Double-Allograft Shoulder Stabilization for Multidirectional Instability Is Associated With Improved Function and Survivability After 2 Years.

Purpose: To describe a double-allograft technique used for patients with severe, symptomatic multidirectional instability and hyperlaxity of the shoulder as well as to introduce a modification of the Beighton score that helps determine when this procedure should be utilized and report long-term outcomes of this procedure in the management of these patients.

Methods: A retrospective review of patients with multidirectional instability who were managed with the double-allograft technique after failure of extensive physical therapy was conducted. The final analysis included 43 patients (46 shoulders).

Syntheses and structures of chiral rhenium-containing phosphonium salts and phosphines with ReCHP̈Ar or ReCH(R)P̈Ar linkages; enantioselective catalysis of intramolecular Morita-Baylis-Hillman and Rauhut-Currier reactions.

Easily accessed (η-CH)Re(NO)(PPh)(CH) (2) is treated with PhC PF (-78 °C) to generate the methylidene cation [(η-CH)Re(NO)(PPh)(CH)] and then secondary phosphines PArH (Ar = a, Ph; b, -tol; c, -CHOCH; d, -CHN(CH); e, 2-biphen; f, α-naph) to give the phosphonium salts [(η-CH)Re(NO)(PPh)(CHPArH)] PF ([1a-f-H] PF, 87-94%). Additions of -BuOK yield the phosphines 1a-f (64-91%). Analogous procedures starting with ()-2 give enantiopure ()-1a-d in comparable yields.

Initiating Testosterone Therapy Without Indication for Treatment of Low Testosterone Is Associated With Higher Risk of Tendon Tear.

Background: Studies have demonstrated an increasing rate of testosterone supplementation in patients who do not meet criteria for testosterone deficiency, but the risks associated with testosterone supplementation are unclear.

Hypothesis: Patients initiating testosterone therapy would be diagnosed with significantly more tendon tears and undergo significantly more tendon repairs than matched controls never on testosterone therapy.

Study Design: Cohort study.

Forty-Two Percent of Patients Undergoing Arthroscopic Shoulder Surgery Are Using Psychotropic Medications.

Purpose: To determine the prevalence of psychotropic medication use in patients undergoing shoulder arthroscopy at a single institution and to identify the most common medications and classes of drugs being taken in this specific patient population.

Methods: We conducted a retrospective chart review of patients treated by 3 fellowship-trained orthopaedic sports medicine and shoulder surgeons between 2019 and 2021. All patients who underwent shoulder arthroscopy during this period were included.

Management of Partial-Thickness Rotator Cuff Tears: Biologic and Surgical Interventions.

Partial-thickness rotator cuff tears (PTRCTs) are a common source of shoulder pathology, both in the aging population and in younger overhead athletes. Advanced imaging modalities used currently have led to increases in recognition, diagnosis, and treatment of these tears. The anatomy, five-layer histology, and relationship to the Ellman classification of PTRCTs have been well studied, with recent interest in radiographic predictors, such as the critical shoulder angle and acromial index.

Biologics in rotator cuff repair.

Rotator cuff tears are common in middle-aged and elderly patients. Despite advances in the surgical repair of rotator cuff tears, the rates of recurrent tear remain high. This may be due to the complexity of the tendons of the rotator cuff, which contributes to an inherently hostile healing environment.

TFIIB-Termination Factor Interaction Affects Termination of Transcription on Genome-Wide Scale.

Apart from its well-established role in the initiation of transcription, the general transcription factor TFIIB has been implicated in the termination step as well. The ubiquity of TFIIB involvement in termination as well as mechanistic details of its termination function, however, remain largely unexplored. Using GRO-seq analyses, we compared the terminator readthrough phenotype in the mutant (TFIIB) and the isogenic wild type (TFIIB) strains.

Genome-wide analysis of TFIIB's role in termination of transcription.

This study provides evidence that the role of TFIIB extends beyond initiation to include the termination step of transcription. Using GRO-seq analyses, we compared terminator readthrough phenotype in mutant (TFIIB ) and the isogenic wild type (TFIIB ) strains. Approximately 74% of genes analyzed exhibited a 2-3-fold increase in readthrough of the poly(A)-termination signal in the TFIIB mutant compared to TFIIB cells.

Genome-wide analysis of TFIIB's role in termination of transcription.

Apart from its well-established role in initiation of transcription, the general transcription factor TFIIB has been implicated in the termination step as well. The ubiquity of TFIIB involvement in termination as well as mechanistic details of its termination function, however, remains largely unexplored. To determine the prevalence of TFIIB's role in termination, we performed GRO-seq analyses in mutant (TFIIB ) and the isogenic wild type (TFIIB ) strains of yeast.

Vergence and accommodation deficits in paediatric and adolescent patients during sub-acute and chronic phases of concussion recovery.

Introduction: Visual function deficits have been reported in adolescents following concussion. We compared vergence and accommodation deficits in paediatric and adolescent patients at a tertiary medical centre in the sub-acute (15 days to 12 weeks) and chronic (12 weeks to 1 year) phases of concussion recovery.

Methods: The study included patients aged 7 to <18 years seen between 2014 and 2021, who had a binocular vision (BV) examination conducted within 15 days and 1 year of their concussion injury.

On the multiscale dynamics of punctuated evolution.

For five decades, paleontologists, paleobiologists, and ecologists have investigated patterns of punctuated equilibria in biology. Here, we step outside those fields and summarize recent advances in the theory of and evidence for punctuated equilibria, gathered from contemporary observations in geology, molecular biology, genetics, anthropology, and sociotechnology. Taken in the aggregate, these observations lead to a more general theory that we refer to as punctuated evolution.

Medial Ulnar Collateral Ligament Reconstruction With Allograft Provides Excellent Clinical Outcomes, High Rates of Return to Play, and a Low Incidence of Postoperative Complications: A Systematic Review.

Purpose: To perform a systematic review evaluating clinical outcomes in patients undergoing medial ulnar collateral ligament reconstruction (MUCLR) with soft-tissue allograft.

Methods: A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcomes evaluated were patient-reported outcome scores, return to play (RTP) rates, incidence of postoperative complications, and rates of graft rupture or mechanical failure.

Operative Treatment of Ulnar Collateral Ligament Injury in Female Athletes.

Background: Ulnar collateral ligament (UCL) reconstruction has been the standard surgical intervention for elite male athletes with UCL insufficiency. Recently, UCL repair and augmentation with an internal brace has been increasingly performed.

Purpose: To evaluate the clinical and functional outcomes as well as return-to-sport rate after UCL repair in female athletes.

Bornean tropical forests recovering from logging at risk of regeneration failure.

Active restoration through silvicultural treatments (enrichment planting, cutting climbers and liberation thinning) is considered an important intervention in logged forests. However, its ability to enhance regeneration is key for long-term recovery of logged forests, which remains poorly understood, particularly for the production and survival of seedlings in subsequent generations. To understand the long-term impacts of logging and restoration we tracked the diversity, survival and traits of seedlings that germinated immediately after a mast fruiting in North Borneo in unlogged and logged forests 30-35 years after logging.

Projected Colorectal Cancer Incidence and Mortality Based on Observed Adherence to Colonoscopy and Sequential Stool-Based Screening.

Introduction: Modeling supporting recommendations for colonoscopy and stool-based colorectal cancer (CRC) screening tests assumes 100% sequential participant adherence. The impact of observed adherence on the long-term effectiveness of screening is unknown. We evaluated the effectiveness of a program of screening colonoscopy every 10 years vs annual high-sensitivity guaiac-based fecal occult blood testing (HSgFOBT) using observed sequential adherence data.

The mobilization and transport of newly fixed carbon are driven by plant water use in an experimental rainforest under drought.

Non-structural carbohydrates (NSCs) are building blocks for biomass and fuel metabolic processes. However, it remains unclear how tropical forests mobilize, export, and transport NSCs to cope with extreme droughts. We combined drought manipulation and ecosystem 13CO2 pulse-labeling in an enclosed rainforest at Biosphere 2, assessed changes in NSCs, and traced newly assimilated carbohydrates in plant species with diverse hydraulic traits and canopy positions.

Tropical tree ectomycorrhiza are distributed independently of soil nutrients.

Mycorrhizae, a form of plant-fungal symbioses, mediate vegetation impacts on ecosystem functioning. Climatic effects on decomposition and soil quality are suggested to drive mycorrhizal distributions, with arbuscular mycorrhizal plants prevailing in low-latitude/high-soil-quality areas and ectomycorrhizal (EcM) plants in high-latitude/low-soil-quality areas. However, these generalizations, based on coarse-resolution data, obscure finer-scale variations and result in high uncertainties in the predicted distributions of mycorrhizal types and their drivers.

Punctuated equilibrium at 50: Anything there for evolutionary anthropology? Yes; definitely.

The theory of punctuated equilibrium (PE) was developed a little over 50 years ago to explain long-term, large-scale appearance and disappearance of species in the fossil record. A theory designed specifically for that purpose cannot be expected, out of the box, to be directly applicable to biocultural evolution, but in revised form, PE offers a promising approach to incorporating not only a wealth of recent empirical research on genetic, linguistic, and technological evolution but also large databases that document human biological and cultural diversity across time and space. Here we isolate the fundamental components of PE and propose which pieces, when reassembled or renamed, can be highly useful in evolutionary anthropology, especially as humanity faces abrupt ecological challenges on an increasingly larger scale.

Protein interaction network revealed by quantitative proteomic analysis links TFIIB to multiple aspects of the transcription cycle.

Although TFIIB is widely regarded as an initiation factor, recent reports have implicated it in multiple aspects of eukaryotic transcription. To investigate the broader role of TFIIB in transcription, we performed quantitative proteomic analysis of yeast TFIIB. We purified two different populations of TFIIB; one from soluble cell lysate, which is not engaged in transcription, and the other from the chromatin fraction which yields the transcriptionally active form of the protein.

Mycorrhizal feedbacks influence global forest structure and diversity.

One mechanism proposed to explain high species diversity in tropical systems is strong negative conspecific density dependence (CDD), which reduces recruitment of juveniles in proximity to conspecific adult plants. Although evidence shows that plant-specific soil pathogens can drive negative CDD, trees also form key mutualisms with mycorrhizal fungi, which may counteract these effects. Across 43 large-scale forest plots worldwide, we tested whether ectomycorrhizal tree species exhibit weaker negative CDD than arbuscular mycorrhizal tree species.

Medial elbow injuries in the throwing athlete.

There has been an epidemic increase in injuries to the elbow in our youth sports over the past 15 years. Initially, career-ending elbow injuries occurred almost exclusively in the professional population. The landmark procedure developed by Dr.

Positive effects of tree diversity on tropical forest restoration in a field-scale experiment.

Experiments under controlled conditions have established that ecosystem functioning is generally positively related to levels of biodiversity, but it is unclear how widespread these effects are in real-world settings and whether they can be harnessed for ecosystem restoration. We used remote-sensing data from the first decade of a long-term, field-scale tropical restoration experiment initiated in 2002 to test how the diversity of planted trees affected recovery of a 500-ha area of selectively logged forest measured using multiple sources of satellite data. Replanting using species-rich mixtures of tree seedlings with higher phylogenetic and functional diversity accelerated restoration of remotely sensed estimates of aboveground biomass, canopy cover, and leaf area index.

Patients Prefer Medical Facts and Educational Videos From Sports Medicine Surgeons on Social Media.

Purpose: To provide updated information on which sports medicine patients are most influenced by provider presence on social media, as well as their preferences in social media platforms and content.

Methods: Between November 2021 and January 2022, an anonymous online, voluntary, self-administered questionnaire containing 13 questions was distributed to patients who had a clinic visit with 1 of 2 orthopaedic sports medicine surgeons at the same institution. Descriptive statistics were used to analyze the data.