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PURPOSE: The primary aim was to compare the early knee-specific functional outcome after articular surface mounted (ASM) navigation with non-navigated TKA. The secondary aims were to compare general physical and mental health improvement, patient satisfaction, and reliability of component alignment in the sagittal and coronal planes between ASM navigated TKA with that of non-navigated TKA. METHODS: Prospective functional outcome and radiographic data were collect for 123 patients undergoing ASM navigation and 172 patients undergoing non-navigated TKA by a high volume single surgeon. Pre-operative and one-year Oxford knee score (OKS) and short form (SF-) 12 scores were collected. Patient satisfaction was also assessed at one year. Implant position was assessed on post-operative radiographs (alpha, beta, gamma, and sigma angles) by a blinded observer. RESULTS: There was no significant difference for improvement in OKS, SF-12 physical or mental components, or satisfaction between the groups one year following surgery. The non-navigation group was significantly more likely to have outliers (greater than 3 degrees) in femoral varus/valgus coronal alignment [odds ratio (OR) 4.5, 95% confidence interval (CI) 1.0-20.7, p = 0.049] and for posterior tibial slope (OR 8.3, 95% CI 1.1-65.0, p = 0.03). CONCLUSIONS: ASM navigation significantly reduces the number of outliers for the femoral and tibial components when compared to conventional non-navigation alignment. However, the short-term functional outcome is not influenced by the surgical technique used. If the surgeon wants to reduce their number of outliers, then ASM navigation should be considered but the overall functional outcome in the short term is not influenced. LEVEL OF EVIDENCE: III Therapeutic investigation, retrospective cohort study.

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The gut protozoan parasite, Giardia lamblia (Assemblage A), has 5 major chromosomes, 1 of which is 2 Mb, as determined from gel separations of whole chromosomes. We originally published a physical map of this chromosome and, now, using the sequence data from 46 chromosome-specific probes, have produced a sequence map of the 2 Mb chromosome. Comparison of the probe sequences with the Giardia genome database (http://GiardiaDB.org) has identified 4 scaffolds (CH991771, CH991780, CH991782, and CH991767) belonging to the 2 Mb, Assemblage A, chromosome. Because of the density of probe sequences, we have been able to predict the orientation of the scaffolds and have identified erroneous inclusions in scaffold CH991767. Exclusion of erroneously included sequences resulted in a 1.96 Mb chromosome sequence. This study brings together experimental data and the GiardiaDB data to compile the sequence of a whole chromosome.

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Forensic evidence in child homicide cases is critical to determine sexual abuse. Forensic evidence can help focus an investigation on a suspect through DNA results. Of 210 missing children found deceased, 68% were homicides, 16% had accidental causes, 12% were unknown, and 4% were suicides.

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1. Threats are indirect acts of criminal behavior designed to weaken or injure individuals, institutions, or property. 2. All threats should be analyzed and investigated quickly and with high priority. 3. An interdisciplinary hospital team should conduct periodic reviews of threats received, threat management, and case outcome.

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OBJECTIVE: This study investigates diagnostic, behavioral, offense, and classification characteristics of juvenile murderers. METHOD: Twenty-five homicidal children and adolescents were assessed using the Diagnostic Interview for Children and Adolescents, clinical interviews, record review, and all available collateral data. RESULTS: DSM-III-R psychopathology was found in 96% of these youths, and one half of them had experienced suicidal ideation at some point in their lives. Nevertheless, only 17% had ever received mental health treatment. Family and school dysfunction were present in virtually all subjects. Histories of abuse, prior violence, arrests, and promiscuous sexual behavior were typical. Motives were equally divided between crime-based and conflict-based causes. A weapon was used in 96% of cases. Significant differences were found between crime classification groups and victim age, physical abuse, IQ, and victim relationship. In addition, those who committed sexual homicide were significantly more likely to have engaged in overkill, used a knife, and been armed beforehand. Ten profile characteristics present in at least 70% of these juveniles were identified. All murders were readily classified according to the FBI Crime Classification Manual (CCM). CONCLUSIONS: These findings support juvenile murderers as being an inadequately treated, emotionally and behaviorally disturbed population with profound social problems. The CCM proved to be a useful instrument for the classification of this sample.

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1. Admitted kidnappers identified four phases involved in stealing an infant as: setting the stage for a baby, planning the abduction, the act of abduction, and post-abduction discovery. 2. Abductors describe personal pressure and interpersonal pressures as motivations in stealing an infant. 3. The act of abducting an infant ranges from the use of no force to lethal force.

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1. Three types of stalkers that are identified in this crime classification are the non-domestic stalker who may know the target through social contact or from a random meeting in a public place; the domestic stalker who may be known to the target and had a close personal relationship with the target; and the erotomania stalker whose target is typically a public figure. 2. Stalking is conceptualized on a continuum from nondelusional to delusional behavior. 3. Classification of a crime is the first step in the investigative process.

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This study identified only 6 out of a possible 33 homicide classifications for workplace violent crime. As expected, the largest number of offenders represented authority killings. Half that number, however, had the largest number of victims and were classified as nonspecific homicide. Interestingly, there is a high number of domestic homicides occurring in the workplace. One could speculate that as families break up, addresses and telephone numbers easily can be changed--but not necessarily employment. Victims are sought out at their places of employment and killed there. Argument/conflict homicides, which were expected to be high, accounted for only 7 homicides. Another important finding was the large number of suicides in this offender group. An important implication of this study for nurses is that violence in the workplace sometimes can be anticipated and possibly deterred. Hospitals and other facilities--with proper preparation and training of employees, and implementation of strict protocols--can become safer workplaces. In the event that workplace violence does occur, however, the nurse can be prepared--and perhaps save his or her life.

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The major finding in this study of 41 serial rapists is the large numbers of reported and unreported victims. For over 1200 attempted and completed rapes, there were 200 convictions. The hidden rapes or earliest nonreported victims of these men as boys and adolescents were identified from their families, their neighborhood, and their schools. Examining the possible link between childhood sexual abuse and criminal behavior in this sample of 41 serial rapists, 56.1% were judged to have at least one forced or exploitive abuse experience in boyhood, as compared to a study of 2,972 college males reporting 7.3% experiencing boyhood sexual abuse. Looking within the abused samples, 56.1% of the rapists reported forced sex, compared to the college sample's 30.4%. Also, the rapist sample revealed higher rates of family member as abuser (48.4%), compared to 22.2% for the college sample. Retrospective reconstruction of the sexual activities and assertive behaviors of these men as boys reveals that 51% of the boys reenact the abuse as a preadolescent with their earliest victims being known to them (48% as neighborhood girls), family (25% as sisters), or girlfriend (25%). The onset of rape fantasies in midadolescence (mean age 16.9) crystalizes the earlier sexually initiated behaviors into juvenile behaviors of spying, fetish burglaries, molestations, and rapes. Repetition of these juvenile behaviors set their criminal patters on strangers--their next group of victims. To reduce victimization, serial rapists need to be identified early and stopped. This means acknowledging and reporting boy sexual abuse. This includes being sensitive to the reenactment behaviors noted in the initiated activities of abused children, which in turn need to be differentiated from peer play. Closer attention needs to be paid to families with incest behavior to insure that younger children are protected. Adolescents showing early repetitive juvenile delinquent behaviors must be assessed for physical and sexual abuse, and intervention must be planned to deal with the victimization. In the investigation and apprehension of serial rapists, law enforcement might pay closer attention to fetish burglaries and the spying, secretive behaviors that serve as the prototype for rape behavior.

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