Peachtree Orthopaedic Clinic

We document a smaller expansion of the negative CDS-bond basis and lower selling pressure during the Covid crisis for bonds issued by firms with high environmental and social (E&S) scores, relative to bonds from low E&S firms. This pattern is consistent with lower investor outflows from sustainability focused funds rather than fund managers discriminating among which bonds to sell. Our results suggest that the relative performance of high and low E&S bonds during a crisis is influenced not only by shifts in firm fundamentals, but also by non-fundamental factors such as investor preferences and trading behaviour.

Introduction: Public health logic models divide interventions into three categories: inputs, activities, and outcomes. Similarly, biosafety programs can be described using this same logic model by describing inputs in the form of program staffing and budget; program activities in the form of risk assessments, routine surveillance, training, incident response, and other services; and outcomes in the form of reported exposures, injuries, compliance, finances, and client satisfaction. Methods: Described here is a systematic means of collecting and displaying biosafety program activity data monthly so that the organizational leadership and associated safety committees can readily grasp the scope of various activities undertaken by the biosafety program to support the broader organizational goals. Discussion: The simplified public health logic model affords guidance on inputs, activities, and outcomes that biosafety programs can use to their advantage. The importance of succinctly reporting the data describing activities can inform and educate upper management and other stakeholders regarding the resources needed to avoid injuries and illnesses and maintain compliance. Conclusion: Within the biosafety profession, on a good day, “nothing bad happens,” so conveying the message of the value of prevention can be challenging. By capturing and readily presenting data that describes the efforts of a biosafety program, individual programs can articulate their needs for staffing and resources more successfully, and the profession stands a better chance of maintaining strong administrative and stakeholder support.

ABSTRACT To characterize sediment compressibility and permeability in the presence of gas hydrate, a naturally occurring combination of water and methane that requires elevated pressure and reduced temperature to remain stable, a high-stress permeameter (HSP) device was developed. The HSP was designed to accept gas hydrate-bearing pressure core specimens in their plastic liner at pressures of 10–11 MPa. The HSP was further designed to carry out compressibility and permeability tests over a range of effective stresses while maintaining the requirements for gas hydrate stability. To verify the validity of HSP measurements of sediment consolidation properties, we tested remolded kaolin samples in the HSP and three standard fixed-ring oedometers. Furthermore, we compared the direct fluid-flow permeability measurements from the HSP with estimates based on Terzaghi’s log-time method for calculating permeability from 1-dimensional oedometer-style consolidation tests. We found agreement between all devices for consolidation (e.g., coefficients of compressibility and recompression) and permeability results. These findings indicate the suitability of the HSP for consolidation tests, as well as the log-time method for estimating permeability from oedometer consolidation tests.

Bike lanes are a critical element of urban infrastructure that promote cycling and support sustainable transportation goals. Effective planning and evaluation require comprehensive inventory datasets that both identify the locations of bike lanes and classify their types. However, existing data collection is limited by inconsistent municipal documentation practices and resource constraints. This paper introduces a computer vision–based approach for the automated detection and classification of bike lanes using publicly available multimodal imagery. Each data sample integrates two street view images, captured from opposite directions, with a corresponding satellite image, enabling complementary perspectives. This approach allows the model to reliably detect bike lane presence and distinguish between designated (marked lanes without physical barriers) and protected (lanes separated from traffic by physical barriers) types. To optimize performance, we conduct ablation experiments across three architectural dimensions: stage of modality concatenation, fusion strategy, and label structure. We also construct a training dataset using Google Street View and satellite imagery from 28 major U.S. cities to ensure broad applicability. Applying the model to over 1000 road segments in Atlanta, Georgia, we demonstrate its scalability and accuracy in a real-world urban setting. By providing an automated, transferable method for developing bike lane inventories, this research addresses a critical gap in infrastructure documentation and supports more effective planning of bicycle networks. • Automated bike lane classification using multimodal street view and satellite imagery. • Systematic evaluation across three architectural dimensions. • Late-stage, decision-level fusion with hierarchical label yields best accuracy. • Training dataset comprises of 1800 segments from 28 U.S. cities. • Applicability validated through deployment on 1000+ road segments in Atlanta.

In an era of persistent and evolving cyberthreats that pose serious risks to patient safety, institutional integrity, and regulatory compliance, health care organizations, particularly radiology departments, must adopt a proactive stance toward cybersecurity. Radiology departments are particularly vulnerable to cyberattacks due to their dependence on digital imaging systems that often are legacy systems and insecure as well as their reliance on network connectivity and specialized software. This AJR Expert Panel Narrative Review offers a strategic road map for health care institutions to prepare for and survive cybersecurity attacks, with a focus on the unique vulnerabilities within medical imaging systems that radiology departments must address. Real-world threats, ranging from PACS network exploitation to DICOM data manipulation, ransomware disruptions, and the consequences of inaction, are examined. Emphasis is placed on practical defense mechanisms, including layered security architecture, regular vulnerability assessments, employee training, and incident response simulations. The insights are intended to inform a defense-in-depth strategy incorporating physical, technical, and administrative safeguards aligned with HIPAA and other regulatory standards. Overall, this guide for radiology practices seeks to align technical controls with operational resilience, to aid practices in detecting, containing, and recovering from cyber incidents with minimal disruption to patient care.

Background:Injuries of the medial ulnar collateral ligament (MUCL) among baseball pitchers are increasing. Surgical treatment is evolving to optimize outcomes.Purpose/Hypothesis:This study’s purpose was to highlight trends in MUCL repair and reconstruction in professional pitchers, describe outcomes such as return to any level of play (RTP), and identify factors impacting these outcomes. It was hypothesized that primary and revision MUCL surgery is increasing, with revision surgery requiring greater RTP time.Study Design:Case series; Level of evidence, 4.Methods:The Major League Baseball (MLB) Health and Injury Tracking System database was used to procure data during the study period (2010-2023). All professional pitchers who underwent MUCL surgery during this period were included. RTP was defined as a pitcher returning to at least 1 professional game after index surgery. Return to the same level of play (RTSL) was defined as return to at least 1 game in the same league of play as before surgery. Because of the coronavirus pandemic, the year 2020 was considered an outlier and omitted from time-trend analysis.Results:A total of 2281 pitchers who underwent MUCL surgery during the study period were included for analysis. The number of MUCL surgeries for pitchers increased yearly (R2 = 0.821; P < .001), as did the number of reconstructions with internal brace augmentation (R2 = 0.896; P < .001). The RTP rate for MLB pitchers was significantly higher than the RTSL rate (93% vs 71%; P < .001). This difference was not observed in Minor League Baseball (MiLB) pitchers (RTP 76% vs RTSL 74%; P = .142). RTP rates after revision surgery were lower than those after primary surgery (71% vs 80%; P = .020). The mean time to RTP was shorter (470 ± 135 days) than the mean time to RTSL (499 ± 153 days; P < .001).Conclusion:The incidence of MUCL surgery and revision surgery is increasing among professional pitchers. Overall, 79% of pitchers returned to any level of play at a mean of 470 days, while 74% returned to the same level of play at a mean of 499 days, but this varied based on level of play. This study will guide athlete expectations and surgeon decision-making.

Complex ablative maxillary and mandibular defects often require osseous free flap reconstruction. Workhorse options include the fibula, scapula, and osteocutaneous radial forearm flap (OCRFF). The choice of donor site for harvest should be driven not only by reconstructive goals but also by donor site morbidity. The goal of this study is to evaluate the long-term postoperative musculoskeletal morbidity at the donor site after osseous free flap harvest. Cohort study and cross-sectional analysis. A retrospective review of patients who underwent free flap harvest at 1 of the 3 donor sites from 2015 through 2021 was performed. An additional cross-sectional analysis at ≥1 year postoperatively was performed from 2021 to 2022 using validated patient-reported orthopedic surveys: Disabilities of the Arm, Shoulder, and Hand for scapula or OCRFF harvest, and Foot and Ankle Ability Measure for fibula harvest. Single, high-volume tertiary care institution. Among 731 eligible patients, 162 (22.1%) answered the telephone surveys and were included. Functional differences between operated and nonoperated sides were 18.5% (scapula, n = 33), 13.5% (OCRFF, n = 29), and 10% (fibula, n = 98). Postoperative physical therapy (for all donor sites), ipsilateral neck dissection (for scapula and OCRFF), and extent of bony resection (for OCRFF) were not factors associated with long-term morbidity. Acute donor site complications were most common in fibula patients and were associated with worse long-term functional outcomes (7.5% difference; 95% confidence interval, -14.0 to -1; P = .03). There is acceptable long-term musculoskeletal morbidity at the donor site after osseous free flap harvest, and patients should be counseled appropriately.

This paper presents a theoretical inquiry into the domain of secure artificial superintelligence (ASI). The paper introduces an architectural pattern tailored to fulfill friendly alignment criteria. Friendly alignment refers to a failsafe artificial intelligence alignment that lacks supervision while still having a benign effect on humans. The proposed solution is based on a biomimetic approach to emulate the functional aspects of biological consciousness. It establishes “morality” that secures alignment in large systems. The emulated function set is drawn from a cross section of evolutionary and psychiatric frameworks. Furthermore, the paper assesses the architectural potential, practical utility, and limitations of this approach. Notably, the architectural pattern supports straightforward implementation by activating existing foundation models. The models can be underpinned by simple algorithms. Simplicity does not hinder the production of high derivatives, which contribute to alignment strength. The architectural pattern enables the adjustment of alignment strength, enhancing the adaptability and usability of the solution in practical applications.