bassham (CBB) CO2 fixation pathway. Additionally, genetic and metabolomic experiments revealed that NADH-activated phosphoribulokinase is an intermediate in the signalling pathway. Thus, nitrogenase activity appears to be linked to cbb gene repression through phosphoribulokinase.

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CASE: This report describes a sixty-one-year old man who was diagnosed with a myxoid liposarcoma of the left thigh that was resected and then treated with radiation therapy. He underwent yearly surveillance imaging but presented seventeen years after initial resection with symptoms of heart failure. He was found to have a cardiac abnormality that was first thought to be a pseudoaneurysm but was later shown to be a myxoid liposarcoma, presumably metastatic. CONCLUSION: Myxoid liposarcoma can present with late metastasis, including to the heart.

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Osteoporosis has been recognised as a public health concern for at least three decades but it has been relatively recent that the push has been for orthopaedic surgeons to take a more active role in the diagnosis and treatment of patients with decreased bone mineral density (BMD). Most often these patients are encountered after they have suffered a fracture making secondary prevention the area where orthopaedists may exert the greatest influence on patient care. The purpose of this article is to provide a succinct framework for the diagnosis and treatment of patients with decreased BMD. Patients are deemed to have decreased BMD if they have suffered a fragility fracture, a fracture caused by a low-energy traumatic event. These patients are often encountered in the emergency department and admitted for further treatment of their fractures or recommended for follow-up in the clinic. Regardless of treatment course these are opportunities for the orthopaedic surgeon to intervene in the osteoporotic disease process and positively affect a patient's bone health. This article compiles the available literature on osteoporosis and presents it succinctly with the incorporation of both a diagnosis algorithm and treatment profile table. With the use of these two tools, orthopaedic surgeons everywhere should be able to take a more active role in their patients' bone health.

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Previously, the RubisCO-compromised spontaneous adaptive Rhodobacter sphaeroides mutant, strain 16PHC, was shown to derepress the expression of genes that encode the nitrogenase complex under normal repressive conditions. As a result of this adaptation, the active nitrogenase complex restored redox balance, thus allowing strain 16PHC to grow under photoheterotrophic conditions in the absence of an exogenous electron acceptor. A combination of whole genome pyrosequencing and whole genome microarray analyses was employed to identify possible loci responsible for the observed phenotype. Mutations were found in two genes, glnA and nifA, whose products are involved in the regulatory cascade that controls nitrogenase complex gene expression. In addition, a nucleotide reversion within the nifK gene, which encodes a subunit of the nitrogenase complex, was also identified. Subsequent genetic, physiological and biochemical studies revealed alterations that led to derepression of the synthesis of an active nitrogenase complex in strain 16PHC.

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Dogs with congenital portosystemic shunt (PSS) are typically diagnosed before 2 years of age. The objective of this study was to determine if miniature schnauzers are more likely to be diagnosed with congenital PSS at an older age than are other breeds. This retrospective study examined the case records of 171 dogs diagnosed with congenital PSS; dogs were included if they were definitively diagnosed as having congenital PSS by nuclear scintigraphy, contrast portography, and/or exploratory surgery. Seven (23%) of 31 miniature schnauzers diagnosed with congenital PSS were 7 years of age or older at the time of diagnosis, compared to 3.4% for all other breeds. Miniature schnauzers had a relative prevalence ratio of 6.3 (95% confidence interval 2.2 to 18.6; P=0.001) for being diagnosed at or after 7 years of age when compared to all other breeds of dogs. Clinical signs of congenital PSS may not manifest sufficiently to cause an owner to seek veterinary care for some dogs until they are older. Congenital PSS should be considered in mature dogs, particularly miniature schnauzers, that are presented with signs potentially consistent with hepatic encephalopathy.

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The objective of this study was to investigate the weight and weight uniformity of hard gelatin capsules filled with microcrystalline cellulose (MCC) and silicified microcrystalline cellulose (SMCC) powdered formulations. A tamping-type encapsulation apparatus was used to fill the capsules. The four formulations that were tested included MCC alone, MCC blended with fumed silica, SMCC, and high-density SMCC (SMCC-HD). The mean capsule weight and the average variation in mean capsule weight of each formulation were determined. Both SMCC products exhibited better flow than the MCC alone, with SMCC-HD being the freest flowing of the powders investigated. Capsules filled with the SMCC products had higher fill weights than those containing the MCC powders. The SMCC-containing capsules exhibited the lowest variation in weight, although these findings were not significantly different from either of the MCC-containing capsules. Significantly higher weight variations were found in capsules filled with SMCC-HD. A relationship between Carr's compressibility index and capsule weight variation was found, with more compressible materials producing more uniformly filled capsules. No relationship could be established between powder flow and capsule weight uniformity. These findings suggest that powder flow may not be a critical parameter in ensuring capsule weight uniformity when the encapsulation equipment utilizes a tamping-type filling system.

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