Acromioclavicular joint augmentation at the time of coracoclavicular ligament reconstruction fails to improve functional outcomes despite significantly improved horizontal stability

Purpose: Acromioclavicular joint reconstruction is a well-established and frequently performed procedure. Recent scientific and commercial interest has led to a drive to develop and perform surgical techniques that more reliably restore horizontal stability in order to improve patient outcomes. The aim of this systematic review was to evaluate the biomechanical evidence for procedures directed at restoring horizontal stability and determine whether they are associated with superior clinical results when compared to well-established procedures. Methods: A review of the online databases Medline and EMBASE was conducted in accordance with the PRISMA guidelines on the 23rd December 2017. Biomechanical and clinical studies reporting either static or dynamic horizontal displacement following acromioclavicular joint reconstruction (Coracoclavicular reconstruction or Weaver-Dunn) were included. In addition, biomechanical and clinical studies reporting outcomes after additional augmentation of the acromioclavicular joint were included. The studies were appraised using the Methodological index for non-randomised studies tool. Results: The search strategy identified 18 studies eligible for inclusion: six biomechanical and 12 clinical studies. Comparative biomechanical studies demonstrated that acromioclavicular augmentation provided significantly increased horizontal stability compared to the coracoclavicular reconstruction and Weaver–Dunn procedure. Comparative clinical studies demonstrated no significant differences between coracoclavicular reconstruction with and without acromioclavicular augmentation in terms of functional outcomes (American Shoulder and Elbow Surgeon and Constant score), complication or revision rates. However, one comparative study did demonstrate an improvement in Taft (p = 0.018) and Acromioclavicular Joint Instability scores (p = 0.0001) after acromioclavicular augmentation. Conclusion: In conclusion, coracoclavicular reconstruction with augmentation of the acromioclavicular joint has been shown to provide improved horizontal stability in both biomechanical and clinical studies compared to isolated coracoclavicular reconstruction. However, comparative studies have shown no clinical advantage with respect to American Shoulder and Elbow Surgeon or Constant scores and, therefore, the results of this systematic review do not support acromioclavicular augmentation in routine clinical practice. Level of evidence: IV

Wilbur and Orville Wright: A Bibliography Commemorating the One-Hundredth Anniversary of the First Powered Flight, December 17, 1903

This annotated bibliography of material about Wilbur and Orville Wright and the first powered flight, commemorates the one hundredth anniversary of the event. This publication represents an updated version of the classic, "Wilbur and Orville Wright: A Bibliography Commemorating the Hundredth Anniversary of the Birth of Wilbur Wright, April 16, 1867" which was originally published in 1968. Aspects of the Wright brothers' lives covered include: their published writings, biographical references, airplanes used and flight records, airplane components, patents, court records, Wright companies and schools, the Wright-Smithsonian controversy, monuments and museums, memorials, medals and honors, memorabilia, art, poetry, music, motion pictures and juvenile publications. An index is included

Slaughterline records of various postmortem pathological lesions and their influence on carcass and meat quality in slaughtered pigs

The aim of this study was to identify the prevalence of pathological lesions in pigs from small-scale farms and to determine associations between pathological lesions and hematological parameters, and carcass and meat quality in slaughtered pigs. The study was conducted on 625 pigs (similar to 115 kg) originating from 20 small-scale farms. Any signs of pneumonia, pleurisy, pericarditis, and liver milk spots were recorded as present or absent. Complete blood count was investigated. The following carcass quality parameters were measured: live, hot and cold carcass weights, cooling loss, dressing percentage, backfat thickness, and meatiness. Meat pH and temperature were measured 45 min postmortem. Of the 625 examined pigs, 41.8% had pneumonia, 23.5% pleurisy, 2.7% pericarditis, and 29.9% liver milk spots. The presence of pathological lesions in slaughtered pigs adversely affected hematological parameters, reduced live, hot and cold carcass weights, and meatiness and had deleterious effects on meat quality (higher pH(45min) and higher prevalence of dark, firm and dry meat). In conclusion, this study showed a high prevalence of pathological lesions in slaughtered pigs, indicating serious health problems in smallholder pig production systems. The presence of single and, especially, multiple pathological lesions in slaughtered pigs negatively affected hematological parameters, and carcass and meat quality

Effects of dispersed recreational activities on the microbiological quality of forest surface water

The microbiological quality of forest surface waters in the Greenwater River watershed was examined to investigate the influence of heavy motorized camping in an area with no sanitary facilities. Indicator densities increased during weekend human-use periods when compared to weekdays. Increases in indicator densities were also noted downstream from heavily used camping areas when compared to upstream sites. Seasonal, weekly, and diurnal fluctuations in indicator densities were observed. This study suggests that potential health hazards exist in this watershed during periods of human use