Surgical Management of the Horizontal Instability of the Acromioclavicular Joint of a Young Athlete: A Case Report.

The acromioclavicular joint (ACJ) is commonly injured due to a force to the lateral aspect of the shoulder with the arm in adduction resulting in vertical or multidirectional instability. However, in this case report, we present a rare case of an athlete with isolated horizontal ACJ instability, which was treated surgically using a hamstring allograft. We highlight the surgical technique use to stabilize the joint in the horizontal (anterior to posterior) plane.

Management of a Failed Distal Tibial Allograft Procedure for Anterior Shoulder Instability in a Patient With Epilepsy: A Case Report.

Shoulder instability episodes are observed in high-energy injuries, such as seizures. In this case report, we highlight the management of a failed distal tibial allograft procedure for recurrent shoulder instability in a patient with a bony Bankart lesion and epilepsy. The patient was treated with an iliac crest autograft and a proximal humerus osteochondral allograft procedure.

Investigating the Potential Strategic Implications of COVID-19 for Biological Weapons Pursuit: A New Expert Simulation.

To investigate the impact of the COVID-19 pandemic on the strategic decisionmaking of leaders with respect to biological weapons, this study employed a prospective simulation technique called Asynchronous Strategic Dynamics Red Teaming. Using an immersive, multimedia simulation conducted remotely and asynchronously, the effort engaged 240 carefully selected and curated expert participants in either biological weapons or the countries of interest (as well as 60 naïve participants). Across our sample of 30 countries, simulated interest in pursuing some type of biological weapons program (defensive or offensive) remained low to moderate.

Follow-Up: Effects of a Pandemic and Isolation on Alcohol and Psychoactive Medication Use in a Population of Rehabilitation and Pain Patients.

Objective: The conjunction of the coronavirus disease lockdown and the use of illicit drugs suggests the potential increase in drug usage and opioid deaths. Because of other studies, we felt the need to examine if the lockdown has caused a change in the drug intake of our population of substance abuse and pain management patients. Our initial study indicated no increase in the use of illicit and antianxiety drugs.

Update: Correlation of Fentanyl Positive Drug Screens with other Medications in Patients from Pain, Rehabilitation and Behavioral Programs.

Objective: To monitor fentanyl polydrug use over past six years.

Method: Calculate percent of fentanyl and other drugs positive in urine drug tests.

Results: Percent of fentanyl positive drug tests remained unchanged, but increases in fentanyl/methamphetamine and fentanyl/marijuana were observed.

Effects of a Pandemic and Isolation on Alcohol and Psychoactive Medication Use in a Population of Rehabilitation and Pain Patients.

Objective: The conjunction of the coronavirus disease lockdown and the use of illicit drugs suggests the potential increase in drug usage and opioid deaths. Because of other studies, we felt the need to examine if the lockdown has caused a change in the drug intake of our population of substance abuse and pain management patients.

Materials: Urine drug testing is a strategy to reduce harm to patients in pain management and substance abuse treatment programs.

Reduction of Drug-Drug Interaction Risk; CDC Guidelines Influence on Opiate Benzodiazepine Prescribing.

We examined the results of 1.3 million drug tests performed on patients being monitored for compliance with pain medications and substance abuse rehabilitation to determine if the 2016 CDC prescribing guidelines had any impact on opiate benzodiazepine use. We observed that the combination of the opiate drugs morphine, oxycodone, and hydrocodone with the benzodiazepine metabolites oxazepam, alphahydroxyalprazolam, and 7-aminoclonazepam showed many patients were on a combination of these drugs.

Community-Level Exposure to the Rural Mining Industry: The Potential Influence on Early Adolescent Alcohol and Tobacco Use.

Purpose: Rural youth have higher rates of alcohol and tobacco use compared to their urban counterparts. However, the economic dependence of rural communities may differentially influence risk behaviors. While research has shown that adults working in mining have elevated rates of alcohol and tobacco use, the influence of living in a mining community on early adolescent substance use is unknown.

Expert Views on Biological Threat Characterization for the U.S. Government: A Delphi Study.

Biological threat characterization (BTC) involves laboratory research conducted for the purpose of biological defense. BTC research is important for improving biological risk assessment and informing resource prioritization. However, there are also risks involved in BTC work, including potential for escape from the laboratory or the misuse of research results.

Understanding the Adoption Process of National Security Technology: An Integration of Diffusion of Innovations and Volitional Behavior Theories.

After the 9/11 terrorist attacks, the U.S. government initiated several national security technology adoption programs.

Cross-Milieu Terrorist Collaboration: Using Game Theory to Assess the Risk of a Novel Threat.

This article uses a game-theoretic approach to analyze the risk of cross-milieu terrorist collaboration-the possibility that, despite marked ideological differences, extremist groups from very different milieus might align to a degree where operational collaboration against Western societies becomes possible. Based upon theoretical insights drawn from a variety of literatures, a bargaining model is constructed that reflects the various benefits and costs for terrorists' collaboration across ideological milieus. Analyzed in both sequential and simultaneous decision-making contexts and through numerical simulations, the model confirms several theoretical arguments.

Widespread colonization of the lung by Tropheryma whipplei in HIV infection.

Rationale: Lung infections caused by opportunistic or virulent pathogens are a principal cause of morbidity and mortality in HIV infection. It is unknown whether HIV infection leads to changes in basal lung microflora, which may contribute to chronic pulmonary complications that increasingly are being recognized in individuals infected with HIV.

Objectives: To determine whether the immunodeficiency associated with HIV infection resulted in alteration of the lung microbiota.

Sexual assault: a report on human immunodeficiency virus postexposure prophylaxis.

The objective of this report is to describe an urban county hospital human immunodeficiency virus (HIV) infection prevention protocol offering prophylactic combination antiretroviral medications to female victims of sexual assault. A retrospective chart review was conducted from June, 2007 through June, 2008 of 151 women who were prescribed antiretroviral prophylaxis by protocol. All women receiving HIV prophylaxis initially screened HIV seronegative.

Linking microbial oxidation of arsenic with detection and phylogenetic analysis of arsenite oxidase genes in diverse geothermal environments.

The identification and characterization of genes involved in the microbial oxidation of arsenite will contribute to our understanding of factors controlling As cycling in natural systems. Towards this goal, we recently characterized the widespread occurrence of aerobic arsenite oxidase genes (aroA-like) from pure-culture bacterial isolates, soils, sediments and geothermal mats, but were unable to detect these genes in all geothermal systems where we have observed microbial arsenite oxidation. Consequently, the objectives of the current study were to measure arsenite-oxidation rates in geochemically diverse thermal habitats in Yellowstone National Park (YNP) ranging in pH from 2.

Emerging technologies and fourth generation issues in cartilage repair.

The goals of successful cartilage repair include reducing pain, improving symptoms, and long-term function; preventing early osteoarthritis and subsequent total knee replacements; and rebuilding hyaline cartilage instead of fibrous tissue. Current methods such as microfracture, osteoarticular autograft transfer system, mosaicplasty, and autologous chondrocyte implantation are somewhat successful in regenerating cartilage; however, they also have significant limitations. The future of fourth generation cartilage repair focuses on gene therapy, the use of stem cells (bone marrow, adipose, or muscle derived), and tissue engineering.

Isolation and distribution of a novel iron-oxidizing crenarchaeon from acidic geothermal springs in Yellowstone National Park.

Novel thermophilic crenarchaea have been observed in Fe(III) oxide microbial mats of Yellowstone National Park (YNP); however, no definitive work has identified specific microorganisms responsible for the oxidation of Fe(II). The objectives of the current study were to isolate and characterize an Fe(II)-oxidizing member of the Sulfolobales observed in previous 16S rRNA gene surveys and to determine the abundance and distribution of close relatives of this organism in acidic geothermal springs containing high concentrations of dissolved Fe(II). Here we report the isolation and characterization of the novel, Fe(II)-oxidizing, thermophilic, acidophilic organism Metallosphaera sp.

Intraoperative ultrasound localization of nonpalpable breast cancers.

Background: Preoperative localization of nonpalpable breast cancers requires good coordination between imaging and surgery departments, and insertion of a guide wire can be traumatic for the patient. This study was designed to evaluate the efficacy of intraoperative ultrasound localization of nonpalpable breast cancers directly by the surgeon.

Methods: This prospective study was conducted from June 2006 to October 2006 in 70 patients who underwent surgery for nonpalpable invasive breast cancer.

Laparoscopic segmental colorectal resection for endometriosis: limits and complications.

Background: Deep pelvic endometriosis with colorectal involvement is a complex disorder often requiring segmental bowel resection. This study investigated the limits and complications of laparoscopic segmental colorectal resection.

Methods: Laparoscopic segmental colorectal resection was performed for 71 women with bowel endometriosis.

It is hard to predict the future: the evolving nature of threats and vulnerabilities.

This paper describes the evolving nature of threats and vulnerabilities associated with biological disasters with animal origins, and introduces some of the pitfalls and opportunities associated with anticipating future threats. Evolving threats and vulnerabilities include continued deforestation and encroachment on virgin habitats, the effects of globalisation on trade and transportation, the increased interdependence and social vulnerability of modern society, the commingling of intensive agriculture and traditional farming methods, the periodic appearance of pandemics and epizootics, and indications that numerous human actors are displaying an increasing interest in and capability of using biological agents as weapons. These developments must be viewed in the context of various impediments to accurately gauging future threats, such as the appearance of new elements that depart from current trends and the inherent difficulty in anticipating human, and especially terrorist, behaviour.

A history of biological disasters of animal origin in North America.

This paper examines past occurrences in North America relevant to the possibility of biological disasters with animal origins. With respect to naturally occurring animal disease outbreaks, North America, while not as adversely affected by epizootics as other regions, has had its fair share of such outbreaks of both 'traditional' and emerging animal diseases. The traditional category includes such diseases as anthrax, classical swine fever, bluetongue, brucellosis, foot and mouth disease, and the family of equine encephalomyelitis viruses.

Inner-shell photodetachment thresholds: unexpected long-range validity of the Wigner law.

Threshold behavior in inner-shell photodetachment is studied for the first time, specifically with 2-, 3-, or 4-electron emission from He- and S-. The threshold shapes are surprisingly consistent with the Wigner threshold law in all cases, despite large PCI effects observed in He-. In S-, the s-wave law is observed to agree with the data over an unprecedented range, more than an order of magnitude greater than predictions, and allows for the observation of the d-wave component.

Syne proteins anchor muscle nuclei at the neuromuscular junction.

Vertebrate skeletal muscle fibers contain hundreds of nuclei, of which three to six are functionally specialized and stably anchored beneath the postsynaptic membrane at the neuromuscular junction (NMJ). The mechanisms that localize synaptic nuclei and the roles they play in neuromuscular development are unknown. Syne-1 is concentrated at the nuclear envelope of synaptic nuclei; its Caenorhabditis elegans orthologue ANC-1 functions to tether nuclei to the cytoskeleton.

Photoexcitation of He- hollow-ion resonances: observation of the 2s2p2 4P state.

Highly correlated states are studied in He-, a fundamental 3-electron system and prototypical negative ion. The 2s2p(2) 4P state is observed for the first time. This state is detected in a resonant simultaneous double-Auger decay of unprecedented strength.